What is transcutaneous lower blepharoplasty?

Transcutaneous lower blepharoplasty is a specific surgical procedure designed to improve the appearance or functionality of the lower eyelids. The procedure involves an external incision made just below the lash line, allowing access to the underlying tissues. With this method, the surgeon can precisely remove excess skin, fatty pockets or sagging tissue, while treating the deep wrinkles that mark this delicate area of the face.

This technique is particularly useful for patients with bags under the eyes, excess sagging skin or sagging tissues. It can also be used to correct signs of fatigue or aging that alter the overall appearance of the eyes, giving a more youthful, rested look.

However, despite its apparent advantages, transcutaneous lower blepharoplasty is notorious for the risks it can entail, not least because of the sensitivity and complexity of this anatomical area.

The tissues of the lower eyelids are particularly thin and delicate, which increases the likelihood of complications such as visible scarring, skin irregularities or side effects such as eyelid retraction.
In addition, direct manipulation of fat pockets requires great precision. Excessive fat removal or poor tissue redistribution can alter the natural balance of the face, creating a hollowed or tired appearance. For these reasons, this technique is often described as risky, especially when not performed by a surgeon experienced in cosmetic eyelid surgery.

Despite these drawbacks, some patients find this approach effective, especially when it is well adapted to their specific morphology and needs. However, before choosing this method, it is crucial to fully understand its implications, possible results and available alternatives, such as transconjunctival blepharoplasty, which offers significant advantages in terms of safety and aesthetics.

Risks associated with transcutaneous blepharoplasty

Transcutaneous lower blepharoplasty is a popular surgical procedure for improving the appearance of the lower eyelids, but it carries risks that are important to be aware of. This method, which involves an external incision below the lash line, can lead to a variety of aesthetic and functional complications.

Visible scars and skin irregularities on the eyelids after transcutaneous lower blepharoplasty

The transcutaneous route requires an external incision, which exposes patients to the risk of visible scarring. Although surgeons try to make the incision unobtrusive, some scars may become hypertrophic, irregular or poorly positioned, affecting the aesthetic appearance of the eyes. These skin imperfections may require corrective treatments such as injections or laser sessions to improve their appearance. In the event of poor healing, the overall appearance of the eyelids can be compromised, affecting the symmetry and harmony of the face.

Risk of eyelid retraction after transcutaneous lower blepharoplasty

One of the major risks of this operation is retraction of the lower eyelid, also known as electropion. This complication occurs when the eyelid is pulled downwards, excessively exposing the eye and leading to eye problems such as dryness, irritation or even impaired vision. Such a situation may require further surgery to restore the eyelid’s natural position and avoid lasting damage.

Fat and tissue complications after transcutaneous lower blepharoplasty

Direct manipulation of fatty bags under the eyes is a key step in transcutaneous blepharoplasty, but there are certain dangers involved. Excessive fat removal can cause a hollowing effect, making the face look tired and compromising the natural balance of the eyes.

Conversely, inadequate redistribution of fat or tissue can lead to asymmetry or aesthetic irregularities. In addition, the formation of internal scar tissue can restrict the natural mobility of the eyelids, causing lasting discomfort.

Risks of infection and bleeding after transcutaneous lower blepharoplasty

Like all surgical procedures, lower blepharoplasty carries a risk of infection or bleeding. Poorly controlled infection can damage surrounding tissues and prolong the recovery period.

Excessive bleeding, although rare, may require emergency surgery. These complications, combined with the possible effects of anesthesia, reinforce the importance of choosing a qualified, experienced surgeon.

Postoperative asymmetry after transcutaneous lower blepharoplasty

Even with an excellent surgeon, the risk of asymmetry after blepharoplasty is not negligible. This may be due to differences in healing, poor tissue handling or an unpredictable response from the patient’s body. Visible asymmetry or an unbalanced look may require surgical touch-ups, lengthening the recovery process and increasing the overall costs of the procedure.

A safer alternative with transconjunctival blepharoplasty

Given the risks associated with the transcutaneous approach, many surgeons now prefer the transconjunctival technique. This approach involves making an incision inside the eyelid, thus avoiding any visible external scarring.

The advantages of the transconjunctival route :

• No external scarring

The incision is made inside the eyelid, preserving the natural appearance of the eyelids and avoiding any visible scarring on the skin.

• Reduced risk of eyelid retraction

This method minimizes stress on the tissues, and considerably reduces the risk of ectropion or other functional complications.

• Better fat conservation

Rather than completely removing fatty pockets, this technique distributes them harmoniously, offering a more balanced result and a more youthful look.

• Faster recovery

Thanks to the absence of external incisions, the recovery period is often shorter, with less swelling, scarring or post-operative complications.

