The word blepharoplasty is derived from the Greek words Blepharon, meaning eyelid, and plastos, meaning formed. Blepharoplasty surgery is one of the oldest described treatments of the aging face. The goal of surgery is to remove excess tissue which causes and overhang of skin leading to cosmetic (poor appearance) or functional (reduced field of vision) consequences. The first recorded blepharoplasty surgery was by a Spanish surgeon, Albucasis, a pioneer in the creation of surgical instrumentation, including the use of cautery (to control bleeding) in 1000 A.D.
Modern blepharoplasty techniques have certainly come a long way. Current upper lid blepharoplasty procedures focus on the excision of variable amounts of skin, muscle, and fat. An increased interest in lower lid blepharoplasty surgery has also evolved. Lower blepharoplasty surgery primarily focuses on preventing lower eyelid droop (ectropion, retraction) and hollowing (volume depletion). These complications are inherent to the more traditional excisional (tissue removal) surgery. Modern lower blepharoplasty focuses on tissue preservation (fat repositioning) or augmentation (fat transfer)
Fat preservation and repositioning in lower lid blepharoplasty continues to develop. Dr. Guy Massry (Beverly Hills Ophthalmic Plastic Surgery), a blepharoplasty surgery specialist has made many advancements in the lower blepharaoplasty procedure. Most recently Dr. Massry has published on and presented results of combined fat repositioning and lid lifting (The Lift and Fill Blepharoplasty) http://www.ncbi.nlm.nih.gov/pubmed/22460677 , http://www.prweb.com/releases/liftandfill/lower-blepharoplasty/prweb9449357.htm and comparing fat repositioning techniques http://archfaci.jamanetwork.com/onlineFirst.aspx (open PDF to article Transconjunctival Lower Blepharoplasty With Fat Repositioning: A Retrospective Comparison of Transposing Fat to the Subperiosteal vs Supraperiosteal Planes by Donald B. Yoo, MD; Grace Lee Peng, MD; Guy G. Massry, MD). If you are considering blepharoplasty surgery you can visit Der. Massry online http://drmassry.com/#/home/ for more information.