Where is the incision exactly on transconjunctival surgery?

Question

I can't figure out how this scarring or sutures don't rub on your eyeball after surgery since it's on the inside. I am especially curious because i wear contact lenses.

Jeffrey M. Darrow, MD · Answer

The transconjunctival blepharoplasty incisions are inside the lower eyelid, approximately 1 cm below the eyelash line.  The tissue heals very well and usually no sutures are needed to close the incision.  You should avoid contact lenses for 2 weeks after the surgery.

Ashlin Alexander, MD · Answer

The incision is made approximately 1cm below the lash line on the inside of the eyelid.  It heals beautifully and no stitches are required.  There's typically less swelling of the eyelid/cheeks after this approach, and less chance of changing the position of the lower eyelid margin (compared to the approach that involves an incision on the outside of the eyelid).  If there's excess skin of the lower eyelid after the fat has been removed from the inside, you can undergo a conservative "skin pinch" to tidy up the outer appearance.  Contact lenses shouldn't be worn for about 2 weeks.Good luck!Dr. Alexander

Marc Pacifico, MD, FRCS(Plast) · Answer

This is a procedure where excess fat can be removed from the inside of the eyelid.The incision is around 0.5cm away from the edge of the eyelid and the small scars are usually left to heal on their own without the need for stitches.If you are a contact lens wearer, I would suggest changing to glasses for around a month after surgery, and keeping your eyes well-lubricated.I hope this helps!

J. Jason Wendel, MD, FACS · Answer

Thank you for your question.In the transconjunctival blepharoplasty, the incision is low enough in the depths of the inferior fornix that the sutures are away from the cornea and do not scratch the eyeball. You may not be able to wear contact lenses for several weeks.

For more details, see two or more board
certified and experienced plastic surgeons in your area for a full and complete
evaluation.

I hope this helps.

For more details, see two or more board
certified and experienced plastic surgeons in your area for a full and complete
evaluation.

I hope this helps.

Anand G. Shah, MD · Answer

Hello.  I hope this explains the thought process.  The trans-conjunctival approach to cosmetic lower eyelid blepharoplasty is very favorable. Instead of approaching the fat pads from the outside (trans-cutaneous blepharoplasty) the dissection is actually performed from behind, within the eyelid. The trans-conjunctival blepharoplasty is usually combined with an external skin pinch, to remove the redundant skin, once the fat pads are removed and deflated.Lower lid Blepharoplasty may be performed with a combination of local anesthesia as well as light IV sedation anesthesia. General anesthesia is not necessary, although patient preference should always be taken into consideration.Hope this at least provides useful information.  Good luck and best wishes.  Dr. Shah

William McClure, MD · Answer

Thank you for your question. As you've seen from the other responses, the incisions heal well without suturing. Some surgeons make a long single horizontal incision. Most surgeons make two or three smaller horizontal incisions. I let my patients wear contacts in one week. Many patients benefit with a removal of excess lower eyelid skin at the time of transconjunctival blepharoplasty. This leaves a scar beneath the eyelashes which blends in very well, almost to the point of being invisible.

Steven Wallach, MD · Answer

The transconjunctival approach is used to remove fat or redrape fat during blepharoplasty.  The incision is made within the lower lid between the lash line and eyeball.  I do not sew the incision closed because sutures like you said may irritate the eye.. It heals quickly on its own.

John J. Martin, Jr., MD · Answer

The incision with a transconjunctival blepharoplasty is about 8-10mm below the eyelid margin.  It is low enough that the incision itself will not be felt after the surgery.  I never use sutures to close this incision as it heals well on its own.  I find that sutures can create inflammation and they really are not needed.  You should be able to wear your contacts within a week - just make sure you aren't pulling down on your lid to put them in.

William Portuese, MD · Answer

The  trans- conjunctival incision is located on the inside of the lower lids approximately 1 cm below the lash line on the inside. In our practice we make 2 small incisions approximately  4 mm long and  remove a conservative amount of fat out  from the 3  fatty compartments in the lower lids. The advantage of the trans-conjunctival incision is that there is no incision on the outside, so there is no violation of the muscle which can cause a pull down effect of the lower lids. No sutures are required  for the trans-conjunctival  approach and  the incision heals up very rapidly. We do not recommend contact lenses to be worn for at least 2 weeks after the procedure.  For many examples, please see the  link below  to our eyelid surgery photo gallery

Sean M. Blaydon, MD, FACS · Answer

The incision is generally made several  millimeters below the hard plate (tarsus) on the inside of the eyelid and deep in the fornix.  Most surgeons do not close this incision with sutures at the end of the case as it comes together nicely and heals well when the eyelid is returned to its normal position.  The incision is low and there are no sutures that will rub on the cornea.  Patients generally have little discomfort with this approach to lower eyelid cosmetic surgery.

Where is the incision exactly on transconjunctival surgery?

Answers (11)

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