Abstract: Objective To explore the clinical effect of modified lower blepharoplasty for lower eyelid rejuvenation. Methods A total of 101 cases treated by modified lower blepharoplasty with skin incision from May 2018 to May 2020 were selected in the retrospective analysis. Surgical procedures included subcutaneous and muscular decohesion, orbital septum fat release and displacement, orbicularis oculi muscle and suborbicularis oculi fat （SOOF） lifting, lateral canthal anchoring, and pretarsal fullness reconstruction of the lower eyelid. Postoperative clinical effect was evaluated. Results In the selected 101 patients, the appearances of blepharochalasis, lower eyelid bags, lacrimal sulcus deformity, middle face ptosis were improved with varying degrees. Among them, 79 cases （78.22%） were markedly effective, 31 cases （30.69%） were effective, and 1 case （0.9%） was ineffective; the total effective rate was 99%. One case developed mild lower eyelid ectropion and recovered immediately after lateral tarsal strip procedure; the complication rate was 0.9%. The preoperative and postoperative 1-, 3-, and 6-month satisfaction scores of the patients were 1.66±0.48, 3.92±0.76, 4.32±0.62, and 4.62±0.55, respectively. The difference between postoperative and preoperative scores was statistically significant （P<0.05）. Conclusion Modified lower blepharoplasty can effectively rejuvenate lower eyelid, with the advantages of good and permanent overall effect, fewer complications, and high satisfaction.

Key words: Modified lower blepharoplasty, orbital septum fat release, Lacrimal sulcus deformity, Middle face ptosis, Lower eyelid rejuvenation