The transconjunctival lower eyelid blepharoplasty is extremely effective at reducing fullness of the lower lid due to prominent orbital fat. We performed 68 consecutive transconjunctival blepharoplasties over the past 31 months via a preseptal plane. Inadequate fat removal, the most common complication when the transconjunctival method was used, occurred in 2 patients(2.9%) and was believed to be best avoided by careful graded and thorough removal of herniated lower lid fat. Minimal postoperative wound hemorrhage without hematoma formation occurred in 1 patient(1.5%). There were no cases of lower lid retraction, ectropion, entropion, inferior oblique palsy or over-excision of fat. We found that the main advantage of this technique is that it avoids the most common complication of the transcutaneous lower eyelid blepharoplasty, ie, lower lid retraction. Patients exhibiting prominent orbital fat without excess lower lid skin were found to be ideal candidates for transconjunctival lower eyelid blepharoplasty.