Transconjunctival blepharoplasty of the lower eyelids - reviews, complications

Pronounced nasolacrimal grooves, bags and dark circles under the eyes give the look a tired expression. In addition, the face is perceived as puffy, and therefore not very healthy. This is read by the interlocutor literally in the first seconds of communication with a person. Fatty hernias are not always associated with age; they can also occur in younger patients. It's all about genetics. The transconjunctival blepharoplasty method is a minimally invasive and effective way to solve the problem of “tired” eyes. If you don't want to be misled by lower eyelid problems, learn more about transconjunctival blepharoplasty here.

Advantages of this correction method:

• minimal tissue trauma: point access does not damage the epithelium of the eyelids and does not require visible sutures;
• the operation does not last long - up to 1 hour;
• the correction is carried out almost bloodlessly, using coagulation, which minimizes the risk of hematomas in the postoperative period;
• after the operation there are no visible traces left - no one will know that you had plastic surgery;
• the risk of infection during the recovery period is minimal;
• rapid recovery – 6-10 days;
• the most natural result - the eye does not become round, the lower eyelid looks organic.

Is there transconjunctival blepharoplasty of the upper eyelids? Correction of this area cannot be done through a transconjunctival approach. An incision is required to remove drooping upper eyelids.

Features of surgical intervention

The duration of all manipulations rarely exceeds 1-1.5 hours. Both upper and lower transconjunctival blepharoplasty are performed under local anesthesia, which ensures complete painlessness for the entire period of the operation. The patient is discharged from the hospital after 5-7 hours.

Access when performing this operation is carried out by two methods: traditional scalpel and using a cutting laser (laser blepharoplasty).

Scheme of lower transconjunctival blepharoplasty

Upper eyelid blepharoplasty

To correct defects of the upper eyelid, an incision is made on the inside of the eyelid (the conjunctiva is cut), after which a special endoscope is inserted there, with the help of which a brow lift is performed. This allows you to remove the overhang of the fold and manually model the shape of the eyebrows. In order for the effect to remain as long as possible, in some cases (in older patients with insufficiently elastic skin), implants are used. After the operation, there are no stitches left, and the result is in no way inferior to that of percutaneous blepharoplasty.

Transconjunctival blepharoplasty of the lower eyelid

The surgeon makes an inconspicuous incision behind the eyelash line (on the conjunctiva), without the use of additional external incisions. The fat sac is removed through an incision made on the inside of the eye. After the operation, patients are left with no scars or visible signs of the surgical intervention.

Preparation and progress of the operation

Transconjunctival blepharoplasty requires preparation, which should begin a month before the scheduled date of the operation:

• consult with a surgeon and undergo all tests;
• stop taking medications that affect blood thickness, we are talking about analgin, aspirin, lecithin;
• give up alcohol and smoking or limit their consumption;
• limit physical activity.

This is enough for the operation to be successful. But it is important not only to follow the recommendations and advice of the plastic surgeon before the procedure, but also after its completion.

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Lifting the lower and upper eyelids has different specifics. Transconjunctival blepharoplasty of the upper eyelid proceeds according to the following scheme:

1. The doctor makes an incision on the inside of the upper eyelid.
2. The plastic surgeon inserts a special endoscope into the cut conjunctiva.
3. Using an endoscope , the doctor performs a brow lift.

If age-related changes are too noticeable and the patient’s skin has lost the necessary elasticity, the surgeon can use special implants. This will help remove overhanging folds of skin and visually model the shape of the eyebrows.

Correction of the lower eyelid occurs in stages:

• The first stage, infiltration , is a process in which the anesthesiologist makes several injections into the patient’s lower eyelid area.
• The second stage is marking before the operation. The plastic surgeon uses a special marker to mark the area of ​​the eyelid.
• The third stage is the plastic itself . The surgeon checks the level of anesthesia, and then makes a puncture and removes excess fatty tissue.
• The last stage is suturing . The doctor sews up the wound using absorbable threads, which self-destruct after 5 days.

