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Background <p>Blepharoplasty is one of the most frequently performed cosmetic surgical procedures and is widely recognised as the most effective method for periorbital rejuvenation, particularly in the ageing face, compared to nonsurgical alternatives.</p> Aim <p>This retrospective study evaluates clinical outcomes and complication rates associated with transcutaneous lower blepharoplasty combined with midface lifting and lateral canthopexy to assess the safety and effectiveness of this integrated facial rejuvenation approach.</p> Methods <p>From March 2021 to June 2024, patients underwent extended transconjunctival lower eyelid blepharoplasty, midface lifting, and lateral canthopexy. Fat herniation was addressed through repositioning techniques, while midface elevation was achieved using deep anchoring sutures. Lateral canthal support was reinforced through tarsal ligament suspension.</p> Results <p>A total of 145 patients were included (mean age 51.79 ± 8.9 years; 75.2% female; mean follow-up 9.4 ± 3.1 months). In a randomly selected morphometric subgroup (<i>n</i> = 35), all objective outcome measures demonstrated statistically significant improvement: lid–cheek junction vertical distance (LCJ-VD) decreased from 14.73 ± 2.20&#xa0;mm to 9.26 ± 1.09&#xa0;mm (<i>p</i> &lt; 0.001), tear trough depth from 3.60 ± 0.83&#xa0;mm to 1.63 ± 0.39&#xa0;mm (<i>p</i> &lt; 0.001), and palpebromalar groove depth from 3.96 ± 0.86&#xa0;mm to 1.88 ± 0.47&#xa0;mm (<i>p</i> &lt; 0.001). Patient satisfaction was high, with 82.8% of the subgroup reporting satisfaction or very high satisfaction. No cases of ectropion or lower eyelid retraction were recorded. The overall major complication rate was 5.71%.</p> Conclusion <p>Combined Transcutaneous lower blepharoplasty, midface lift, and lateral canthopexy produced statistically significant improvement in periorbital morphometry with an acceptable complication profile. Conservative surgical technique with routine canthal support appears important in minimising complications. Prospective studies using standardised grading tools and longer follow-up are warranted to confirm these findings.</p>

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Clinical Outcomes of Combined Transcutaneous Lower Blepharoplasty, Midface Lift, and Lateral Canthopexy: A Retrospective Study

  • 期刊论文

  • 发表日期：

    2026年4月2日

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  • Ismael Y. M. Faqih,
  • Arez Hassan,
  • Parwin J. Jalil,
  • Shireen J. Mohammed,
  • Mukhtar H. Ahmed

摘要

Background

Blepharoplasty is one of the most frequently performed cosmetic surgical procedures and is widely recognised as the most effective method for periorbital rejuvenation, particularly in the ageing face, compared to nonsurgical alternatives.

Aim

This retrospective study evaluates clinical outcomes and complication rates associated with transcutaneous lower blepharoplasty combined with midface lifting and lateral canthopexy to assess the safety and effectiveness of this integrated facial rejuvenation approach.

Methods

From March 2021 to June 2024, patients underwent extended transconjunctival lower eyelid blepharoplasty, midface lifting, and lateral canthopexy. Fat herniation was addressed through repositioning techniques, while midface elevation was achieved using deep anchoring sutures. Lateral canthal support was reinforced through tarsal ligament suspension.

Results

A total of 145 patients were included (mean age 51.79 ± 8.9 years; 75.2% female; mean follow-up 9.4 ± 3.1 months). In a randomly selected morphometric subgroup (n = 35), all objective outcome measures demonstrated statistically significant improvement: lid–cheek junction vertical distance (LCJ-VD) decreased from 14.73 ± 2.20 mm to 9.26 ± 1.09 mm (p < 0.001), tear trough depth from 3.60 ± 0.83 mm to 1.63 ± 0.39 mm (p < 0.001), and palpebromalar groove depth from 3.96 ± 0.86 mm to 1.88 ± 0.47 mm (p < 0.001). Patient satisfaction was high, with 82.8% of the subgroup reporting satisfaction or very high satisfaction. No cases of ectropion or lower eyelid retraction were recorded. The overall major complication rate was 5.71%.

Conclusion

Combined Transcutaneous lower blepharoplasty, midface lift, and lateral canthopexy produced statistically significant improvement in periorbital morphometry with an acceptable complication profile. Conservative surgical technique with routine canthal support appears important in minimising complications. Prospective studies using standardised grading tools and longer follow-up are warranted to confirm these findings.