Transconjunctival blepharoplasty. Complications and their avoidance: a retrospective analysis and review of the literature
F. R. Palmer 3rd, D. H. Rice and M. M. Churukian
Department of Otolaryngology-Head and Neck Surgery, University of Southern California, School of Medicine, Los Angeles.
The transconjunctival approach to lower eyelid blepharoplasty is becoming
increasingly popular. From 200 transconjunctival blepharoplasties performed
between 1984 and 1991, 40 randomly selected cases were reviewed to identify
the complications associated with this technique. This represents the
largest reported series (to our knowledge) in the English-language
otolaryngology head and neck surgery literature. A review of the literature
was performed to compare this series with reported complications associated
with this approach, as well as to compare the reported complications from
the transcutaneous method. Discussion on how to best avoid these
complications is included. We found that the transconjunctival approach
avoided the most common complication associated with transcutaneous
blepharoplasty, lower lid malposition. Inadequate fat removal, the most
common complication when the transconjunctival method was used, was
believed to be best avoided by the careful graded and through removal of
herniated lower lid fat. Patients exhibiting prominent fat without excess
lower lid skin were found to be ideal candidates for transconjunctival
blepharoplasty.
