Transconjunctival versus transcutaneous lower eyelid blepharoplasty: a prospective study

Area of Science:

• Ophthalmology
• Plastic Surgery
• Facial Aesthetic Surgery

Background:

• Lower eyelid blepharoplasty is a common procedure to address aging.
• Transconjunctival and transcutaneous approaches are debated for efficacy and aesthetics.
• Patient-specific outcomes and surgeon preference often guide technique selection.

Purpose of the Study:

• To compare the clinical outcomes of transconjunctival versus transcutaneous lower eyelid blepharoplasty.
• To evaluate patient satisfaction and aesthetic results between the two surgical methods.
• To assess complications such as scarring and scleral show.

Main Methods:

• A prospective, comparative study involving ten patients undergoing bilateral lower eyelid blepharoplasty.
• One eye underwent transconjunctival preseptal approach, the contralateral eye underwent transcutaneous subciliary musculocutaneous flap approach.
• Clinical evaluation included patient questionnaires, standardized photographs, and blinded grading at multiple postoperative intervals.

Main Results:

• No statistically significant difference in fornix depth or fat removal between the two techniques.
• Overall aesthetic grading was excellent and comparable for both transconjunctival (0.68) and transcutaneous (0.60) sides.
• Mild scleral show occurred in three patients bilaterally and one unilaterally (transcutaneous); external scarring was not a perceived issue.

Conclusions:

• Both transconjunctival and transcutaneous lower eyelid blepharoplasty techniques provide comparable and satisfactory aesthetic outcomes.
• Neither approach demonstrated superiority in terms of efficacy or complication rates in this patient cohort.
• The choice between techniques may continue to be influenced by surgeon expertise and patient-specific factors.