The operation lasts no more than an hour, after a few hours the patient can go home. He was prescribed bed rest for the next three days.

Principle of the procedure

Transconjunctival blepharoplasty can be performed on both the lower and upper eyelids, and in most cases the operation is associated with the first of the proposed options. Its main difference from other procedures is that all manipulations are carried out on the inner part of the eyelid - the mucous tissue, which allows the stitches after the incisions to be masked as much as possible. And performing laser surgery helps reduce the risk of bleeding and further minimizes side effects.

Regardless of the method of implementation, the operation usually takes at least one hour, and in most cases it is performed under local anesthesia, due to which the body’s recovery occurs much faster than after general anesthesia. The principle of performing manipulations largely depends on which eyelid the corrective measures will be taken:

• Lower . The incision is made on the mucous membrane. Through it, existing hernias or fat deposits are eliminated.
• Upper . An incision is also made on the mucous membrane of the specified area. Through it, a special device is inserted into the problem area, with the help of which the skin is tightened and a new shape of the eyelid is modeled.

After completing all the procedures, you need to stay in the clinic for at least another 2–3 hours. You should only get home in the company of an accompanying person.

Transconjunctival blepharoplasty of the lower eyelids

Preparing for surgery

To carry out the operation, you need to take tests and undergo a series of examinations. List of required clinical studies:

1. Blood group and Rh factor
2. Blood for infections: hepatitis B, C, syphilis, HIV
3. CBC with leukocyte formula and ESR
4. Coagulogram: APTT, fibrinogen, INR, PTI
5. Blood test: glucose, ALT, AST, total protein, creatinine, urea, total and direct bilirubin
6. General urine analysis
7. ECG with interpretation
8. If there is a somatic pathology, consult a therapist and cardiologist

Eyelid surgery also requires prior consultation with an ophthalmologist.

Indications for surgery

• The desire of the patient himself (the presence of various cosmetic defects that cause psychological discomfort, but do not affect the state of health);
• Correction of ptosis;
• Hernias of the lower eyelid;
• Marked stretching of the skin in the paraorbital area with the appearance of large bags under the eyes.

The advantages of this type of surgery:

• Minor trauma during the operation;
• Absence of a seam in the area of ​​blepharoplasty;
• A quick rehabilitation period is only one to one and a half weeks and the swelling of the eyelids almost completely disappears;
• The risk of postoperative complications is reduced: the likelihood of ectropion (lower eyelid inversion) is almost zero. In addition, seamless access guarantees the absence of scarring in the future.

What else is important in the preoperative period:

1. If you are taking blood thinners, stop taking them two weeks before your procedure.
2. A few days before surgery, it is better to avoid alcohol, fatty and spicy foods. To speed up recovery, it is recommended not to smoke during this period and at least for several days after eyelid surgery.
3. Before the operation, you should not sunbathe - neither on the beach nor in the solarium. It is advisable to avoid prolonged exposure to the sun for 14 days before the intervention.
4. If the surgeon has prescribed you to take any medications, do not neglect these recommendations.

Preliminary preparation

The presented operation is a gentle procedure that is low-traumatic, but in some cases it may be contraindicated. That is why, before performing surgery, it is necessary to perform the following procedures:

• Carry out the necessary tests (biochemical and general blood tests, urine);
• Three weeks before, stop taking non-steroidal anti-inflammatory drugs;
• Do not sunbathe and give up alcohol two weeks before blepharoplasty;
• Release the next week after surgery. In order not to burden yourself during the postoperative recovery period;
• Consult an ophthalmologist.

The photo shows transconjunctival blepharoplasty “before and after”:

When can you not have surgery?

The surgeon has the right to refuse to perform surgery on you in the following cases:

• For acute diseases or chronic diseases during the period of exacerbation;
• During menstruation;
• With high blood and intraocular pressure;
• With the so-called “dry eye”;
• For diabetes mellitus;
• For oncological diseases;
• For systemic blood diseases;
• In case of violations of blood coagulation functions;
• For diseases of the thyroid gland;
• For HIV and AIDS.

