| Cosmetic Complications
As with upper eyelid lift, if insufficient skin has been removed, the most direct remedy is to excise a little more. Be aware, however, that skin excision will not go far in eliminating any wrinkles, while overzealous removal of lower eyelid skin will always cause substantial problems (see below).
The most common "cosmetic problem" is insufficient removal of fat resulting in a noticeable bulge (or, in the case of fat transfer, an unacceptably irregular shape and contour). If objectionable, most such irregularities can be addressed by revision from a transconjunctival approach. It is, however, best to be conservative with fat removal.
Excessive removal of lower eyelid fat can create a hollowness that requires grafting of fat obtained from elsewhere on the body.
Functional Complications
Hematoma, orbital hemorrhage, loss of vision (see  Chapter 29).
The most common functional complication of lower eyelid blepharoplasty is an alteration of the position of the lower eyelid ("malposition"), thus interfering with its relationship with the eyeball. Malposition may be due to . . .
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