Lower blepharoplasty is still one of the most sought-after procedures in facial aesthetic surgery. Modern approaches demonstrate a shift from resections to tissue-sparing techniques aimed at maintaining and restoring the volume of soft tissues and anatomical structures in periocular region. Understanding the role of septum orbitale not only as anatomical barrier but also as functional element of the lower eyelid opens new possibilities for optimization of surgical techniques. A systematic review is devoted to evolution of lower blepharoplasty over the past 50 years with emphasis on anatomical and functional significance of septum orbitale.

Keywords. septum orbitale, lower blepharoplasty, plastic surgery, ectropion, lower eyelid eversion, orbital fat pad, review