Canthopexy

lower eyelid blepharoplasty
The lower eyelid is a common space for patients to notice changes due to aging. This article describes the anatomy of the lower eyelid and the reasons for aging. It focuses on different operating principles and changes in practice, including complications and procedures Booster

Introduction
The alterations caused by aging are first visible around the eyes, then on the neck and lower face. periorbital rejuvenation continues to evolve with a more detailed understanding of the anatomy of the eyelid and its subsequent effects on anatomy with aging. Procedures have been developed over time, with surgeons trying to get a younger look.

Anatomy of the lower eyelid
The anterior lamella consists of skin and orbicularis muscle. The middle lamella consists of the orbital septum, which originates from the arcus marginalis and inserts on the lower edge of the tarsus. The posterior lamella including the conjunctiva and lower eyelid retractors.
The orbicularis oculi is immediately under the skin of the lower eyelid and extends from near the ciliary margin past the edge of the infraorbital cheek. It has two pretarsal and preseptal components. Pretarsally, the orbicularis muscle is closely adherent to the underlying tarsus. The portion of the cephalic preorbital orbicularis has attachments to the orbital rim along the orbicularis retaining ligament and along the downstream margin of the fascia surrounding the origin of the elevators of the upper lip (zygomatic muscles). The ligaments that support the maintenance orbicularis oculi to the rim behind the orbit and is used to set the muscle firmly against the frame behind the face.
The orbital septum is deep to the orbicularis. A plane of loose connective tissue, fascia suborbicularis lies between the orbicularis and orbital septum. The suborbicularis oculi fat (Soof) is in the plan and the continuum of pad14 malar fat. The triangular malar fat has its base at the naso-labial fold and its apex at the malar eminence, and is located between the skin and superficial musculoaponeurotic system (SMAS). It is loosely connected to the AMS and firmly attached to the skin.
The orbital septum fuses with the upper tarsus and inferiorly with the periosteum of the orbital rim, which attaches the lower wall is called the Arcus marginalis. The arcus marginalis medially attached to the anterior lacrimal crest and thins as it extends laterally mounting about 2 mm below the rim on the facial appearance of the zygomatic bone. The orbital septum is used to keep the orbital fat into the orbit. Fat mass as it encircles the extraocular muscles, which causes it to be divided into three blocks, medial, central and lateral.

The aging lower eyelid-cheek complex
The pathogenesis of orbital fat herniation below has been debated for decades. Whether the excess fat seemed to old age or if it was moving the contents intraorbital is unclear. The concepts of Manson et al and assigned Camirand et al sheath less fat to a weakening of the suspensory ligament of Lockwood with the presence of partitioning intraorbital fat compartments in limiting the degree of protrusion. De la Plaza and Arroyo first proposed the theory that fat protrusion is linked to the weakness of the support system of the planet, allowing it to descend and cause enopthalmos pseudoherniation and lower eyelids (bags).
The most poorly supported the orbicularis oculi is the preseptal portion and this portion of the orbicularis that shows the greatest tendency to descend. By keeping the ligaments relax with aging, fat becomes lower lid herniated located not only in front, but down below the orbital rim.