Lateral canthal tendon resection with conjunctiva preservation for the treatment of lower eyelid laxity during lower eyelid blepharoplasty.

Lower eyelid laxity is a problem commonly encountered in patients undergoing lower eyelid blepharoplasty. Two problems associated with the numerous surgical procedures used for the management of this condition are (1) postoperative alteration of the shape of the palpebral fissure and lateral canthal angle and (2) difficulty with appropriate suture positioning or placement when reattaching the resected lateral canthal tendon. To address these problems, the surgical technique of lateral canthal tendon resection was modified by preserving the lateral conjunctiva, thus maintaining normal anatomic landmarks and ensuring proper suture placement. To date, this technique has been performed effectively on 50 patients who demonstrated mild to moderate eyelid laxity during preoperative evaluation for lower eyelid blepharoplasty. The only complication encountered has been undercorrection in one patient. The benefits of this procedure have been prevention of alteration of the palpebral fissure or canthal angle shape, greater ease and more accurate suture placement when reattaching the lateral canthal tendon, and avoidance of the need for full-thickness eyelid resection.