In addition, some patients may benefit from a temporal lift or other non-invasive aesthetic procedures to optimize results without the need for external incisions.

However, the transconjunctival route is not suitable for all patients, especially those with marked excess skin. Prior consultation with a qualified surgeon is essential to determine the most appropriate method for each situation.

Choosing the right technique

Transconjunctival blepharoplasty is particularly suitable for patients with fatty pockets without significant excess skin. On the other hand, for patients with marked skin sagging or drooping eyelids, transcutaneous blepharoplasty can sometimes be more effective. A consultation with a qualified surgeon is essential to assess each patient’s case and determine the most appropriate method.

In conclusion, although transcutaneous blepharoplasty can offer excellent aesthetic results, its risks must be carefully weighed. Transconjunctival blepharoplasty, on the other hand, offers a less invasive alternative, with often more natural results and a shorter recovery period.

How to minimize risk?

Lower blepharoplasty, while effective for rejuvenating the eyes and correcting functional or aesthetic problems of the lower eyelids, can entail certain risks if not performed under optimal conditions. To reduce these surgical risks and ensure a satisfactory result, it is essential to take preventive measures before, during and after the operation.

Choose a qualified, experienced surgeon

A surgeon specialized in cosmetic eyelid surgery is essential to minimize complications. Check the qualifications, experience and opinions of other patients before choosing your practitioner. A good surgeon will be able to analyze your eyelid morphology and skin type, and adapt the technique to your specific needs, whether it’s a transconjunctival approach or a more conventional method.

If in doubt, ask to see before-and-after photos of similar procedures, which will give you a better idea of the possible results.

Give preference to a personalized assessment

Each patient has unique needs depending on facial structure, skin condition, and the presence of fatty pockets or wrinkles. A thorough consultation is essential to determine whether surgery is necessary or whether other non-invasive aesthetic treatments might suffice. During this assessment, the surgeon will take into account elements such as:

• Excess skin or fat on the lower eyelids.
• Skin quality and elasticity.
• Any history of eye problems or past surgery.

Follow pre- and post-operative instructions

• Before surgery: avoid medications that may increase the risk of bleeding, such as aspirin or anti-inflammatory drugs. Prepare your skin with the care prescribed by your surgeon.
• After the operation: use cold compresses to reduce inflammation, apply creams or ointments to promote healing, and observe rigorous hygiene to prevent infection.
  The recovery period varies from patient to patient, but most can resume their daily activities after two to three weeks, while avoiding strenuous physical exertion.

Consider complementary non-surgical treatments

In some cases, non-invasive aesthetic treatments can be an alternative or complement to blepharoplasty. Techniques such as hyaluronic acid injections, laser or radiofrequency can reduce the appearance of wrinkles and improve the quality of the skin around the eyelids.

These options are ideal for patients with moderate signs of aging or who wish to avoid the scars associated with surgery.

Avoid hasty interventions

It’s important to think carefully before embarking on eyelid surgery. Take the time to evaluate the different techniques, such as the transconjunctival technique, which leaves no external scar, or the classic technique to treat more marked skin excesses.

Discuss the advantages, disadvantages and expected results with your surgeon to choose the method that’s best for you.

Protect his eyes during recovery

After blepharoplasty, it’s essential to protect your eyes to avoid eye complications. Wear sunglasses to protect the area from external aggressions, such as UV rays, wind or dust. If eye irritation occurs, contact your surgeon immediately for appropriate follow-up.

Transconjunctival blepharoplasty procedure

Transconjunctival blepharoplasty is a modern, discreet cosmetic surgery technique, ideal for correcting fat pockets on the lower eyelids without leaving visible scars. In this procedure, the surgeon makes a small incision inside the eyelid, at the level of the conjunctiva, to gain access to excess fat.

This method makes it possible to remove or reposition these fatty tissues while preserving the integrity of the skin. The absence of external incisions not only reduces the risk of infection or skin complications, but also guarantees a natural, harmonious aesthetic result.

Transconjunctival blepharoplasty is particularly indicated for patients who still have firm skin and few eyelid wrinkles. After the operation, the eyes appear fresher and younger, without compromising the overall appearance of the face.

To conclude

While transcutaneous lower blepharoplasty may seem an attractive way of correcting certain aesthetic problems, its risks should not be underestimated. Complications such as visible scarring, eyelid retraction or skin irregularities underline the importance of choosing the right technique and surgeon.

The transconjunctival technique, while also having its limitations, is a safer alternative for many patients. Whatever the choice, careful evaluation and rigorous preparation are the keys to achieving satisfactory results while minimizing risks.

By choosing a competent surgeon and scrupulously following post-operative instructions, you maximize your chances of success and satisfaction.