Upper blepharoplasty, performed to rejuvenate the eyes, is a technique that must be adapted to the anatomy. Indeed, there are changes in the volume of orbital fat (rolling organ) and sub-orbicularis fat in the eyebrow (Charpy's organ), cutaneous laxity, but sometimes also of the aponeurosis of the levator muscle as well as fibrous expansions between the skin and this muscle. In the case presented here, there is an excess of skin, an excessive internal fat pocket but no volume abnormality of the sub-orbicularis fat, and of the median portion of the orbital fat nor involvement of the levator muscle.
On the other hand, there is evidence of rounding due to the decrease in tone of the orbicularis muscle and a loosening of the lower tarsal ligament sling. An external canthopexy is therefore performed to support the outer corner.