Lower Eyelid Retraction: Anterior Lamellar Correction Using Skin Grafting

Lower eyelid retraction describes an inferior displacement of the lower eyelid that can be a result of multi-factorial etiologies. Anterior lamellar deficiency is one of the major causes of lower lid retraction. In addition to anterior lamellar deficiency, there are numerous other factors that contribute to lower eyelid retraction, including middle lamellar contracture, posterior lamella shortening, lateral canthal tendon laxity, and decreased orbicularis tone. Lower eyelid retraction may be associated with significant ocular comorbidities. Treatment for lower eyelid retraction due to anterior lamellar deficiency should be targeted to each patient’s condition. Nonsurgical and surgical options exist as treatment options. Surgical options for addressing anterior lamellar deficiency include a full thickness skin graft, local myocutaneous flap, or a midface lift.