There are several advantages to transconjunctival blepharoplasty. First, no skin incision is made. This reduces post-operative discomfort. Second, because the skin, and the septum (membrane behind which the fat-pads are found) are not violated it is believed that the risk of ectropion or lid eversion, scleral show (lid drooping and/or retraction), and other serious post-operative problems are avoided. When combined with carbon dioxide laser resurfacing, however, retraction may still occur. This procedure should be reserved for patients with minimal skin excess in the lower lids, minimal malar (cheek) pad descent, mild nasolabial folds (smile lines) but considerable bulging of the lower lid fat pads.
Jacob Gerzenshtein, MD, FACS,
A Board Certified Plastic Surgeon
