Transconjunctival Lower Blepharoplasty has no chance of Lower Eyelid Retraction

Lower eyelid retraction is an unusual expose of “white” of the eyeball by pulling down the lid. Scar-related retraction in internal lower eyelid is a complication in usual blepharoplasty. The risk of this internal complication can be eliminated with transconjunctival lower blepharoplasty by trimming bagging orbital fat. This operation doesn’t harm the delicate and important middle layer of eyelid, so the deep scarring by contracture does not produce after a years of operation.
If transconjunctival blepharoplasty procedure is used for fat repositioning in cheek hollow, cheek implant or tear trough placement then extended dissection is required. In such case, there would be a little risk of internal scar-related retraction. There can be other reason also for lower eyelid retraction other than lid scarring. If excess orbital fat is removed from lower eyelid, the support to lower eyelid may lose and crumple downward into hollow.

Transconjunctival Blepharoplasty to Avoid Hound Dog Eyes

Earlier people prefer to undergo traditional scalpel blepharoplasty. The usual problem with this surgery is when blepharoplasty surgeon cuts through the supportive muscle of the lower eyelid, the eyelid support is often lost. Also, the scarring created by the blepharoplasty surgery tends to pull down the eyelid. If a patient already has a loose lower eyelid, the condition becomes even worse. The outcome of surgery may be a sad eyed look which surgeons called as hound dog eyes.
Fortunately, a newer blepharoplasty technique can be used to avoid the hound dog eyes. This procedure is called transconjunctival blepharoplasty.

The transconjunctival blepharoplasty is performed in a different manner from the old scalpel blepharoplasty and prevents injury to the supporting eyelid muscles. The inner pink part of eyelid is called conjunctiva. In transconjunctival blepharoplasty, a small incision is made with a laser inside of the lower eyelid through conjunctiva. This procedure avoids injury to the supporting muscle of eyelid. After that, fat is repositioned or removed from the inside of lower eyelid and tightened the lid. Dark circles corrected by performing an arcus marginalis release. Laser transconjunctival blepharoplasty is becoming more popular nowadays.

Following are the advantages of the transconjunctival laser blepharoplasty:

1. Eyelid shape not change after surgery.
2. No visible scar on the lower eyelid.
3. Transconjunctival technique avoids the hound dog eyes or sad eyed look.
4. Healing and recovery after surgery is generally quicker.
5. Bruising over eyelid is less.

If your lower eyelid loose or turns down, the old style scalpel blepharoplasty may results in serious sad eyed look or hound dog eyes. Very few blepharoplasty surgeons perform the transconjunctival laser blepharoplasty.

Selective Tissue Sparing Blepharoplasty

As in traditional blepharoplasty, the intrinsic weakness associated with excess tissue subtraction and tucking has progressively understood by surgeons. Now efforts to develop more soothing approaches to eyelid rejuvenation have yielded a lot of advance blepharoplasty techniques that seek better short and long-term outcomes.
Basically traditional blepharoplasty is a removal technique in which unstable skin, orbital fat or muscles are subtracted with an objective of debulging the upper and lower eyelids. Once orbital fat has been removed or moved out of the orbit, standard volume associations are changed. Once muscle has been incise or subtracted, its final power is everlastingly weakened. The most general problem resulting from traditional blepharoplasty is excessive tissue removal weakens the eyelid’s support and an aesthetic problem is eyelid hollowing.
These outcomes after traditional blepharoplasty are generally analyzed as unavoidable limitations. They are undesirable results and do nothing to appear eyes more attractive or youthful.
"Tissue sparing blepharoplasty" should not be misinterpreted to simply signify performance of the usual blepharoplasty in a more conventional manner. Mostly denotes "selective tissue sparing blepharoplasty" in terms of both subtraction and tissue injury. Some patients may be most benefited from leaving assured tissues completely alone while carefully removing other tissues. Some patients may be considered for newer and very special approaches that remove little or nothing.
Upper eyelid tissue sparing blepharoplasty is a well-developed secure and efficient operation. Lower eyelid tissue-sparing is not in extensive use and still under development.

Blepharoplasty for Inborn Crease Imbalance

The natural asymmetry in the crease shape, height and depth is not at all uncommon. As well as imbalance in the height and width of eyelid opening is known as “palpebral fissure”. During a study, eyebrow, eyelid and orbital measurement comparing in models with the average population and observed that moderate asymmetry around the eyes were common even with good looking faces.
Natural asymmetry is more common in Asian descent and may be influenced by some anatomic variables. Most of the patients believe their imbalance is due to difference in amount of skin and fat in the two lids, but this problem is quite related to weak natural crease fixation instead of tissue excess or deficiency.
It is advisable for exceptionable asymmetry to have blepharoplasty on both eyelids simultaneously, even if one eyelid already has acceptable natural crease. By undergoing blepharoplasty to both eyelids at the same time, surgeon has better chances to achieve balanced final match. When blepharoplasty performed only on one eyelid, it is more difficult for the surgeon during the operation to judge exactly how much to evaluate developing symmetry between the two eyelids.
In some rare cases, the presence of considerable ptosis affecting only one eyelid and the deficient eyelid may show no crease formation. For such cases, patient must undergo ptosis surgery along with double blepharoplasty for better improvement.
If asymmetry in crease shape is the cause of earlier double eyelid blepharoplasty surgery rather than inborn preexisting imbalance, surgical treatment can be especially challenging. Crease reformation for marked natural asymmetry or unacceptable surgery relies on advanced blepharoplasty techniques that are far more complicated and less expected than those used in normal double blepharoplasty surgery.