Transconjunctival Lower Blepharoplasty: Fat Excision or Repositioning

  • Guy G. MassryEmail author
  • Paul S. Nassif


In lower blepharoplasty, the eyelid fat pads can be accessed externally through the skin (transcutaneously), or internally through the conjunctiva (transconjunctivally). Transconjunctival surgery leaves key anatomic structures (orbicularis muscle/orbital septum) undisturbed, which reduces the incidence of postoperative lower lid malposition. For this reason, the transconjunctival approach to surgery has gained wide acceptance over the last 20 years. Transconjunctival surgery does not directly address excess lower lid skin or eyelid laxity. When these deficits are present, a skin pinch and canthal suspension can be added. Transconjunctival surgery is a more complex procedure than the traditional transcutaneous approach. However, when the technique is mastered, results are enhanced and patient satisfaction is high.


Orbicularis Muscle Inferior Oblique Muscle Orbital Septum Lower Eyelid Retraction Lower Blepharoplasty 
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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Ophthalmic Plastic SurgerySpaulding Drive Cosmetic Surgery and DermatologyBeverly HillsUSA
  2. 2.Spaulding Drive Cosmetic Surgery and DermatologyBeverly HillsUSA
  3. 3.Department of Otolarlaryngology–Head and Neck SurgeryUniversity of Southern California School of MedicineBeverly HillsUSA

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