Transconjunctival blepharoplasty is a refined surgical technique primarily used to correct lower eyelid issues, such as the prolapse of orbital fat, without leaving visible scars. This method, which involves a radiosurgical incision of the conjunctiva, allows for the effective removal of fat pockets with minimal recovery time and reduced risk of complications like ectropion or scleral show.
Transconjunctival blepharoplasty targets the fat pockets that often bulge in the lower eyelids, a common aesthetic concern among patients. This approach is favored over the transcutaneous method due to its scar-free healing, as the incision is made inside the eyelid. Notably, this technique does not require suturing, and it preserves the integrity of the orbicularis muscle, significantly minimizing the risk of postoperative complications.
The procedure can be performed under local or general anesthesia. Local anesthesia involves a deep subcutaneous injection of 2% Xylocaine with epinephrine, followed by a subconjunctival injection to achieve additional anesthesia, vasoconstriction, hydrodissection, and tissue wetting, which facilitates the radiosurgical incision. However, due to the potential stress and discomfort associated with local anesthesia, general anesthesia is often preferred. It allows for better control of blood pressure, reducing the risk of bleeding and enhancing comfort for both the patient and the surgeon.
Following the surgery, no sutures are placed; instead, an antibiotic ointment is applied, and a cooling compress is used to reduce swelling. Tranexamic acid may be administered intravenously to minimize postoperative bleeding. Patients typically return for a follow-up six days post-surgery, where conjunctival edema and potential skin wrinkling are assessed. In rare cases where skin wrinkling persists, a superficial peeling might be recommended after one month.
According to the American Society of Plastic Surgeons, over 325,000 eyelid surgeries were performed in 2020, making it one of the top five cosmetic surgical procedures in the United States. The transconjunctival approach, in particular, has gained popularity due to its effectiveness and minimal invasiveness. Recent advancements in this technique focus on enhancing fat repositioning rather than removal, aiming to preserve the natural contour of the eyelid and prevent the 'sunken eye' appearance commonly associated with aging.
For further reading on eyelid surgery techniques and their benefits, visit the American Society of Plastic Surgeons.
Transconjunctival blepharoplasty offers a modern, less invasive option for addressing lower eyelid concerns, with the added benefits of no visible scarring and reduced recovery time. This technique not only improves cosmetic appearance but also maintains the functional integrity of the eyelid, making it a preferred choice for both patients and surgeons.
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