| Get ready because this chapter is a long one.
Fat removal in the lower eyelid may be accomplished by using either of two basic but very different approaches --from an incision placed along the inside surface of the eyelid (tranconjunctival) or from a skin incision placed just below the lashes (transcutaneous):
Transconjunctival Lower Blepharoplasty
• Other names: Posterior approach lower blepharoplasty
• Primary goal: Removal of bulging fat
• Special anatomy: As noted in Chapter 4: Eyelid Anatomy. The "conjunctiva" is the thin clear membrane of tissue that lines the back of the eyelid and then reflects onto the front surface of the eyeball to cover the sclera (the "white").
• Anesthesia: Local anesthesia with oral or intravenous sedation
• Operative technique: The lower eyelid is gently pulled away from the eyeball using a blunt retractor, while the eyeball is protected with a plastic plate. An electrocautery or laser is used to sweep across the conjunctiva (back side of the eyelid) along most of its length near its junction with the eyeball . . . |