Features of the procedure

As a rule, an experienced surgeon performs the operation within an hour, a maximum of one and a half. It can be on the upper or lower eyelid, but is performed exclusively under local anesthesia. Anesthesia guarantees absolute painlessness during the operation. The patient can go home after an average of 6 hours.

The operation can be performed using two methods: using a laser or a scalpel.

Efficiency

Transconjunctival plastic surgery is a fairly simple operation from the point of view of doctors, but its effectiveness is noted by both surgeons and patients. The correction has virtually no restrictions on its implementation, and numerous reviews indicate its effectiveness and advantages.

• During the intervention, the doctor works only with fatty tissue, the skin is not injured. Therefore, the risk of spoiling the appearance of the lower eyelid is reduced to zero;
• The correction takes a minimum of time. Rehabilitation lasts only seven days. In a short period of time, the patient can not only improve his appearance, but also return to his usual lifestyle;
• The correction does not cause pain or discomfort;
• Seamless plastic surgery can be safely combined with upper eyelid blepharoplasty;
• Compared to other cosmetic surgeries, the procedure is low cost;
• The effect of the intervention lasts for a period of six to twelve years, depending on further lifestyle.

According to surgeons, the technique is an ideal option to get rid of shortcomings for young ladies from thirty to thirty-five years old. At this age, the skin still retains its elasticity and tone, so after removing fatty tissue, additional tension of the epidermis is not required.

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Features and differences of corrective techniques

Despite the similarity of preoperative preparation for each type of plastic surgery, the surgeon’s further actions will depend on the chosen operating technique.

Operations will differ in cost and duration of rehabilitation. If, for example, after epicanthus plastic surgery the patient will need from 2 to 4 weeks to recover, then with sangapuri - from one to one and a half months.

Features of lower eyelid correction

Beautiful expressive eyes increase a woman's attractiveness, but with age everything changes. Plastic surgery helps solve many problems:

1. reduces the severity of nasolacrimal folds;
2. eliminates excess fatty tissue under the eyes;
3. removes sagging and wrinkled skin in this area, increases turgor;
4. has an overall rejuvenating effect.

Blepharoplasty allows you to achieve a smooth transition between the lines of the eyelids and cheekbones, which gives the face a special attractiveness and sophistication.

The procedure lasts from half an hour to 3 hours, depending on the severity of the case and the need for additional procedures (for example, when performed simultaneously with canthopexy). The effect of plastic surgery lasts up to 10 years (subject to the surgeon’s recommendations).

Key points of upper blepharoplasty

A sagging upper eyelid makes your look sullen and adds a few extra years to your face. In addition, the defect negatively affects eye health - over time, visual acuity begins to decrease. Therefore, the operation is popular not only among mature patients, but also often among young girls and men.

The reason for prescribing blepharoplasty is drooping of the eyelid tissue by more than 2 millimeters. There are other indications:

• eye asymmetry;
• entropion of the eyelids (congenital or resulting from unsuccessful earlier plastic surgery);
• hypertrophic growth of adipose tissue;
• excess skin in this area, its sagging;
• injury to the eyelid;
• skeletonization of the problem area;
• pronounced swelling, etc.

The post-operative scar will hide in the natural crease of the eyelid, so within a month no one around you will be able to guess about surgical rejuvenation.

The duration of the procedure depends on the complexity of the case and the number of defects - the operation can last from an hour to three. The patient will enjoy the results obtained from seven to fifteen years (depending on the characteristics of the body and lifestyle).

Features of a circular lift

A circumferential lift helps correct all acquired or congenital defects of the periorbital zone. It is often combined with canthopexy or forehead lift to achieve more perfect facial proportions. Surgery is resorted to when age wins in the struggle for beauty, and numerous visits to a cosmetologist do not give the desired effect.

By following your doctor’s recommendations and giving up bad habits, you can maintain your results for 10-15 years.

Instant rejuvenation allows you to visually remove 5-10 years and give an open, radiant look.

