Transconjunctival blepharoplasty with chemoexfoliation

Transcutaneous blepharoplasty has been the standard for improving the overall appearance of the lower eyelid, as it addresses skin, muscle, and pseudoherniated orbital fat. Postoperative problems, including poor scarring, scleral show, and even frank ectropion, have led many surgeons to alternate techniques. Transconjunctival blepharoplasty is known to be a reliable method of removing lower eyelid fat, but has been touted as inadequate for those possessing excessive skin and has even been cited as being responsible for increasing lower eyelid wrinkling. Chemoexfoliation, utilizing trichloroacetic acid and phenol, was performed simultaneously with transconjunctival blepharoplasty in 146 patients, whose data are retrospectively reviewed. Excellent results were obtained in lower eyelid skin appearance and pseudoherniated fat in the majority of patients, without an external lower eyelid scar.