Reconstructive lower lid blepharoplasty.

The traditional lower lid blepharoplasty highlighted by fat removal and excision of excess skin via a transcutaneous approach has been replaced by a reconstructive blepharoplasty involving minimal fat removal, sculpting, or fat repositioning. Simultaneous application of chemical peels, microdermabrasion, or laser resurfacing procedures is an acceptable alternative to skin excision when there is minimal skin redundancy. This article reviews the anatomic changes in the lower eyelid that occur as a result of aging and addresses reconstructive techniques for rejuvenation of the lower eyelid.