I am a 40yr old female with prominent eye bags. I am fortunate not to have any wrinkles and or crows feet around my eyes and I don't have saggy skin all i have is alot of bulginess. I have seen several doctors and I have gotten different opinions from them, from getting a transconjunctival approach to transcutaneous approach with fat grafting. I am so confused. Not sure which approach is right for me?
Answer: Trans-conjunctival lower blepharoplasty For the last 25 years, we have used trans- conjunctival fat removal lower blepharoplasty to rejuvenate the eyelids. We do not recommend the transcutaneous approach, because it violates the anterior lamella and muscle of the lower lids which can then change to shape of the lower lids. For many examples, please see the link below
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CONTACT NOW Answer: Trans-conjunctival lower blepharoplasty For the last 25 years, we have used trans- conjunctival fat removal lower blepharoplasty to rejuvenate the eyelids. We do not recommend the transcutaneous approach, because it violates the anterior lamella and muscle of the lower lids which can then change to shape of the lower lids. For many examples, please see the link below
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CONTACT NOW Answer: Transconjunctival vs Transcutaneous Blepharoplasty Either approach might work well, but in a younger patient with minimal excess skin or skin laxity, I tend to recommend a transconjunctival blepharoplasty approach. Sometimes no skin excision is needed at all, while in other cases, a small skin pinch might be needed. I will often also laser the lower eyelid area with a fractional CO2 laser at the same time (often without the skin pinch) in order to give a small amount of tightening of the skin without removing any skin or making any incisions. For patients with a deep tear trough, this needs to be addressed in some way as well, usually either through fat repositioning, fillers, cheek augmentation, or a combination of the above. Talking with a facial plastic surgeon can be very helpful for an in-person exam and to discuss all of the options in detail. All the best,
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CONTACT NOW Answer: Transconjunctival vs Transcutaneous Blepharoplasty Either approach might work well, but in a younger patient with minimal excess skin or skin laxity, I tend to recommend a transconjunctival blepharoplasty approach. Sometimes no skin excision is needed at all, while in other cases, a small skin pinch might be needed. I will often also laser the lower eyelid area with a fractional CO2 laser at the same time (often without the skin pinch) in order to give a small amount of tightening of the skin without removing any skin or making any incisions. For patients with a deep tear trough, this needs to be addressed in some way as well, usually either through fat repositioning, fillers, cheek augmentation, or a combination of the above. Talking with a facial plastic surgeon can be very helpful for an in-person exam and to discuss all of the options in detail. All the best,
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August 25, 2019
Answer: Surgical approach for lower lid bags Most of the surgeons here have recommended transconjunctival blepharoplasty, which is a reasonable approach for someone with isolated fat bulging, as you tend to see in younger patients such as yourself. What concerns me is that your skin may have been stretched out enough that once the fat is removed, you will have some skin excess. I think it defeats the purpose of doing a transconjunctival blepharoplasty if you ultimately have to make an external incision to remove excess skin anyway. In those cases it would have made more sense to do an external approach. This is a judgement call that a surgeon can best make by examining you. You can then discuss the best options with him or her.
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CONTACT NOW August 25, 2019
Answer: Surgical approach for lower lid bags Most of the surgeons here have recommended transconjunctival blepharoplasty, which is a reasonable approach for someone with isolated fat bulging, as you tend to see in younger patients such as yourself. What concerns me is that your skin may have been stretched out enough that once the fat is removed, you will have some skin excess. I think it defeats the purpose of doing a transconjunctival blepharoplasty if you ultimately have to make an external incision to remove excess skin anyway. In those cases it would have made more sense to do an external approach. This is a judgement call that a surgeon can best make by examining you. You can then discuss the best options with him or her.
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August 25, 2019
Answer: Trans conjunctival versus transcutaneous approach for blepharoplasty From your photos provided it appears you have significant puffiness in the lower eyelids without evidence of redundant skin. For this reason, most experienced eyelid surgeons would recommend transconjunctival approach and (if needed) a skin "pinch" technique for removal of a small amount of lower eyelid skin.
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Answer: Trans conjunctival versus transcutaneous approach for blepharoplasty From your photos provided it appears you have significant puffiness in the lower eyelids without evidence of redundant skin. For this reason, most experienced eyelid surgeons would recommend transconjunctival approach and (if needed) a skin "pinch" technique for removal of a small amount of lower eyelid skin.
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August 25, 2019
Answer: Prominent fat pads You have significant fat pads for your age. A transconjunctival is the method of choice for most surgeons these days. There are usually less complications with this approach. From the inside of the lid, the fat can be repositioned inferiorly to fill in the tear trough. You have so much fat that some may need to be removed as well. If there is excess skin, a pinch of skin can be removed from directly under the lash line .
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CONTACT NOW August 25, 2019
Answer: Prominent fat pads You have significant fat pads for your age. A transconjunctival is the method of choice for most surgeons these days. There are usually less complications with this approach. From the inside of the lid, the fat can be repositioned inferiorly to fill in the tear trough. You have so much fat that some may need to be removed as well. If there is excess skin, a pinch of skin can be removed from directly under the lash line .
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