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Hester TR et al. - Minimizing trauma to the orbital septum of the lower lid and correction of horizontal lower lid laxity when present are effective techniques in lowering the risk of postoperative lower lid complications. Trauma is minimized by eliminating dissection in the plane between the orbicularis muscle and orbital septum. The passive septal tightening that occurs with this technique combined with fat micrographs to the tear trough and over the inferior orbital rim has rendered more traumatic open surgical manipulation of the septum or postseptal fat almost universally unnecessary.

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