Raising the suborbicularis fat (SOOF)

[...]I feel that the study offers insufficient evidence to support these conclusions. Since the addition of SOOF lifting to a relatively straightforward lateral tarsal strip procedure is likely to enhance its morbidity (more conjunctival chemosis, as stated by the author, possible damage to the infraorbital nerve, more bleeding and infection) I would suggest that routinely adding a SOOF lift to the tarsal strip procedure should be postponed until the advantage of this addition has been demonstrated more clearly, preferably in a randomised prospective series that quantifies the lower eyelid position and that uses an independent observer for qualitative comparison.