Would I be a candidate for transconjuctival lower bleph? (Photo)

I want to explore options outside of fillers, and surgery seems like the best option.. But I'm not sure that I am a candidate for surgery. What are my options outside of fillers?

Doctor Answers 20

Fillers versus blepharoplasty

It is difficult to tell from your pictures, but from what you submitted it looks like blepharoplasty surgery might not be the best option.  My recommendation would be filler under the eyes. You have volume loss in your mid-face, which is creating the appearance of a bag. Products such as Restylane, Radiesse, or Juvederm (depending upon the volume loss) could give you a beautiful result.  With advanced facial fillers, I think you will get a very natural and predictable response. This is an “off-label” treatment, however, so make sure you go to a provider who is well versed in treating the area around the eyes.  An oculofacial plastic surgeon who's also a skilled injector would probably be best.

New York Oculoplastic Surgeon
4.8 out of 5 stars 62 reviews

Fillers versus surgery...

The ideal treatment would be to do both lower blepharoplasty (transconjuctival), and filler or fat injection to the crease underneath the fat. It is important to not overresect the fat or some hollowing could occur. Proper reduction of fat along with filling the crease will give the smoothest, most natural result.

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 182 reviews

Transconjunctival blepharoplasty

The short answer is yes, you would be a candidate for transconjunctival lower lid blepharoplasty. An alternative - if you have not ruled it out yet - would be a combination of filler to enhance the cheek volume and laser to gently tighten the skin over the fat pads. If you opt for the surgery, be cautious as surgery is not reversible. You appear to be a young person with hopefully many years on the planet! You don't want to have a gaunt appearance - overzealous use of surgery can leave you with problems and fewer options down the road. best wishes with your decision.

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Would I be a candidate for transconjuctival lower bleph?

You can do well with either option but transconjunctival lower blepharoplasty with fat repositioning is usually the best long term option. See video and link below.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 58 reviews

Lower eyelid surgery or fillers

For young patients with excess eye fat, most plastic surgeons would perform lower eyelid via transconjunctival approach. However, lower eyelid surgery alone may not be sufficient in some cases. Volume enhancement is often required, either with fat transfer or facial filler injections. If you haven't already, then speak with a facial plastic surgeon to review options.Best,Dr. Chaboki

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 77 reviews

Transconjunctival blepharoplasty

Hello,Thank you for your question. The TC bleh might very well be the answer but I would be careful. From you photos it appears that you might have some sagging of the underlying muscle which can really only be addressed from a standard blepharoplasty technique. The 'trap' is believing that 'excess skin' is the only determinant of whether or not to have TC procedure. You need the opinion of a plastic surgeon with at least 15 years of experience in this area. Hope this helps.Leland Deane MD FACSManhattan, Garden City, and Babylon

Leland Deane, MD
Long Island Plastic Surgeon
5.0 out of 5 stars 27 reviews

Inferior Blepharoplasty with Fat Transposition

Dear patient, from your photos, I see definitely you got some bags under your eyes, and you are definitely a candidate for inferior blepharoplasty with fat transposition. I always recommend to do fat transposition with inferior blepharoplasty (take the under-eye fat and transposition it in the same surgery to cheek) to avoid hollow eyes after taking out the fat. Please check certified doctors who do inferior blepharoplasty with fat transposition since it is the best option for your case. Best regards.

Nabil Fakih, MD
Lebanon Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Would I be a candidate for transconjuctival lower bleph?

An exam is needed for a definitive answer but from that photo it appears you would have only a slight improvement at best from transconjuctival lower bleph. You would have a much more attractive result by adding volume below the bulge. If your aversion to fillers is because you don't want to have to repeat injections every few months I suggest fat transfer. Properly performed transferred fat will last for decades. Please see examples.

Curtis Perry, MD
Downey Facial Plastic Surgeon
4.8 out of 5 stars 16 reviews

Trans conjunctival approach for lower blepharoplasty

From the one limited photograph, it appears that there is herniated fat in the lower lids. A trans conjunctival approach conservative fat pad removal can accomplish rejuvenating the lower lids with all of the incisions placed on the inside of the lower lids. No external incision is required. For more information and many examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Lower eyelids

From the photo, it seems that you are young and have fullness of your lower eyelids with minimal or no excess skin.  In general, this is the ideal indication for a transconjunctival lower blepharoplasty.  The excess, pouching fat around the eye is removed without visible scars.  It would be impossible to say for sure without examining you in person.  I recommend a consultation with a board certified plastic surgeon.  Good luck!

Brian A. Pinsky, MD
Long Island Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.