Can Transconjunctival Blepharoplasty Also Lift, Remove or Tighten Cheek Muscle?

My sister had both uper and lower eyelid done in Palo Alto. She told me that her doctor lifted the cheek muscle besides repositioning fat and pinched the skin under the eyes. Is it true that cheek muscle can be lifted with this procedure? She looks gorgeous.

Doctor Answers 9

Transconjunctival approach to lift cheeks

While there is a minor lift that can be performed with a transconjunctival approach, it involves lifting a gristle layer of the cheek, not the true muscle layer.  Lifting the cheek up vertically tends to make the eyes look smaller and we do not recommend this procedure.  We perform all of our lower lid blepharoplasty through a transconjunctival approach and when cheek lifts are needed we perform cheek implants for a flattened low volume cheek or a lower face/neck lift for sagging jowls.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 146 reviews

Cheek Lift through the Transconj incision

Access to the midface through a transconjunctival incision alone is not really possible.  You can, however, continue the incision through the canthus (where the lower eyelid joins into the bone on the outside), releasing the canthal tendon to get better visualization.  From here you can perform a SOOF (suborbicularis occuli fat) lift or connect to a temple incision and perform a true mid-face lift (using Endotines or sutures).  Also, fat repositioning, as opposed to fat excision, is very difficult through the transconjunctival incision alone. 

John Bitner, MD
Salt Lake City Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Can Transconjunctival Blepharoplasty Also Lift, Remove or Tighten Cheek Muscle?

Thank you for your question.  While it is possible to reach the muscle through this approach it is highly unlikely that the cheek muscles were lifted.   This approach is quite restrictive and it is difficult to obtain access to  adequately address the cheek muscles.  It is,however,  very common to lift the orbicularis muscle (the muscle surrounding the eye) in the lower eyelid with this approach.  I would suspect that this was the muscle the surgeon was referring to. 

Donald M. Brown, MD (retired)
San Francisco Plastic Surgeon
5.0 out of 5 stars 8 reviews

Eyes and surgery

A transconjunctival blepharoplasty can remove fat from the lower lid as well as release the adherence of the lid and cheek.  A skin pinch can remove some skin on the outside without violating the muscle. Sometimes a canthopexy is done to help tighten the corner of the eye.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Transconjunctival cheek lift

The transconjunctival approach in lower lid rejuvenation is great to correct fat, though the exposure is not one used for cheek lift. Also, if the skin was 'pinched' under the eyes, she had more than a transconjunctival lid correction in order to reduce skin excess. Hard to say why she looks gorgeous. Great that she does.

Best of luck,

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Can Transconjunctival Blepharoplasty Also Lift, Remove or Tighten Cheek Muscle?

No, if this is attempted, IMHO, it's far more likely that the cheeks will pull down the eyes beacuse they weight much more than the lower eyelids.  Far better to shape the cheeks and midface directly just be sure that the plastic and cosmetic surgeon understands and follows the proper aesthetics of facial beauty.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

Cheek Lift Through Transconjunctival Blepharoplasty Incision

While not commonly done, this type of an incision can be used to give a little bit of lift to the cheek area below the  lower eyelid. It is possible that this was done. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 70 reviews

Lower blepharoplasty and cheeks

It is possible depending on the problem and the goal.  There are a variety of techniques available for a variety of problems. A personal consultation would go over options for you.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 74 reviews

Transconjunctival blepharoplasty for eyelid bags not cheeklift.

 Transconjunctival blepharoplasty for eyelid bags not cheeklift. You cannot really get a good cheeklift from that limited incision. As long as she is happy that is what counts!

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

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.