Beneficial effects of turnover orbicularis oculi muscle suspension flap for treating facial fractures via subciliary incision.

In patients with moderate lower lid laxity, the lower orbicularis oculi muscle becomes atonic or ptotic. Hence, in such patient populations, with periorbital fractures, additional vertical support endorsement either by lateral canthopexy or orbicularis oculi muscle suspension flap must accompany plate and screw fixations. In this report, we shared our experience in applying prophylactic suspension to the lower lid with turnover orbicularis oculi transposition muscle flap in zygomatic fractures treated by subciliary approach in 98 patients. Our results show that turnover orbicularis oculi muscle suspension flap avoids the rounding of the lateral canthal angle more successfully and prevents ectropion better than the resuspension orbicularis oculi muscle flap does. We advocate using this flap where zygomatic fractures are approached via the subciliary incision. We foresee that it is a reliable and easily executed technique especially in middle-aged patients with moderate lower lid laxity for the prevention of ectropion.