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Is Transconjunctival Blepharoplasty Safe?

Transconjunctival Blepharoplasty is a safe procedure, but it’s essential to understand the surgery and realize that there are two approaches to lower blepharoplasty. One is transconjunctival and the other is transcutaneous. Transconjunctival blepharoplasty is done by making an incision inside, through the mucosa, while  a transcutaneous blepharoplasty is performed through an incision in the skin. To decide which approach to use, I look at the individual patient and determine what they have going on with their eyes.

If the patient only has a bulge of fat but no extra skin, I use the transconjunctival approach because we can get the fat out very safely this way. However, if the patient has redundant or bulging fat along with extra skin and wrinkles, I use the transcutaneous approach because that allows us to take out the fat or move the fat, transposing it to the rim which can sometimes be concave or indented. Essentially, we’re robbing Peter to pay Paul, where Peter is the fat bulge and Paul is the concavity under the eye. We can do this while removing redundant skin and muscle that causes wrinkles and crow’s feet. 

How long does this last?

The length of time this improvement lasts depends on the aging of the eyelid and how it affects the skin. If the aging eyelid has resulted in skin redundancy and we remove it during surgery, the patient will still continue to age and down the line can end up with more redundant skin. If bulgy fat is the problem, we don’t take out all the fat. Instead, we leave some that sits along the orbit in a cone and protects the eyeball, but that fat can re-herniate over the years causing it to bulge again. Overall, both surgeries last for many, many years, with a minimum of seven to ten years. 

Is this a painful surgery?

This surgery is really not very painful. Even though I give my patients narcotic pain pills, it’s not uncommon for them not to use them. I don’t like them to send them home without any narcotics just in case there’s a need, but it’s not uncommon for the patient to only need acetaminophen or Tylenol. Any pain that might be felt can be further diminished by icing the eyes, getting rest and refraining from physical activity for a few days.

How long does it take to heal from lower blepharoplasty?

Healing time from lower blepharoplasty depends on which procedure is used, and if any other procedures are added to the  surgery,  If we are doing a lower blepharoplasty, bruising and swelling is typically gone within five to seven days. At that point,  women can wear makeup on their eyes without issue. After the swelling goes down, the patient may feel healed, but they may have some low-grade swelling for a month or two. However, most people can get  back to work in five days. 

If you have questions about lower blepharoplasty, upper blepharoplasty, or any periorbital surgery or surgery on the face, call me, or email me. I do a very detailed, individualized consultation where I determine what is best for you. I’d love to see you in my office. 

About Dr. Jonathan Sykes

Dr. Jonathan Sykes is a world-famous expert plastic surgeon who performs all cosmetic and functional plastic surgery procedures on the face and neck. He is a past president of The American Academy of Facial Plastic and Reconstructive Surgery, and served on their Board of Directors for over 10 years. He is also a Professor Emeritus in Facial Plastic Surgery from UC Davis Medical Center, and the former Director of Facial Plastic Surgery at that institution.

He is known as the expert’s expert, and is often called to consult and advise other plastic surgeons in both Northern California and Beverly Hills. He has a special interest in eyelid and browlift surgery, facial rejuvenation surgery including facelifts, and rhinoplasty. He also has a particular interest in facial feminization surgery. Have questions? Email Dr.Sykes at: [email protected]