Worth doing lower transconjunctival blepharoplasty? (photos)

I'm a 26 yo man and I've got two problems under my eyes: The skin is thin, therefore it looks purple, and they are puffy. Two places both said I should avoid filler. One offered blepharoplasty but didn't offer transconjunctival. I also feel fat repositioning would be useful in the tear troughs. I wanted to see La Belle Forme in Glasgow but they charge £100 just to chat so opinions here are appreciated. This is a lot of money for me but would make a big difference to my confidence.

Doctor Answers 15

Transconjunctival Blepharoplasty with Fat Repositioning

There are 3 main factors that contribute to the current appearance of your lower eyelids: Protruding eyelid fat (bags) combined with a shallow maxillary bone structure, and thin eyelid skin that allows the underlying muscle and vascular bed to "show through" as a purple discoloration. I would recommend a transconjunctival approach to reposition the lower eyelid fat onto the maxilla, filling the tear trough as well as the upper portion of the mid-cheek furrow. I would also consider using a vascular laser to reduce the purple discoloration under your eyes after you have healed from surgery. Good luck with your decision.

Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 112 reviews

Transconjunctival blepharoplasty

I would not recommend surgery - the illusion of "too much" fat in your lower lids is caused by the lack of skeletal support of your eyelids.  This can be corrected without surgery by augmenting your cheek bones with a semi-permanent filler or by placing a permanent cheek implant.
Removing fat will correct the problem temporarily, but will lead to premature aging changes down the road.

Jason J. Hall, MD, FACS
Knoxville Plastic Surgeon
5.0 out of 5 stars 11 reviews

Worth is really up to you...

as you would get subtle improvements at your age.  Fillers are a waste of time.  If you have fat somewhere, you could consider that as an alternative but the bottom line, you need to decide what kind of result would you find satisfactory and whether the costs of that is worth it to you.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Transconjunctival lower blepharoplasty with fat repositioning

The quick answer is yes, you appear to be a good candidate for transconjunctival lower blepharoplasty. It is important to preserve the fat though and not just remove it. That means repositioning the fat to the area underneath it that is hollow. That way you maintain youthful eye area for a long time to come. See an oculoplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Lower eyelid trans-conjunctival approach

The  puffiness in the lower lids is created by herniation of 3 fat pads in the lower eyelids that create a tired look. A trans-conjunctival lower lid blepharoplasty approach involves removing a portion of these fatty deposits through incision on the inside of the eyelids. An external incision is completely avoided. For many examples and more information please see link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Worth doing lower transconjunctival blepharoplasty?

I think you are a very good candidate for the transconjunctival blepharoplasty and fat transfer. Your are is not an issue as this is a familial trait and not age related in your case.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Trans conjunctival blepharoplasty with fat repositioning.

Trans conjunctival blepharoplasty with that repositioning is what you need. The only reason to make an external  incision is if there is excess skin present. See a very experienced surgeon for this.

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

Worth doing lower transconjunctival blepharoplasty?

Yes, you are a candidate for transconjunctival blephroplasty, as you do have prominent fat pads in your lower eyes.  Having some type of filler to your lower eyes will only make the area appear fuller.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews


It does appear from your photos that you would be a good candidate for a TC Blepharoplasty.  I would suggest a consultation so that the lids can be fully examined.

Jessica Lattman, MD
New York Oculoplastic Surgeon
4.9 out of 5 stars 30 reviews

Worth doing lower transconjunctival blepharoplasty?

You do have prominence of the lower eyelid fat pads that would be amenable to a transconjunctival blepharoplasty. A personal consultation is an important aspect of any assessment prior to surgery for both yourself and the surgeon involved. Otherwise you look like a good candidate.
Dr Guy Watts

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.