What is plastic surgery for Asian eyes?

Dreaming of a European appearance, Asian girls turn to a surgeon to correct their eye shape.

There are four types of incisions used in Asian blepharoplasty:

1. Classical. The result is characterized by maximum naturalness, which is ensured by a smooth transition of the fold above the eye into the groove of the inner corner.
2. For patients with ethnic characteristics of different nationalities. The semilunar fold obtained as a result of the correction gives the face a special sophistication and a slight flirtatiousness to the look.
3. Female. During the operation, the doctor forms a fold along the contour, leaving a slight distance to the inner corner.
4. For elderly patients. By lifting the outer corners of the eyes, the surgeon achieves the effect of significant facial rejuvenation.

In some cases, the operation is performed on patients with a European appearance.

What is canthopexy

The surgical intervention is based on tightening the outer corner of the eye, which, sagging, contributes to the appearance of a mournful expression on the face. The reason for such a defect may lie both in the patient’s genetic predisposition and in age-related changes (for example, in sprained ligaments).

The operation is almost never performed as a separate surgical intervention; it is an addition to other types of blepharoplasty.

Due to the severity of the procedure and the level of intervention at the bone level, canthopexy is performed under general anesthesia.

Postoperative swelling goes away after 2 weeks, but minor discomfort due to tension may be felt for two months.

How does the procedure work?

1.

The doctor's consultation. When you arrive at the clinic, you tell the surgeon about your wishes. The doctor conducts an examination, asks questions and, if nothing interferes with the transconjunctival correction, approves it as a way to restore the aesthetics of your eyelids. In other cases, the plastic surgeon offers an alternative: traditional blepharoplasty, a combination of operations (for example, midzone lift + blepharoplasty) or cosmetic rejuvenation methods such as filler injections, resurfacing, etc.

2.

Taking tests. The research results should be no more than 14 days before the date of surgery. You can donate blood at our clinic; for this, by prior arrangement, you need to come on a convenient day on an empty stomach.

3.

Day of surgery. If the operation is under general anesthesia, you should not eat or drink in the morning. If under local anesthesia, consult your doctor for nutritional advice. When you come to the clinic, you enter into an agreement. Next, if necessary, the doctor applies preoperative markings, you place your things in the room, and then are transferred to the operating room.

4.

The intervention itself lasts no more than 1 hour. After the operation, a special bandage is applied to the eyes, with which you will have to lie in the ward for several hours. In the evening you can go home. If desired, you can spend the night in a hospital (paid separately).

5.

The next day or the day after you need to come for a dressing and examination. By following the dressing schedule drawn up by your doctor, you make a big contribution to the durability and controllability of the result.

What to do at the preparation stage

A good long-term result is not only a well-done job by the plastic surgeon, but also the correct behavior of the patient during the preparation and recovery period.
Before the operation, be sure to inform the doctor about any previous diseases, since many of them are a contraindication to blepharoplasty.

After examining the problem area and collecting anamnesis, the doctor gives a referral for examination (if necessary, prescribes consultations with related specialists). Having received permission to perform plastic surgery, you must follow the following rules:

• when planning blepharoplasty, you will have to refuse to perform tattooing in this area;
• you cannot drink alcohol or smoke for at least half a month before eyelid surgery (these bad habits negatively affect the body’s regeneration, and if they are not eliminated, rehabilitation may come with complications);
• at least 10 days before the correction, it is important to give up medications that affect the composition of the blood and the rate of its clotting;
• on the eve of plastic surgery (in the evening) it is not recommended to eat (especially if the operation is complex and is performed under general anesthesia);
• Avoid using any cosmetics on the day of the corrective procedure.

These rules apply to absolutely all types of blepharoplasty.

How does transconjunctival blepharoplasty differ from traditional blepharoplasty?

Traditional blepharoplasty differs from transconjunctival blepharoplasty in that the incision is made directly under the eyelashes of the lower eyelid. The thin seam in this place becomes almost invisible. Classic blepharoplasty is indicated for patients with excess skin of the lower eyelids that needs to be removed.

