ABSTRACT
PURPOSE: Traditional transcutaneous incision and transconjunctival incision methods are commonly used in the lower blepharoplasty. The transconjunctival method leaves no visible scars nor does it change the shape of lower eyelid contour and the surgical technique is not difficult. However removal of excess baggy skin is not possible through this method. Therefore, the transconjunctival incision method is useful only for patients who still have normal elasticity of the lower eyelids and fat that is protruding only anterocaudally. The Author will introduce a technique, which complements the limitations of these two methods mentioned above. METHODS: The author combined the transconjunctival approach and lower blepharoplasty with only the excised skin flap method. This method does not go beyond the previous methods but does apply the advantages of them. RESULTS: From March 2007 to October 2010, this new technique was performed in a total of 62 patients. Fat was removed and repositioned through transconjunctival incision. Drooped skin was excised as in the traditional blepharoplasty but only the skin flap was elevated. This prevents post-operative complications such as ectropion, sclera show, and deformation of the shape of the lower eyelids or under-resection of fat. All patients were satisfied with the post-operative appearance. CONCLUSION: The author was able to get satisfactory results while avoiding complications of traditional transcutaneous technique with this combined technique of the transconjunctival approach and the lower blepharoplasty method of skin flaps only.