Transconjunctival Lower Blepharoplasty: A 2-Sided Assessment of Results and Subjects’ Satisfaction

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To assess the results and satisfaction after transconjunctival lower blepharoplasty, evaluate the effect of associated aesthetic procedures on the satisfaction, and compare surgeon versus subjects’ perspective on the results.


In a retrospective cross-sectional study, a chart review was performed on transconjunctival lower blepharoplasty procedures performed by 1 eye plastic surgeon from April 2003 to April 2009. Subjects with less than 6 months follow-up time or reoperation were excluded. Demographic data, associated surgical procedures, intra and postoperative complications, subjects and surgeon’s perspectives on postoperative results, photographs (before and after the operation), and satisfaction score (Visual analogue scale score) at last follow-up time were recorded.


There were 164 subjects (133 women, 81.1%) with mean age of 50.7 years (standard deviation = 11.6, range: 23–80). Mean follow-up time was 22.8 months (standard deviation = 11.5, range = 6–60 months). Complications, observed by the surgeon and subjects, were undercorrected fat excision (4.9% vs. 3.7%), eyelid retraction (1.2% vs. 1.2%), and tear trough deformity (9.7% vs. 0.6%). Subjects reported less complication rate (5.4%) than surgeon (15.8%). Mean visual analogue scale score was 92.8 (standard deviation = 0.36), which was significantly higher in subjects who had simultaneous upper blepharoplasty and lower in subjects with postoperative eyelid retraction.


Transconjunctival lower blepharoplasty is associated with a high satisfaction. Subjects reported less complication rate than surgeon especially for tear trough deformity. Postoperative eyelid retraction significantly decreased and simultaneous upper blepharoplasty procedure significantly increased the satisfaction.

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