Lower eyelid surgery (transconjunctival)

With age, the skin around the eyes loses firmness and elasticity. This is due to the natural processes of aging, as well as the influence of poor lifestyle, stress and genetic predisposition. As a result, wrinkles, puffiness, dark circles, and bags under the eyes appear. Transconjunctival blepharoplasty is considered as one of the methods for correcting such changes.

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Who is indicated for intervention?

Transconjunctival blepharoplasty is a surgical procedure aimed at correcting aesthetic and functional problems of the lower eyelids. The procedure involves removing or redistributing excess fatty tissue through an incision on the inside of the eyelid (conjunctiva). This avoids external scars, which reduces the visible signs of surgery. This method is often used to eliminate bags under the eyes and improve facial contours, creating a more open and fresh look.

It is especially effective in the following cases:

  • Fine wrinkles and crow's feet. Minor changes in the skin, especially in the early stages, can be corrected using this procedure
  • Initial stage of swelling. If puffiness around the eyes is not associated with diseases of the internal organs, transconjunctival blepharoplasty of the lower eyelids can help reduce this symptom
  • Dark circles around the eyes, especially if they are associated with the accumulation of fatty tissue
  • Danging of the lower eyelids
  • Small hernias and bags under the eyes. If the problem is not advanced and a small amount of adipose tissue has accumulated, transconjunctival plastic surgery can be effective

However, it is worth remembering that when a significant amount of fatty tissue has accumulated or when skin imperfections are too noticeable, resection blepharoplasty with eyelid lift is required.

Who is indicated for intervention?

When not to have surgery

Although this method improves appearance and vision, there are a number of contraindications in which the procedure may be unsafe or undesirable.

Some of the listed contraindications are temporary. For example, surgery may be postponed until you have recovered from an infectious disease.

Contraindications to sutureless blepharoplasty can be divided into several categories:

  • Age restrictions The procedure is not performed on minors due to the incomplete process of tissue growth and development.
  • Infectious and viral diseases Influenza, ARVI, or local infections in the eyelid area increase the risk of complications.
  • Oncological diseases It is a strict contraindication, since surgical intervention can provoke progression of the disease.
  • Hormonal disorders and endocrine pathologies For example, thyroid disorders may affect the healing and results of the procedure.
  • Problems with circulation and blood clotting Prolongation of clotting time increases the risk of bleeding during and after surgery.
  • Eye pathologies Increased intraocular pressure, glaucoma, or dry eye syndrome may become worse after blepharoplasty.
  • Autoimmune diseases Conditions such as rheumatoid arthritis or systemic lupus erythematosus can interfere with the healing process and cause unwanted reactions.
Procedure options

In modern medicine, two main techniques of lower blepharoplasty are used:

  • Surgery with partial removal of periorbital fat
  • Procedure for redistribution of adipose tissue

If it is necessary to fill the nasolacrimal and eyelid-buccal grooves, preference is given to the fat-preserving technique. This method allows you to smooth out facial contours and give them a more natural look. In this case, the fat can be fixed with internal sutures to the periosteum or skin, which provides a more long-term effect.

Traditional classical surgery is performed using a surgical scalpel. In this case, the doctor makes an incision in the conjunctiva and removes excess fatty tissue. However, today, laser blepharoplasty is gaining increasing popularity due to its advantages. This method is considered the safest and least traumatic, since the laser beam coagulates the vessels, preventing the formation of hematomas and minimizing the risk of postoperative hemorrhages.

Risks

However, there are a number of potential complications, among which several main ones should be highlighted:

  • Swelling and hematomas are usually temporary and disappear within the first weeks after surgery. Their intensity may fluctuate and depends on the individual characteristics of the organism
  • Eyelid distortion (improper position), in particular, eversion or ptosis (drooping), can occur due to improper surgical technique or tissue healing characteristics
  • A feeling of dryness in the eyes or, conversely, increased tearing can be caused by temporary changes in the functioning of the tear ducts
  • Infectious complications, although rare, require immediate medical intervention and selection of antibacterial therapy
  • Photosensitivity is usually temporary and decreases as the tissue heals

Choosing a clinic for a successful operation

To minimize the risk of complications, it is important to carefully choose a clinic and specialist. Preference should be given to medical centers that have a high reputation and specialize in plastic surgery, where qualified surgeons with experience in performing such interventions work. In addition, you should pay attention to the following aspects:

  • Availability of modern equipment and use of advanced technologies in surgery
  • Professional qualifications and accreditation of doctors
  • Preliminary consultation and individual approach to each patient
  • Positive reviews and recommendations from previous patients

Preoperative preparation, including a full physical examination and discussion of all possible risks with the patient, also plays an important role in the prevention of complications. Postoperative care, including strict adherence to all doctor's recommendations, is mandatory for a successful outcome and speedy recovery.

Choosing a clinic for a successful operation

General information about the procedure

Preparing for the intervention

Before undergoing transconjunctival blepharoplasty, it is important to prepare. It is necessary to consult an ophthalmologist and therapist to exclude possible contraindications to surgery. You should also stop taking medications that affect blood clotting to avoid complications during and after surgery. Avoiding prolonged exposure to the sun or visiting a tanning salon for a month before the procedure will help prevent unwanted effects of ultraviolet radiation on the skin of the eyelids. In addition, it is equally important to stop smoking and drinking alcohol 10-14 days before plastic surgery, since these bad habits can significantly slow down the healing process of the conjunctiva and affect the final result of the operation.

