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.