title: A key to canthopexy: the tarsal strap. A fresh cadaveric study.
abstract: BACKGROUND
  This article describes a poorly understood yet clinically significant eyelid structure the authors have labeled the tarsal strap. The tarsal strap anchors the tarsus to the periosteum of the inferolateral orbit. Releasing this tethering band is the cornerstone of achieving lasting, superior surgical results during lateral canthopexy and periorbital restoration in aesthetic and reconstructive surgery.
  
  
  METHODS
  An 87-year-old, male, fresh cadaveric head of Caucasian origin was studied. The dissection was repeated on 15 cadaver heads, including both male and female cadavers, from various ethnic backgrounds, to confirm the anatomy of the tarsal strap described in this article.
  
  
  RESULTS
  The tarsal strap was identified in all 16 cadaver dissections and appeared in a consistently similar location.
  
  
  CONCLUSIONS
  Until now, the tarsal strap has been a poorly understood entity, despite being an anatomically and clinically significant eyelid structure. Knowledge of its significance is essential to restoring the lateral canthus and returning periorbital structures to their youthful state. It should be routinely sought out and properly released.
authors.affiliation: Plastic Surgery Center of the Pacific, Honolulu, Hawaii, USA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Flowers
authors.forename: John M
authors.initials: JM
authors.lastname: Nassif
authors.forename: Peter A D
authors.initials: PA
authors.lastname: Rubin
authors.forename: Tom
authors.initials: T
authors.lastname: Hayakawa
authors.forename: S Kent
authors.initials: SK
authors.lastname: Lehr
mesh_terms: D000369:Aged, 80 and over; D005143:Eyelids / Q000033:anatomy & histology* / Q000601:surgery*; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery*; D019651:Plastic Surgery Procedures