Subciliary or transconjunctival eyebag realignment? (Photo)

Hi, my surgeon suggests me to do subciliary approach because my lower eyelids are tight to the eyeballs, with transconjuntival approach it is very challenging to reposition the fat pad. If only the fat removal can be done, it will leave depression there. I am 29yo chinese female. I am very concerned about the 2 cut lines scarring after the surgery. The 2nd surgeon I consulted also said transconjuntival is challenging for fat repositioning. 3rd surgeon said he only does subciliary. Thanks!

Doctor Answers 2

First you do not need lower eyelid surgery.

Secondly, an infracillary incision will permanently damage your appearance and you will be profoundly disappointed with this surgery.  I am sorry but I cannot advise you to follow your surgeons advice.  The surgery will wipe out your lower eyelid muscle function and place what will be an unsightly scar on your lower eyelid.  Your lashes are so thin, this scar, perfectly done, will not be hidden.  The surgery damages the muscle at the eyelid margin and this can cause the lower eyelid to slump.  The thing you and your surgeon think is a bag is not herniated orbital fat.  What you have an under eye circle and the think that looks like a "bag" is actually your orbital rim.  This issue is best managed by under eye fillers in my opinion.  Consider seeing Dr. Alice Goh Siew Ching at the International Specialist Eye Centre Malaysia in Kuala Lumpur for a second opinion.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Subciliary or transconjunctival approach with tight lower eyelids

I rarely do subciliary incisions but if you have tight lower eyelids and the fat needs to be repositioned then this is a logical plan. I have never seen a noticeable scar in this location. I think you have gotten good advice. 

Laurence Kirwan, MD, FRCS, FACS
Norwalk Plastic Surgeon
3.7 out of 5 stars 11 reviews

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