Getting Older and Signs of Age Showing Under Eye.*

This patient was unhappy with her lower eyelids, she felt that they made her look older than her actual age. The skin was crepe-like and there were dark circles. The surgery needed to address the fullness by removing some of the excess lower eyelid fat that was bulging. This was done with an incision behind the lower eyelid. In addition, excess skin needed to be remove. This was accomplished with a pinch blepharoplasty. The combination of the two approaches has a significant safety advantage. By not violating the lower eyelid septum the dreaded eyelid complication called ectropian is avoided. We call this type of approach marriage blepharoplasty because it combines two different approaches for safety and cosmetic outcome.