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Published on: December 7, 2016
Quantified Incision Placement for Postseptal Approach Transconjunctival Blepharoplasty
Satyen Undavia1, César A Briceño, Guy G Massry
1*Facial Plastic and Reconstructive Surgery, Head and Neck Associates, Havertown, Pennsylvania; †Eye Plastic, Orbital and Facial Cosmetic Surgery Service, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan; ‡Clinical Professor of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California; and §Beverly Hills Ophthalmic Plastic and Reconstructive Surgery, Beverly Hills, California, U.S.A.
This study found that placing the transconjunctival lower eyelid blepharoplasty incision 0.5 mm posterior to visible fat optimizes direct access to orbital fat. This technique successfully entered the postseptal space in 82% of cases, improving surgical outcomes.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Anatomy
Background:
- Transconjunctival lower eyelid blepharoplasty is a common procedure for aesthetic and functional improvement.
- Optimizing surgical access to orbital fat compartments is crucial for effective blepharoplasty.
- Current incision placement guidelines lack precise quantitative validation.
Purpose of the Study:
- To quantify the optimal incision location in transconjunctival lower eyelid blepharoplasty.
- To enhance direct postseptal access to eyelid and orbital fat.
- To provide a validated, quantitative method for incision placement.
Main Methods:
- Retrospective chart review of 66 transconjunctival blepharoplasties performed by a single surgeon.
- Utilized globe retropulsion and eyelid infraplacement to visualize anatomical landmarks.
- Measured distance from inferior tarsus to superior fat projection; incision placed 0.5 mm posterior to this point.
Main Results:
- The mean distance from the inferior tarsus to the superior fat projection was 6.03 mm.
- The mean incision placement was 6.53 mm, successfully accessing the postseptal space in 82% of cases.
- Postoperative chemosis occurred in 7.6% of cases, resolving with conservative treatment; no other incision-related complications were noted.
Conclusions:
- Placing the conjunctival incision 0.5 mm posterior to the superior fat projection provides reliable direct postseptal access.
- This quantitative method improves upon subjective, anecdotal incision placement recommendations.
- The technique is safe and effective, with a low rate of minor, transient complications.
