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Transconjunctival vs. Transcutaneous Blepharoplasty

asked 1 year ago by Frank1234 in Duluth, GA
Latest answer by Joseph A. Eviatar, MD
Question viewed 993 times
Tags: age 25-34, male, eye bags, transconjunctival, transcutaneous

I am a 34 year old male with eye bags. I have gotten two opinions on how to treat them. Now I am confused.Is one procedure safer than the other? How long do the results last?

21 answers to Transconjunctival vs. Transcutaneous Blepharoplasty

You want to be very careful in doing transcutaneous blepharoplasty

In general you want to be very careful in doing transcutaneous blepharoplasty. Most patients, especially if you are 34 years old, do not need skin removal. The transconjunctival approach, with a physician who is experienced, has less chance of lower lid retraction and a more natural result. You have to be very careful and not have too much fat resected and be conservative about it. Some of the fat prolapse is because there is hollowing underneath the fat pocket. In a position like yours... more

Joseph A. Eviatar, MD
Bronx Oculoplastic Surgeon

www.ChelseaEye.com

Transconjunctival vs transcutaneous lower lid bleph

For you, based on age and pix, I would say that the transconj is probably best....you may not need any skin excision and therefore there will be no visible outside scars (not that it matters because they heal imperceptibly). The transcuteneous approach requires cutting accross the orbicularis muscle to reach the fat (bag) and it MAY weaken the lower lid and cause rounding.

Andrew Pichler, MD
Sacramento Facial Plastic Surgeon

facedr.com

Transconjunctival vs. Transcutaneous Blepharoplasty - which is better?

Based on your photos, as a young individual whose predominant problem is puffiness to the lower lids, you are an ideal candidate for a transconjunctival blepharoplasty. The minimal amount of excess skin you have will re-drape nicely after the fat is removed, and if performed by an experienced surgeon, the healing time with the transconjunctival approach will be very short with minimal discomfort. Both approaches are quite safe when applied appropriately since the chance of ectropion in... more

William F. DeLuca Jr, MD
Albany Plastic Surgeon

www.delucaplasticsurgery.com

Type of Blepharoplasty Is Based On Eyelid Anatomy And Aging Concerns

It is not question of whether there is a safety difference between transconjunctival vs transcutaneous blepharoplasty, it is a question as to which one is better for you and your eyelid anatomy and aging issues. As you can see by the answers posted here, every conceivable blepharoplasty option has been suggested. So it is not surprising that of your two consults, you have gotten two seemingly different blepharoplasty suggestions. In good hands, both options will offer improvement and it is a... more

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon

Transconjunctival or Subciliary Blepharoplasty

Frank, you live in an area with outstanding blepharoplasty surgeons who can examine you personally, talk to you at length about your specific issues, and give you world class treatment for either technique. In the right hands, both techniques are safe and effective. The longevity of your procedure is impossible to answer as it depends on your particular aging and sun exposure--both of which are unique to you. I would request a consultation with... more

Luis Zapiach, MD
Paramus Plastic Surgeon

You may benefit from an Injectable Filler treatment to minimize the appearance of your lower eyelid bags.

I read your concerns and reviewed your photos. In my practice, I hardly ever remove lower eyelid fat (lower blepharoplasty) since it may lead to a hollow appearance, and increase wrinkles in the lower eyelid skin. You may consider a non-surgical, Injectable Filler treatment to fill the lower eyelid groove which could diminish the appearance of your bags. You should make sure your physician is experienced in the delicate art of filling lower eyelid grooves, and check many photos before... more

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

Avoid the skin incision

You will do well with transconjuctival lower blepharoplasty since you do not seem to much extra skin. Your surgeon should prepare you though if extra skin develops after conservative removal of fal and repositioning he may need to remove a little skin.

Vishnu Rumalla, MD
Dallas Plastic Surgeon

Transcutaneous vs transconjunctival blepharoplasty--which is better?

The simple answer is that a transcutaneous incision must be made if there is excess skin and muscle to be removed; this incision (properly performed) leaves a virtually imperceptible scar right below the eyelashes, and allows access to trim, reposition, and properly release eyelid structures, precise surgical maneuvers impossible via a transconjunctival approach. That is why this is considered the "standard" approach, and the one most commonly used by most blepharoplasty surgeons,... more

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon

Transconjunctival vs. transcutaneous lower blepharoplasty

You appear to be a good candidate for the transconjunctival approach, as you do not have excess skin. In my practice I always remove the fat transconjunctivally; I then remove skin from the outside if necessary. This reduces the surgical injury and dramatically lowers the risk of ectropion, or pulling of the lid downward after surgery.

Eric Pugash, MD
Vancouver Plastic Surgeon

Transconjunctival blepharoplasty works great.

