Transconjunctival lower blepharoplasty has gained interest because of less-invasiveness and fast
recovery. This is a study about operative skill, strength, and weakness of transconjunctival lower
blepharoplasty and a trial for suggesting the guidelines for patient selection. The authors reviewed
the medical records and photographs of 530 patients (M:F=470:60) who underwent transconjunctival
lower blepharoplasty with orbital fat reposition and subperiosteal septal reset, retrospectively. Most
of the patients were satisfied with results for correction of orbital fat bulging and tear trough deformity.
Eighteen patients (3.4%) developed relapse of fat bulging requiring revision with subsequent fat
removal (seventeen patients) or fat reposition (one patient). Two patient (0.4%) developed entropion.
One case was corrected with revisional surgery and the other case was recovered after an injection
of triamcinolone. Delayed hematoma was developed in five patients. Surgical evacuation was
required in 3 cases. Minor problems included postoperative swelling, bruise, and transient
paresthesia that resolved spontaneously. Transconjunctival lower blepharoplasty is an excellent
surgical choice for correction of orbital fat bulging and tear trough in the patients who have proper
tension of soft tissue. Invisible scar, fast recovery, and low complication rate are merits of this
method. (Archives of Aesthetic Plastic Surgery 17: 83, 2011)