Temporal MORE (Modified Orbicularis REpositioning) for correction of lower eyelid displacement following cosmetic blepharoplasty: a prospective study on 117 patients.

Abstract

Lower eyelid displacement is probably the most feared complication following lower blepharoplasty.In order to properly plan revision surgery, it is crucial to understand which lamella is involved in the retraction, since different techniques may be used depending on it.The authors report their experience using a particular temporal and midface lift approach, named Temporal MORE, to correct lower eyelid displacement mainly due to a deficit of the anterior lamella. A prospective study was carried out on 117 patients operated between January 2021 and October 2023 for bilateral lower eyelid displacement after lower blepharoplasty.Temporal MORE technique was combined with lateral canthal tightening and lower lid fat grafting in all analyzed cases.Outcomes were assessed through a subjective (patients' questionnaires) and objective evaluation (5 independent surgeons evaluating pre- and post-operative pictures).Complications were recorded. Patients' questionnaires showed high satisfaction with ocular symptoms improvement (decreasing from 74.91 to 9.03 out of 100) and cosmetic results (53.67/60).Surgeons rated the postoperatives changes positively as well (51.97/60).As far as complications are concerned: 6 patients (5.13%) had mild chemosis. 3 patients (2,56%) hypertrophic temporal scar. 2 patients (1,71%) transient frontal nerve palsy. 1 patient (0,85%) temporal hematoma. 2 patients slight asymmetry. 2 patients relapse of lower eyelid displacement. The combination of Temporal MORE, lateral canthal tightening and fat grafting has proven to be a highly effective procedure in the correction of lower eyelid displacement caused by anterior lamella deficiency.