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Transconjunctival Blepharoplasty Vs Arcus Marginalis Release

asked 2 years ago by jaque1 in UK
Latest answer by Craig Harrison, MD
Question viewed 1,865 times
Tags: age 18-24, eyelids, male, eye bags, fat

Hello, I am a 21-year-old male who definitely wants to have my (minor) eye bags removed. I know they're caused by fat because when I squint or lay on my back they disappear. What would benefit me the most, a transconjunctival blepharoplasty or an arcus marginalis release? What are the differences between the two, and the pros and cons of either? Thank you.

17 answers to Transconjunctival Blepharoplasty Vs Arcus Marginalis Release

Arcus marginalis release vs transconjunctival blepharoplasty

Many patients have exactly what you describe, a congenital bulge under the eyes. You have astutely noted that your bulge gets better when you squint; that means the problem is due to a fat bulge. It often looks much better when this fat is removed through a transconjunctival approach. We have abandoned the arcus marginalis release procedure entirely over 5 years ago. It involves curring and release of the arcus marginalis, in my oipinion a dangerous layer that can contract at the... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

www.drbrent.com

The type of eyelid procedure required depends on your problem

The type of eyelid procedure needs to be be tailored to the patient. As an expert in facial and eyelid procedures, your surgeon should be able to give you the pros and cons of each procedure. I perform the following for the following reasons. 1. Transconjuctival Blepharoplsty - This is a procedure most appropriate for very young patients ( less than 30 ) who have the problem of fat bags but not so much extra skin and wrinkles. 2. Arcus Marginalis Release - This is a procedure most... more

Phillip Chang, MD
Leesburg Plastic Surgeon

Transconjunctival blepharoplasty vs arcus marginalis release

Generally a 21 year old in my practice can be treated with fillers at your tear trough or transconjunctival fat removal and or with transposition of fat. I am convinced that a traditional lower lid blepharoplasty which interrupts nerves critical to lower lids function will be replaced by techniques which address budging fat from a transconjuctival approach and skin problems can be corrected with resurfacing or pinch skin only blepharoplasty. Best to let someone see you and talk... more

Craig Harrison, MD
Tyler Plastic Surgeon

Transconjunctival blepharoplasty and the arcus marginalis

Transconjunctival blepharoplasty is a technique for exposing the eyelid fat pockets and arcus marginalis without using a skin incision. This technique uses an incision created on the inside of the eyelid through the conjunctiva ( the conjunctiva is the tissue covering the inner surface of the eyelid). Fat is exposed and removed when the eyelid is puffy or fat is re-positioned when the eyelid is hollow. If additional fat is needed to correct eyelid hollowness, then the... more

Adam J. Cohen, MD
Skokie Oculoplastic Surgeon

Transconjunctival blepharoplasty vs arcus marginalis release

The arcus marginalis is usually only released when there are certain preexisting aging conditions of the eyelids where the lower lids have drooped down. The primary goal of lower blepharoplasty surgery is to have the fat pads removed from the lower lids through a transconjunctival approach, which removes the puffy or double bubble look of the lower lids.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Blepharoplasty vs. arcus marginalis release

Transconjunctival blepharoplasty is performed solely to remove excess or herniated fat that creates the bulging or puffiness of the lower eyelids. If there is excess skin of the lower eyelids, an external skin incision approach is indicated. In my opinion, transconjunctival blepharoplasty is usually indicated in the younger population where there is no skin to remove. However, in a middle aged individual who has multiple rhytids (wrinkles) of the lower lids and puffy fat herniation... more

Sigmund L. Sattenspiel, MD
Freehold Facial Plastic Surgeon

Many factors to consider when deciding which surgery is appropriate

Transconjunctival refers to the type of incision, I assume you are referring to then excising the fat vs an arcus marginalis release where one opens the covering of the bone or perisoteum releasing the area below the fat pad or repositioning the fat pad to that area. Many factors come into play when deciding which surgery is right for you, do you have a midface that is not very prominent (called a negative vector), do you have prominent eyes and others anatomic findings. With that said I... more

Robert Schwarcz, MD
New York Oculoplastic Surgeon

Transconjunctival blepharoplasty easiest way to correct lower eyelid problems

It is very unusual to be 21 and have problems with eyelid bags. If you do have problems with eyelid bags, the easiest way to treat them is to perform the procedure through a transconjunctival approach.

