Minimally invasive lower eyelid blepharoplasty.

[BACKGROUND] Transconjunctival lower eyelid blepharoplasty can significantly reduce the incidence of postoperative eyelid retraction and ectropion encountered with the traditional transcutaneous approach. These complications rarely are encountered because no scarring is induced at the level of the orbital septum and post-orbicularis facia.

[METHODS] A modification of the transconjunctival blepharoplasty procedure is described in which two small buttonhole incisions are used for fat removal. This procedure was performed in 148 eyelids.

[RESULTS] All patients had a subjective improvement of eyelid puffiness after the procedure. Lower eyelid retraction or ectropion did not develop in any of the patients. Two patients were concerned with residual eyelid puffiness and redundant eyelid skin.

[CONCLUSION] The primary advantages of the minimally invasive transconjunctival blepharoplasty are the ease in performing the procedure and the reduction of disruption of the conjunctival surface.