Lower eyelid tightening: a comparative study.

Tightening of the lower eyelid is often performed as an adjunct to various lower lid procedures, and many techniques are available. Herein the author describes a simple and effective surgical technique and compares its failure rate with that of full-thickness pentagonal lid resection and lateral tarsal strip technique. Over a 7-year period, the author has used this procedure on 121 patients (153 eyelids) requiring horizontal tightening of the lower eyelid. The average follow-up period is 19 months and the results have been excellent. Complications included three overcorrections, one undercorrection, three suture abscesses, two exposed sutures, and two suture breakages. The most common complication was a transient point tenderness over the orbital rim lasting 2 to 4 weeks. Comparison of these results with those obtained in 44 other patients (54 eyelids) whose lower eyelids were tightened with either the pentagonal lid resection or the lateral tarsal strip technique showed this procedure to be just as effective and versatile yet much easier to perform.