Transconjunctival approach to lower eyelid blepharoplasty. Experience, indications, and technique in 300 patients

Despite the fact that transconjunctival approach to lower eyelid blepharoplasty is not a new technique, the indications, patient selection, technique, and results using this technique have not previously been widely reported. Specifically, we have compared the results of this blepharoplasty procedure in terms of the indications, expected results, postoperative complications, and patient satisfaction in 300 successive cases of skin-muscle flap approach with those in 300 cases in which the transconjunctival approach was used. The orientation and details of this approach for the facial plastic surgeon are well outlined. Associated adjunctive procedures such as simultaneous chemical peeling and the "pinch" technique for skin excess removal are discussed. Both short- and long-term complications are significantly reduced with the transconjunctival approach to lower lid blepharoplasty compared with the skin-muscle flap approach. Therefore, for the removal of pseudoherniation of orbital fat of the lower eyelid, the transconjunctival approach to lower lid blepharoplasty should have a significant place in the surgical armamentarium of the facial plastic surgeon.