What is Transconjunctival Blepharoplasty?

The more modern transconjunctival approach was not designed to avoid a visible incision, as some people imply. It was done to reduce the chance of a specific complication with the external or subciliary approach. The older approach required cutting through the muscle and orbital septum of the lower lid and it carried with it a higher risk of lower eyelid rounding or ectropion (where the eyelid pulls down and away from the eyeball). These are bad complications.
The transconjunctival approach, on the other hand, avoids this pitfall by accessing the fat from the inside of the eyelid, leaving the muscle and septum intact. And contrary to some assertions by my colleagues, loose or excess skin can still be addressed, It's done through a "skin pinch" excision on the outside without going through those muscle and connective tissue layers.
So much lower is the complication rate with transconjunctival blepharoplasty that I (basically) never do it any other way. And most of the time I'll also combine it with a skin pinch.
The thinking is simple: get the fat from the inside, get the skin from the outside, and leave the middle structures alone.
All the best,
--DCP

hello
you are asking a very technical question! Transconjunctival blepharoplasty is a type of lower eyelid surgery. Historically surgeons used to open the lower eyelid through a skin and muscle incision (subciliary incision). That approach could impair the stability of the eyelid, with a risk of ectropion. So it was found many decades ago that a solution to the problem was to avoid cutting the muscle, and approach the fat of the lower eyelid through the conjunctiva (the red tissue located at the inner aspect of the lower eyelid). 
I use the transconjunctival blepharoplasty in most of my patients to avoid ectropion, and I transpose the fat instead of removing it. 
I hope this will help.! 

Thank you for your question. A  transconjunctival blepharoplasty is a very popular procedure. It involves the meticulous sculpting of fat in the lower eyelids to improve the "bags under the eyes" look. Some doctors remove the fat, some reposition it. Sometimes a skin strip is removed at the same time if necessary.See a surgeon who performs computer imaging. That way, you can see what is realistic based on your anatomy.Best wishes.

Thank you for your question. Transconjunctival Blepharoplasty is done through the inside of the lower eyelid with no visible incision.  The fat pockets are easily removed and the swelling is less than the traditional approach. It is the  preferred method of blepharoplasty when there is no lid laxity or excess skin. If there is excess skin a pinch blepharoplasty with orbicularis muscle suspension can be performed. Please find a Board Certified Plastic or Oculoplastic surgeon who can examine you and help you with all your concerns. All the best!

Transconjunctival blepharoplasty is the technique where the fat pads are removed from the lower eyelids by entering through the back of the eyelid. This works for mild fat protrusion on young patients. For older patients with larger fat pads, it’s best to enter through the skin in order to tighten it as well. Make sure to have your surgery with an experienced oculoplastic surgeon who is comfortable with all techniques. Good luck!

Thank you for your question. Transconjunctival Blepharoplasty is a procedure to improve the appearance of lower eyelids ( fat pads) Lower eyelid surgery is very bespoke and will address the many different concerns that you may have. The incision can be inside the eye (transconjunctival incision) or under the eyelash (subciliary incision) line. The transconjunctival route is appropriate for younger patients with puffy eyes and no extra skin needing removal. The subciliary incision is more commonly used and is in patients where they have skin excess. The surgery itself can address the skin alone. In addition to this, the muscle and fat can be addressed. For hollowing of the orbital area, re-draping the fat to help pad out this area can help. The muscle layer, if dropped can also be hitched up (Canthopexy)  Your surgeon will discuss all these options with you and through the consultation and examination determine what is the best option for you. All the best