A “hood” over the eye is an overhang of the skin of the upper eyelids, which can also be corrected using traditional plastic surgery. In this case, the incision is hidden in the natural fold of the eyelid and after a month becomes completely invisible.

The traditional plastic method solves a wider range of problems than transconjunctival blepharoplasty. In addition to removing or repositioning fatty tissue, the doctor removes excess stretched skin and, if necessary, fixes the eye muscles.

When performing classic blepharoplasty, the surgeon sequentially passes through the skin, mucous membranes and dissects the orbicularis muscle. The level of complexity of the traditional method is higher than that of the transconjunctival approach and requires jeweler precision from the plastic surgeon.

Indications ↑

Traditional blepharoplasty, in comparison with transconjunctival one, involves incisions that subsequently leave sutures or scars.

Differences between traditional and transconjunctival blepharoplasty

After transconjunctival blepharoplasty, the face looks younger, and signs of fatigue and fine wrinkles around the eyes completely disappear. Therefore, there are many positive reviews about the effective outcome of transconjunctival blepharoplasty.

Transconjunctival blepharoplasty is recommended in the presence of the following pathologies:

• facial wrinkles around the eyes;
• deep nasolacrimal groove;
• horizontal fold parallel to the lower eyelid;
• overhanging dermis;
• small hernias;
• bags and dark circles under the eyes;
• decreased firmness and elasticity of the skin of the lower eyelid.

The ideal patient for this procedure is one who has minimal excess skin of the lower eyelids, but there is protrusion of subcutaneous fat.

The use of this method will not solve all problems of eyelid deformation. Transconjunctival blepharoplasty is not suitable for all patients. If the dermis has excessive excess and deep wrinkles, it is more effective to choose traditional blepharoplasty of the upper and lower eyelids or laser techniques.

Recovery after surgery

During the recovery period, it is important to take medications and drop drops prescribed by your doctor. Sutures are removed a week after surgery. During this period, you should not strain your eyes; watching TV for a long time, sitting at a computer or using a smartphone is prohibited, especially in low light conditions. For the first week you will have to do without decorative cosmetics.

Physical activity is prohibited for 14 days (minimum) after the intervention. Consult your doctor if you exercise regularly. You are also prohibited from going to the bathhouse, swimming pool, or swimming in the sea or fresh water bodies. It is forbidden to steam your face or take a hot bath.

You cannot wear lenses for 21 days after surgery. When going out in the sun, wear sunglasses, even in cold weather.

Rehabilitation period and doctor’s recommendations

The rehabilitation period is kept to a minimum; in the first three days, the patient may notice the appearance of symptoms such as:

1. Swelling of the eyelids.
2. Bruises under the eyes.
3. Hematomas.
4. Slight pain.

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Swelling goes away after 3-4 days, the maximum recovery period lasts no more than 7-10 days. At this time, you need to monitor your health and follow the recommendations of a specialist:

• apply cool compresses to the eyes;
• patches for 3 days to reduce swelling and bruising;
• do not use decorative cosmetics for 7 days;
• do not sit at the computer, do not read books and do not strain your eyes;
• stop eating salty foods;
• do not wear contact lenses for 3–4 weeks;
• do not go to the solarium, sauna or steam bath;
• do not take a hot shower or bath;
• Protect your eyes from ultraviolet rays with sunglasses .

After surgery, glasses must be worn for at least 3 months, no less. They can be removed indoors, but not outdoors.

It is also not recommended to exercise vigorously or bend over frequently. This may lead to undesirable consequences.

If after surgery the patient is bothered by discomfort in the eyes, a feeling of dryness, or decreased visual acuity, it is necessary to notify the doctor about this. He will help you get rid of unpleasant symptoms and prescribe eye drops or other remedies.

Regeneration

As stated earlier, the postoperative recovery period takes about one and a half weeks, during which swelling of the eyes, eye irritation, and a feeling of discomfort may be observed.

