title: Prevention of lower eyelid malposition after blepharoplasty: anatomic and technical considerations of the inside-out blepharoplasty.
abstract: OBJECTIVE
  To determine the position of the lower eyelid and lateral canthus after release of the lower eyelid retractors with the "inside-out technique" by measuring the marginal reflex distance 2 (MRD2) and using the lateral canthal rounding scale.
  
  
  METHODS
  Retrospective analysis.
  
  
  RESULTS
  Of the 171 patients who underwent inside-out blepharoplasty, 78 were followed up for 3 months. Preoperative MRD2 was 0.942 pixels. Postoperatively, the modified MRD2 was 0.903. Although the score of the modified MRD2 was found to decrease postoperatively, the decrease was not statistically significant (P < .07). The lateral rounding scale reviewed an average preoperative score of 2.04 and a postoperative score of 1.99. There was no statistical difference between pre- and postoperative observations based on a 1-tailed t test. No complications were reported.
  
  
  CONCLUSIONS
  Using photographic analysis, the study found no difference in lateral canthal shape or MRD2 before and after surgery in patients who underwent inside-out blepharoplasty.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Manhattan Eye, Ear, & Throat Hospital, 115 East 61st Street, New York, NY 10021, USA. drdavidrosenberg@aol.com
authors.forename: David B
authors.initials: DB
authors.lastname: Rosenberg
authors.forename: Jessica
authors.initials: J
authors.lastname: Lattman
authors.forename: Anil R
authors.initials: AR
authors.lastname: Shah
mesh_terms: D000328:Adult; D019882:Blepharoplasty / Q000379:methods*; D005123:Eye / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies