The blepharo-periorbitoplasty: anatomical basis.

A new combined subperiosteal-subcutaneous musculo-aponeurotic system and suborbicularis technique is described: the "blepharo-periorbitoplasty." This technique achieves complete mobilization of the forehead and brow, the lower eyelid, the raphe and lateral canthal area, the upper palpebral region, and of the suprazygomatic and infrazygomatic soft tissues, including the cheeks. These soft tissues are displaced upward and moderately backward. If a major lateral upward slant of the palpebral fissure is desired, Hinderer's lateral canthoplasty must be added. The blepharo-periorbitoplasty technique can be combined with a facial-cervical rhytidectomy. The technique is also useful for senile preectropion and postoperative "round eye" conditions with scleral show. The safety has been proven both clinically and in anatomical dissections.