Background: Transconjunctival blepharoplasty remains a popular and safe technique to treat periorbital aging. In the lower lid, it can be used successfully for orbital fat excision, redistribution, or septal tightening. In the upper lid, transconjunctival blepharoplasty has a role in removal of the nasal fat pad via an isolated, direct approach.
Methods: The authors review anatomy, indications, and surgical approaches for upper and lower lid transconjunctival blepharoplasty.
Results: Potential complications, patient results, and the senior author's personal series are discussed.
Conclusions: In the lower lid, this technique can be advocated in an effort to avoid lower lid complications such as sclera show or lid malposition. In the upper lid, it can be effective in treating isolated fat pads with minimal skin excess.