A thorough medical examination before surgery includes a number of tests and procedures:

  • Clinical tests of blood and urine
  • Blood biochemistry
  • Coagulogram (test for blood clotting)
  • Determination of blood group and Rh factor
  • Tests for hepatitis, HIV, syphilis
  • ECG (electrocardiogram)
  • Fluorography

These studies allow you to assess the general health of the patient and identify possible contraindications to surgery.

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The essence of the operation

The essence of lower eyelid plastic surgery is that surgery is performed through a micro-incision on the inside of the lower eyelid (in the conjunctival area). Here, tissue regeneration occurs faster, due to which the recovery period is reduced.

Main stages of the procedure:

  1. Marking and anesthesia. The doctor applies an antiseptic to the eyelids and makes markings. In most cases, local anesthesia is used for the procedure, but in some situations general anesthesia may be required.
  2. Gaining access. Using a micro-incision in the mucous membrane of the lower eyelid, the surgeon gains access to the necessary tissues.
  3. Fat removal and skin tightening. During the operation, lipid hernias are removed and subcutaneous fat is distributed, as well as, if necessary, skin tightening.
  4. Closing the wound. After all manipulations are completed, the wound is closed, cosmetic sutures and bandages are applied.

The main advantage of transconjunctival blepharoplasty is minimal trauma and rapid recovery. Thanks to the use of micro-incisions on the inside of the eyelid, there are practically no visible marks left after the operation. In addition, the duration of the procedure itself does not exceed one hour.

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Rehabilitation

After completion of the lower transconjunctival blepharoplasty procedure, the patient returns home. On the first day, you should protect your eyes with sunglasses and apply cold compresses to reduce swelling, as recommended by your doctor.

During the period from days 2 to 5, it is important to avoid getting water and shampoo into your eyes. Cosmetics and computer use should be limited. Prescribed antibacterial drops should be used regularly. On the fifth day, a visit to the clinic is usually planned for an examination and, if necessary, removal of stitches.

At this stage, it is still not recommended to apply makeup, and you should also avoid direct sunlight, baths, swimming pools and active physical activity. Swelling gradually decreases and bruises disappear.

By 11-14 days, the eyelids take on a normal appearance. You can start using hypoallergenic cosmetics. After examination by a doctor, moderate physical activity and visiting the pool are allowed.

It is important to follow the following recommendations:

  • Regularly use prescribed medications
  • Sleep on a high pillow, do not put pressure on your face
  • Limit eye contact with water and chemicals
  • Avoid intense physical activity
  • Avoid alcohol, energy drinks, reduce the consumption of strong tea and coffee
  • Reduce consumption of salty and spicy foods
  • Drink enough water
  • Avoid sunbathing, visiting the bathhouse and swimming pool
  • Do not rub your eyes

After a month and a half, after consultation with a doctor, a return to active sports and the use of contact lenses is allowed.

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Postoperative care

After removing the eye patch or patch, it is recommended to apply a gel to the skin of the eyelids, which helps reduce post-operative swelling. If swelling persists for a long time, the plastic surgeon may recommend a special acupressure technique. This procedure accelerates the outflow of lymph and improves blood supply to the eyelids, thereby promoting faster recovery. However, it is worth remembering that massage should be used only in the absence of complications.

Additional procedures may also be recommended to improve the condition of the skin after sutureless surgery. These include:

  • Laser resurfacing that reduces fine lines and improves skin texture
  • Injections of botulinum toxin preparations that reduce facial activity and prevent the formation of new wrinkles
  • Mesotherapy of the periorbital area, which helps moisturize the skin and stimulate its restoration processes

In addition to professional procedures, daily home care also plays an important role. Regular use of moisturizing and nourishing products for the skin of the eyelids helps maintain it in optimal condition and contributes to the long-term preservation of the results of the operation.

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Our doctors

Adamyan
Ruben Tatevosovich
Deputy Chief Physician for Plastic Surgery, Plastic Surgeon
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Primary appointment with a plastic surgeon
from 7 500 ₽
Repeated appointment with a plastic surgeon
from 6 700 ₽

Reviews 10

I was admitted to the clinic with carcinoma. I am happy that I ended up in the hands of Ivan Aleksandrovich. A very competent, attentive to the patient, and most importantly - an honest doctor. I received answers to all my questions and was offered several options for subsequent plastic surgery. The doctor came personally for dressings, after discharge I could always ask questions at subsequent dressings. If you have a choice and have the opportunity to go to Ivan Aleksandrovich - know that you are in reliable and good hands.
01.08.2024
Elizaveta Igorevna
I had surgery in this clinic with Mitoyan Ruzanna Yesaievna, the doctor made an impression from the first appointment. During the consultation, everything was explained in detail about how it goes, what is needed for the operation to take place, and what recovery is like. I received very competent answers to all my questions, I compare with other clinics where I consulted, they wanted to impose such a feeling more than anything else. I really liked her delicacy, attentiveness, charge with calm and confidence. On February 22, 2024, I had upper blepharoplasty, the operation went perfectly, the postoperative period was easy, I followed all the recommendations and no problems arose, there were almost no bruises or swelling and everything healed very quickly. I want to express my deep gratitude to you for your professionalism and light hand! I was delighted with my eyes! It’s been a long time since my look has been so fresh and not overweight. And another miracle that you did - you saved all my colored permanent makeup on my eyelids!
08.04.2024
Lokotko Elena Borisovna
I had mammoplasty with the surgeon Meloyan Misak Mkhitaorovich. I'm very, very pleased. The surgeon, despite his young age, is a professional in his field. Competent approach and accuracy. My stitches are not visible, as if nothing had happened, my breasts are gorgeous! the result exceeded all my expectations. Thanks a lot !!!
29.03.2024
Elena
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