Is Transconjunctival Blepharoplasty Better Than Transcutaneous?

asked 2 years ago by rebi in florida
Latest answer by William Portuese, MD
Question viewed 484 times

I was told that transcutaneous can cause ectropion and change the shape of your eyes

11 answers to Is Transconjunctival Blepharoplasty Better Than Transcutaneous?

Transconj bleph has different indications that traditional blepharoplasty

Transconjunctival blepharoplasty has less chance of ectropion, but it also has limitations in correcting the skin and muscle components of the lower eyelid. However, the skin and muscle can be address with other less invasive procedures including peels and muscle tightening. When using a traditional subciliary incision all of the components (fat, muscle, and skin) can be addressed through the same incision. The traditional approach also allows for more aggressive tightening of... more

Timothy R. Jones, MD
Saint Louis Plastic Surgeon

Transcutaneous vs transconjunctival Blepharoplasty

Generally, the transcutaneous blepharoplasty is the way to rejuvenate aging eyes. The transconjunctival blepharoplasty, in my opinion and that of many others, has only one real use. That use is for younger people who have a significant congenital fat excess of the lower eyelids. For rejuvenation, I have stopped removing fat from the eyelids. This is because we generally lose fat and even bone as we age. If we remove fat from the eyelids other than in congenital excess, the eye looks... more

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Transconjunctival and transcutaneous blepharoplasty

Yes, transconjunctival blepharoplasty is much better than transcontinuous. There is no violation of the lower lid muscles and much less chance of altering eye shape through transconjunctival approach. When performed correctly, it is very rare to see any ectropion or scleral show after transconjunctival blepharoplasty.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Safety of transconjunctival blephs

The two approaches to the lower lid are different in what they can do and the risks they expose you to. While the external approach may have more potential for ectropion, a proper preop evaluation of your lid laxity would indicate certain maneuvers to prevent that ie canthopexy. The transconjunctival approach is best for dealing with fat only and carries an increases risk of damage to the muscles that move your eyes.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

The answer it is No

There are many ways of performing a blepharoplasty, there are indications for each of them, but most important it is the experience of your surgeon. The traditional teaching is that with a external approach you will have more chances of ectropion ( pulling of your lid), you can have also problems with the transconjunctival approach, in my opinion the most important factor its the experience of your surgeon. With the external approach the surgeon should be able to improve certain problems... more

Victor Manuel Perez, MD
Kansas City Plastic Surgeon

Transconj vs. transcutaneous blepharoplasty: Which is better?

Now for the correct answer. ;-) The transconj approach was designed specifically to address the higher rate of ectropion with the subciliary or transcutaneous approach. It was not designed simply to hide a scar. It is also woefully incorrect to claim that transconjunctival approaches are "for younger people who have a significant congenital fat excess of the lower eyelids." Nonsense. The advantage of the transconj approach is that it allows for fat contouring... more

David C. Pearson, MD
Jacksonville Facial Plastic Surgeon

It is not a question of which approach is better, but rather which is most appropriate

It is not a question of whether one approach to eyelid rejuvenation is superior to another but which of the two procedures is best for a given problem. If the issue is lower lid "bags" but the overlying lid skin is taught then the transconjunctival approach is most appropriate. With this technique the surgeon can remove fat causing the "bags' by working through the inside of the lower lid leaving no visible scar on the exterior. However, if the lower... more

David A. Ross, MD
Chicago Plastic Surgeon

Depends on the amount of skin laxity and fat

There is no one treatment that will fit every patients need. The job of a good surgeon is to choose the best treatment for each patient. Transconjunctival is indicated in younger patients.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Transconjunctival eyelid surgery will not help all patients

Transconjunctival blepharoplasty places the lid incision on the inside to better hide the scar yet still allow access to the fat causing the lower lid fullness. The transconjunctival approach is limited in that it will not address skin excess or laxity that has developed through aging. It is a perfect procedure in younger individuals will great skin tone and inherited prominent fatty lower lids. In the past the procedure was combined with laser and peels on the lower lids to help with... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

Transconjunctival vs. traditional blepharoplasty

There are pro's and con's to each approach. The transcon procedure makes the incision inside the lower eyelid, where the fat pads can be accessed. Genreally this technique is used to remove the fat pads that cause bags under the eyes. It does not tighten loose skin but a peel can be done for that. If there is skin laxity, then an external approach is usually better. It is true that the external approach has a higher likelihood of ectropion - pulling down of the eyelid due to scar... more

Richard Baxter, MD
Seattle Plastic Surgeon

Yes this is true.

The less disruption that occurs to the lower eyelid the better. The goal of lower eyelid surgery is generally to improve and contour fullness from anterior orbital fat that projects into the lower eyelid. In addition other goals may include reducing lower eyelid skin lines, lifting the midface, and tightening the lower eyelid margin. Transcutaneous lower eyelid surgery is performed through an incision placed just below the lower eyelid lashes. A cut is make... more