Steven Wallach, MD
Manhattan Plastic Surgeon

Transconjunctival blepharoplasty good to remove bags.

Hi! 1) When people get eyelid bags at a young age, this tends to be a true fat excess which is easily and appropriately removed witha transconjuctival blepharoplasty. 2) In older people, fat should be repositioned instead of removed. This is what the arcus marginalis release ( a more difficult complicated operation) is good for.

George J. Beraka, MD
Manhattan Plastic Surgeon

Too young for lower lid blepharoplasty for cosmetic reasons

I would start by saying that unless there is a significant familial component to your lower lid fullness, you are too young to be having lower lid blepharoplasty for cosmetic reasons. The transconjunctival approach would be a good approach for blepharoplasty in a younger patient with no lid laxity and fat herniation only. The release of the arcus marginalis would be a necessary step in eyelid rejuvenation surgery if you happen to have significant hollowness of the nasojugal area. Both of... more

Philip S. Schoenfeld, MD
Chevy Chase Facial Plastic Surgeon

For your age, arcus marginalis release may be best

Dear Cheekpads Generally when one refers to a transconjunctival blepharoplasty one does not just refer to an approach to the lower eyelid but rather a particular type of lower eyelid surgery. The tranconjunctival blepharoplasty is performed from behind the lower eyelid cutting accross the lower eyelid conjunctiva and the lower eyelid retractors just above the low point behind the lower eyelid on the eyelid side. This permits exposure of the three pockets of fat in the lower eyelid: lateral,... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Unlikely that you need lower eyelid fat removal at your age

Given your age, it is unlikely you need fat removal. Many of my younger patients do not require removal of fat from the lower eyelid but instead a redistribuation of fat or actually fat added to the region around the eye to soften the appearance of the bag. The risk of removing fat (unless you truly have excess) is that your eyes can appear hollow. The transconjunctival approach simply means you can get to the eye fat pad without an external incision, while the arcus release is used to... more

Amir M. Karam, MD
San Diego Facial Plastic Surgeon

www.drkaram.com

Probably need both transconjunctival blepharoplasty and Arcus marginalis release

It is not uncommon for a 21 year old to have noticeable fat deposits in the lower lids causing a baggy appearance. As the amount of lower lid fat tends to be an inherited trait, I see them often in teenagers. Transconjunctival lower lid surgery is an approach to the fat from an incision behind the eyelid which is not visible. This is the preferred approach to orbital fat as it tends to cause less scarring and healing issues with the lower lids. Arcus marginalis release allows the fat to be... more

Peter T. Truong, MD
Fresno Oculoplastic Surgeon

www.facialsurgerydr.com

Consider fillers for younger patients instead of eyelid surgery

The specific answer to your question certainly involves the issue of doing surgery on a 21-year-old; this is quite rare. In general terms, most eyelid cosmetic surgeons will use a variety of techniques to address the individual needs of their patients. In the consultation your surgeon will spend a lot of time reviewing with you to understand your needs and expectations, telling you what techniques are available (usually some sort of combination of various techniques) and helping the you make... more

J. Timothy Heffernan, MD
Seattle Oculoplastic Surgeon

drtimheffernan.com

Eyelid surgery - Arcus Marginalis Release VS Transconjunctival Fat repositioning VS. Fat Removal

The previous response by my colleagues are outstanding and I agree with them. I am also concerned by a 21 year old man requiring lower lid cosmetic surgery. It is very uncommon in my experience for someone as young as you to need such procedures. The question you raised essentially reflects the great developments in cosmetic lower lid surgery. Earlier, the classic operation was done through a skin incision under the lashes through which excess skin and bulging fat were removed. Through a... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Transconjunctival bleph vs arcus release

As Dr. Placik explained, these two procedures are not necessarily mutually exclusive. I would also like to add that in my experience, it would be exceedingly unusual to do a cosmetic bleph on a 21 year-old. There are risks of any surgery and in my opinion, you are too young to be considering this.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Arcus marginalis release (fat transfer) with tranconjunctival ("no visible incision") blepharoplasty

These are not mutually exclusive options. The transconjunctival bleph is an approach and not an endpoint. It essentially means that your incision is made on the internal lining (conjuntiva) of the eyelid rather than the skin surface. Once open, you can use this approach to remove fat, release the arcus, perform an orbital fracture repair or muscle surgery, etc. The arcus release allows the fat to escape the contents of the orbit (softening the appearance of the bags). Many surgeons than sew... more