Which Blepharoplasty procedure to perform

Otto Joseph Placik, MD answers: Which Blepharoplasty surgery technique works best?

I'm looking into lower lid Blepharoplasty and have received two contraditctory opinions:

(1) that it can be done from the inside

(2) it should be done from the outside.

I don't know which procedure is best? Also, I'm interested in Fractional Laser Resurfacing and wonder if the MiXto is the right laser for me. Any comments would be appreciated.


Otto Joseph Placik, MD
9 months ago

The key element here in your decision making process and why it is hard to determine from these photos is the following.

Is your problem:

  1. Prominent fat deposits?
  2. Loose skin?
  3. Both of the above?

If it is 1, then use the transconjunctival technique.

If is is 2, then use the external approach.

If it is 1 and a mild amount of 2, then use the transconjucntival technique plus fractional resurfacing.

If it is 1 and a large amount of 2, the use the external approach.

Although the fractional laser was thought to be excellent in skin tightening, it has also been shown to provide benefits with skin discoloration.

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