Experiences with transconjunctival upper blepharoplasty

Upper blepharoplasty remains a valuable procedure in rejuvenating the upper eyelid. An innovative technique was recently reported whereby medial fat is removed through a transconjunctival approach. This is a preliminary report of our experience with 60 patients treated over the past 10 months using this technique. The technique will be described in detail and cases will be reported. There were no perioperative or postoperative complications. All of the patients are satisfied with the results of their surgical procedure. The technique has the advantage of avoiding an incision of the medial upper eyelid and the inherent risks of excessive scarring in this area. We have found the technique especially useful in secondary blepharoplasty with an isolated prominence of residual medial fat. Other advantages include the following: primary cases in which the surgeon is able to avoid medial extension of the cutaneous incision, patients who possess deep tarsal folds with prominent medial fat, or as an adjunct to eyebrow lifting techniques where in both cases cutaneous excision is unnecessary. No disadvantages have been noted.