Objective: How to improve the lower eyelid when aging is associated with laxity of the OOM and descent of the SOOF.
Methods: Orbiculopexy and fat repositioning will correct the tear trough. Skin laxity had also to be addressed. However, the vectors of traction are different for the muscle-fat compared to the skin.
Results: Some cases are shown, including patients with festoons as well as tips and tricks to avoid complications.
Conclusions: Lower eyelid rejuvenation can be tricky. Not only prominent fat bags are addressed, but we should also include the orbicularis muscle and the SOOF. Analysis of individual cases is critical in assessing patients’ needs.
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