Transconjunctival Lower Blepharoplasty: Fat Excision or Repositioning
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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.
KeywordsOrbicularis Muscle Inferior Oblique Muscle Orbital Septum Lower Eyelid Retraction Lower Blepharoplasty
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