The recovery process follows this principle:

• You can return to work after a week’s sick leave;
• Swelling and bruising may remain for up to ten days;
• The first week of regeneration must be spent without physical stress on the body and eyes in particular;
• After a week's rest, it is possible to use hypoallergenic cosmetics;
• You cannot sunbathe or visit a solarium for two weeks;
• You cannot wear contact lenses for three weeks;
• You cannot swim in hot baths, saunas, or steam baths for a month;
• To protect your eyes from ultraviolet radiation, you should wear sunglasses during the season.

Possible complications and side effects

If the operation is performed by a qualified surgeon in appropriate conditions, if the patient follows the doctor's recommendations during the rehabilitation period, no side effects will occur. If the surgical protocol is violated or the doctor’s advice is ignored, complications such as:

• inflammatory process;
• “inverted eyelid” syndrome;
• bleeding;
• hyperpigmentation;
• long-lasting hematomas;
• eye infection;
• dry eye syndrome.

By contacting “Medial”, you find professionals with extensive experience who regularly improve their skills. Our priorities are safety, comfort and lasting results.

Transconjunctival blepharoplasty of the lower eyelids. Photos before and after

The photographs below show the work of our surgeons. Patients appear in postoperative photographs no earlier than 14 days after the intervention. By this time, swelling usually subsides, and the lower eyelids take on the desired appearance.

Other jobs

- in the gallery at the bottom of the page.

Cost of transconjunctival blepharoplasty

Transconjunctival blepharoplasty of the lower eyelids at the Medial multidisciplinary clinic costs 40,000 rubles. This amount does not include anesthesia, consumables and preoperative tests. To obtain accurate information about the cost of the operation, come for a consultation with a plastic surgeon. Only at a face-to-face meeting with the patient can the doctor determine the method of surgical correction and its scope.

Sometimes patients come to us who want to undergo transconjunctival eyelid surgery, but do not take into account that they require not only removal of hernias, but also excision of excess skin. In case of pronounced age-related changes or genetic characteristics, traditional lower blepharoplasty with an incision in the crease of the lower eyelid under the eyelashes is recommended. This operation can also be performed under local anesthesia.

Since 2002, the Medial Clinic has been helping men and women gain an open, youthful, wide-open look. If you want to become more attractive, sign up for consultations by phone: +7. The operation is performed by chief physician Anzhelika Vladimirovna Nikolaeva-Fedorova, as well as plastic surgeon Levan Leonidovich Valiev.

We are glad to become your companions on the path to beauty, youth and health!

Result

Aesthetic surgery regards surgery as the most effective and less traumatic. Transconjunctival lower blepharoplasty has a minimum of contraindications, and its results last for 7–10 years.

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In addition, the surgeon does not make major incisions, excise tissue or transplant it. That is why the doctor cannot harm the patient. Rehabilitation after surgery does not last long; after its completion, the patient can immediately return to normal life.

After the end of the operation, the person experiences virtually no pain; swelling of the eyelids, a slight burning sensation in the eyes, and increased lacrimation often occur. In addition, the advantages of the procedure include its low cost and comparative accessibility. The average cost of the procedure ranges from 30 to 40 thousand rubles.

There are plastic clinics where such an operation can cost many times more, up to 100 thousand rubles, but it all depends on the qualifications of the surgeon and the rating of the medical institution.

Who should not have blepharoplasty?

Due to the fact that transconjunctival blepharoplasty is a surgical intervention, you should prepare thoroughly for it. The following contraindications must be excluded:

• cold;
• increased body temperature;
• pregnancy and lactation;
• blood diseases;
• herpes in the acute phase;
• diabetes;
• immune system diseases;
• malignant tumors;
• skin diseases;
• arterial hypertension;
• conjunctivitis;
• any disease at the time of exacerbation.

You cannot perform surgery if you are not feeling well. The doctor may not detect such a condition, but the patient, when assessing her health, should take seriously the possible negative consequences due to failure to comply with precautions.