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6359387 
Journal Article 
Review 
Arcus marginalis release in blepharoplasty I: technical facilitation 
Stark, GB; Iblher, N; Penna, V 
2008 
Yes 
Aesthetic Plastic Surgery
ISSN: 0364-216X
EISSN: 1432-5241 
32 
5 
785-789 
English 
18612676 
WOS:000259124700016 
Resection of intraorbital fat compartments in lower-lid blepharoplasty has been widely replaced by their realignment over the orbital rim. For older patients this usually includes an open subciliary approach with skin resection and orbicularis muscle modification. In younger patients this may be done transconjunctivally. Fixation of the adipose tissue is controversial. Whereas reliance of realignment on spontaneous prolapse may be unpredictable, suture fixations may be tedious and even cause scleral show or ectropion. A monofilament, double-armed, polypropylene suture on bent straight needles can be used safely to transfix the three compartments across maxilla and zygoma. These transcutaneous pullout sutures are simply fixed with steri-strips. After only 2 days the orbital fat will be sufficiently adherent to its new bed.