A Camirand. Canthopexy and transconjunctival blepharoplasty are preferable to lower blepharoplasty in the aged. Can J Plast Surg 1994;1(4):184-187. The lateral canthus stretches with age, lowering the lateral corner of the eye from 2 to 3 mm above the medial canthus in youth to the level of or below the medial corner in old age. The lower lid drops from 2 mm above the lower limbus to below it. This creates pseudodermachalasis or tired, sad and aged eyes, which cannot be improved by lower blepharoplasty. Fat pads should be removed via a transconjunctival approach to avoid the risk of scleral show in the elderly.
