Extended blepharoplasty.

Extended blepharoplasty involves extending the dissection of the skin-muscle flap used in standard lower eyelid blepharoplasty to a level below the infraorbital rim. This technique is useful in the management of infraorbital, or malar, bags that are seen in as many as 10% of blepharoplasty candidates. A concomitant eyelid shortening procedure is frequently needed to treat horizontal eyelid laxity. Achievement of satisfactory results depends on the proper suspension of the skin-muscle flap to the lateral canthal periosteum. Extended blepharoplasty is an innovative way to improve infraorbital pouching, which is otherwise beyond the reach of the standard blepharoplasty procedure.