Prevention of Lower Eyelid Malposition After Blepharoplasty Anatomic and Technical Considerations of the Inside-Out Blepharoplasty

Objective  To determine the position of the lower eyelid and lateral canthus after release of the lower eyelid retractors with the “inside-out technique” by measuring the marginal reflex distance 2 (MRD2) and using the lateral canthal rounding scale. Design  Retrospective analysis. Results  Of the 171 patients who underwent inside-out blepharoplasty, 78 were followed up for 3 months. Preoperative MRD2 was 0.942 pixels. Postoperatively, the modified MRD2 was 0.903. Although the score of the modified MRD2 was found to decrease postoperatively, the decrease was not statistically significant ( P t test. No complications were reported. Conclusion  Using photographic analysis, the study found no difference in lateral canthal shape or MRD2 before and after surgery in patients who underwent inside-out blepharoplasty.