Hi. You look like the ideal candidate for this procedure. The fat should not all be removed. Some of it needs to be repositioned lower down your cheek so there is a smooth contour and no hollowness.

George J. Beraka, MD
Manhattan Plastic Surgeon

Transconjuctival vs. transcutaneous blepharoplasty.

The answer is quite simple. No excess skin=transconjunctival. Excess skin that needs to be removed=transcutaneous. This assumes an experienced surgeon who does each very well.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

Best Eyelid Operation for me - Transconjunctival vs. Transcutaneous Blepharoplasty?

Regarding: "Transconjunctival vs. Transcutaneous Blepharoplasty I am a 34 year old male with eye bags. I have gotten two opinions on how to treat them. Now I am confused.Is one procedure safer than the other? How long do the results last" Medicine is an art and every doctor can express his / her opinion. While some opinions can be justifiably different, I cannot understand why would someone recommend that you undergo a "though the skin" (scar along the lashes)... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

2 approaches, both effective

You are young with mostly "puffiness" from fat only without marked skin excess. This condition is nicely improved with the transconjunctival approach which avoids an external scar and can limit the potential for internal scar which can lead to eyelid retraction. The main reasons to use the transcutaneous approach are in older patients with excess/sagging skin/muscle that may need removal and tightening of the eyelid, not necessary in your situation. Good luck! more

David J. Levens, MD
Coral Springs Plastic Surgeon

Lower lid bags

You will do well with transconjuctival lower blepharoplasty. Transcutaneous approach has more risk and you are not going to benefit since you don't have any excess skin. One other nonsurgical option you have is injectable fillers under the bags. Dr Taban

Mehryar (Ray) Taban, MD, FACS
Los Angeles Oculoplastic Surgeon

Blepharoplasty Approaches

There are 2 main approaches for blepharoplasty that you describe, the transcutaneous approach (incision on the lower eyelid skin) and the transconjunctival approach (incision inside the eyelid). Both procedures are safe in the hands of a board certified facial plastic surgeon, plastic surgeon, or oculoplastic surgeon that has experience with blepharoplasty. Philosophically you will find different opinions on what different doctors prefer to perform. I perform both... more

Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon

www.drsteiger.com

The difference between transconjunctival and transcutaneous blepharoplasty

The difference between transconjunctival and transcutaneous blepharoplasty is that in the transconjunctival blepharoplasty, the tissues cannot be tightened as they can with the transcutaneous blepharoplasty. If you have no laxity of the skin or the muscle, a transconjunctival blepharoplasty is an excellent technique for re-contouring the fat of the lower eyelid to eliminate the puffiness and the hollowing.

George Weston, MD
Reston Plastic Surgeon

Best approach to the lower eyelids

Based on your photos and your age, I would recommend a transconjunctival approach-which leaves to external scars. I would not remove any fat but rather reposition the fat by tightening the orbital septum. Fat removal in this area has been shown to actually make patients look older and more gaunt. You want to preserve as much fat as possible in order to maintain a youthful appearance. I recommend consulting with at least one more board certified plastic surgeon in your... more

William Bruno, MD
Beverly Hills Plastic Surgeon

How to treat under eye bags

There are many approaches to treating lower eyelid bags. In young patients like yourself this problem can often be treated entirely via volume enhancement of the cheek/lower eyelid (using fat grafting or facial filler such as restylane for example). Depending on how prominent the lower eyelid fat pads are I may recommend concurrent conservative removal of some of the fat via a transconjuctival approach, but this is less common. I find that if the cheek volume loss isn't... more

Thomas A Lamperti, MD
Seattle Facial Plastic Surgeon

Blepharoplasty

Both of these techniques are great depending on individual patient characteristics. I would recommend getting additional opinions from board certified plastic surgeons in your area. Typically young patients with isolated "puffiness" of the lower eyelids can be appropriately managed with conservative fat resection via the transconjuctival approach. If other issues exist, then the transcutaneous approach can be used.

Chad Douglas Tattini, MD
Bloomington Plastic Surgeon

Lower lid blepharoplasty

To Frank1234 in Duluth, GA - sorry you're confused and got two different opinions! As you can see from the other answers given by other surgeons, these two methods can both be effective in helping the bags under your eyes. It may be the respective opinions of the surgeons you went to - a preference in doing lower lid blepharoplasty with how they trained or the results they tend to get doing it one way or the other. I would suggest going to the surgeon who you feel... more

Keshini Parbhu, MD
Orlando Oculoplastic Surgeon

www.orlandoeyeopener.com

Transconj. blepharoplasty or not

If you simply have an excess of fatty tissue, the transconjunctival bleph. works great...as long as the fat is removed evenly, and not too much is removed. Looking at your photos, it seems like this could certainly work well for you. If there is some excess skin, the TC bleph can be combined with a simple skin pinch technique, for a nice result. Your surgeon can help you with this decision. All the best,