Reconsideration of fat pad management in lower lid blepharoplasty surgery.

Treatment of the protruding fat pads in the lower blepharoplasty is a problem for most surgeons performing this procedure. The problems usually encountered are reviewed, the lid anatomy discussed, and a method of correcting the defect without surgically interrupting the orbital septum is presented. Tightening of the orbital septum may be produced with proper application of electrosurgical current. A total of 364 cases have been done, with a maximum follow-up of 42 months. Results show that this provides a safe and effective method of achieving the desired improvement in the bulging lower lid.