title: Long-term results of lower-lid suspension blepharoplasty: a 30-year experience.
abstract: BACKGROUND
  Muscle suspension blepharoplasty remains a reliable method to tighten the loose skin and muscle of the lower eyelid.
  
  
  OBJECTIVE
  To evaluate the 30-year experience of the senior author (N.J.P.) with the skin-muscle suspension technique for lower-lid blepharoplasty.
  
  
  METHODS
  Of 4395 patients who underwent lower-lid blepharoplasty, 3988 had muscle suspension blepahroplasty performed with adequate follow-up.
  
  
  RESULTS
  Results of the 30-year review showed that most patients were very satisfied with the procedure. There were 67 complications (2 hematomas, 1 poor scar, 24 cases of scleral show <1 mm, and 40 cases of chemosis). Chemosis resolved in 2 to 8 weeks, and there were no cases of ectropion, scleral show greater than 1 mm, dry eye, or vision loss. Revision surgery was needed in 41 patients, all of whom were satisfied after the secondary procedure.
  
  
  CONCLUSIONS
  Despite the recent drift toward orbital fat preservation for lower-lid blepharoplasty, conventional lower-lid muscle suspension offers the surgeon a reliable method to tighten the loose skin and muscle of the lower eyelid and give the patient a more attractive, youthful appearance.
authors.affiliation: The Larrabee Center for Facial Plastic Surgery and the Virginia Mason Medical Center, Seattle, Washington, USA. carlohonrado@hotmail.com
authors.forename: Carlo P
authors.initials: CP
authors.lastname: Honrado
authors.forename: Norman J
authors.initials: NJ
authors.lastname: Pastorek
mesh_terms: D019882:Blepharoplasty / Q000379:methods*; D005260:Female; D006801:Humans; D012189:Retrospective Studies; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome