AIM:To observe the improvements and operation results of lower lid blepharoplasty for patients of different ages and eyelids.

METHODS:Sixty-seven patients(67 eyes)received the lower lid blepharoplasty from May 2010 to May 2015 in our hospital were selected. The patients were classified according to the type of eyelids. They received the different improved operations:12 eyes in group A with bulging fat adopted the trans-conjunctival approach; all the other patients adopted the trans-cutaneous approach. Nineteen eyes in group B with loosing orbicularis oculi muscle and/or loosing skin were required to remove the lower eyelid skin and orbicularis oculi muscle; 13 eyes in group C with loosing skin and bulging orbital fat and 23 eyes in group D with combined cases were both required to remove the orbital fat, skin and orbicularis oculi muscle.

RESULTS:After 5d of operation, the stitches were taken; the patients were visited for 3-6mo after treatment. The excellent rates of surgery in the four groups were 100%, 95%, 100% and 96%(P>0.05).The appearance of lower eyelid was flat; the bulging orbital fat was disappeared; the skin incision had no scar; there was 1 eye with mild ectropion, 2 eyes with sunken inferior orbital margin and 4 eyes with poor aligned incision, which were all recovered after 2mo of treatment. There were no serious complications like collapsed lower eyelid, strabismus, ambiopia, shrinks of lower eyelid, etc. The postoperative complication rates of the four groups were 8%, 11%, 8% and 13%, respectively(P>0.05).

CONCLUSION:The improved lower lid blepharoplasty has a favorable effect for different types of eyelids.