What is transconjunctival lower eyelid blepharoplasty?

Transconjunctival lower eyelid blepharoplasty is one of the top choices for those who want youthful, bright eyes without visible scars. With the combination of precise anatomy and modern technology in Vietnam, you can have healthy, radiant eyes while maintaining the characteristic beauty of Asian features. Let’s explore this method and find out if it is the perfect solution for you.

Understanding the anatomy of the lower eyelid

Understanding the anatomy of the lower eyelid is an important foundation to grasp the aging process and how transconjunctival lower eyelid blepharoplasty delivers results. The lower eyelid is a delicate, complex structure composed of three main layers: skin, orbicularis oculi muscle, and the orbital septum. The skin of the lower eyelid is also the thinnest on the body, only about 0.5mm, making it prone to excess fat and age-related wrinkles.

Beneath it lies the orbital fat, divided into three compartments – medial, central, and lateral – held by a system of locking ligaments and the septum. With age, the septum weakens, allowing fat to protrude and form eye bags, while the skin and muscle lose elasticity, leading to wrinkles and deep tear troughs.

Transconjunctival lower eyelid blepharoplasty approaches from the inner surface of the eyelid, avoiding damage to the skin and muscle, and removes or repositions excess fat without leaving external scars.

A clear understanding of this anatomy allows surgeons to precisely remove excess fat, avoid damaging the levator muscle, and protect the lacrimal duct and sensory nerves, resulting in youthful, natural-looking eyes while maintaining safety.

Many patients researching eyelid anatomy also look into upper and lower blepharoplasty to better understand how different techniques address aging concerns.

Traditional lower eyelid surgery vs. transconjunctival approach

Traditional lower eyelid surgery usually involves an incision just below the lash line. This technique allows surgeons to easily remove excess skin, muscle, and fat, while tightening the orbicularis oculi muscle to smooth the eye area.

However, this method leaves an external scar even with precise suturing. Recovery takes 7–14 days with noticeable swelling. There is also a risk of lower eyelid retraction or eversion if too much skin is removed.

In contrast, Transconjunctival lower eyelid blepharoplasty is performed entirely through a small incision inside the conjunctiva, without touching the skin or surface muscle, focusing only on repositioning or removing excess fat from the three orbital compartments.

This technique leaves no visible scars, minimizes swelling and bruising, allows recovery in just 3–5 days, and protects the lower eyelid supporting structures, providing more natural and safer results for the delicate eyelid skin.

For cases with significant skin laxity, some individuals explore combined procedures such as brow lift with blepharoplasty to achieve more balanced rejuvenation.

Benefits and advantages of transconjunctival lower eyelid blepharoplasty

Transconjunctival lower eyelid blepharoplasty is a popular aesthetic method in Vietnam due to its minimal invasiveness and ability to create youthful lower eyes while maintaining a natural look.

With a completely hidden approach inside the eyelid, this technique not only removes concerns about scarring but also shortens recovery time, making it suitable for the busy schedule of international visitors. Here are the key benefits and advantages:

• No external scars: The incision is made inside the conjunctiva, fully hidden, leaving no visible traces after surgery.
• Fast recovery: Swelling reduces in 3–5 days, and normal activities can resume after 1 week.
• Less pain and bruising: No skin or surface muscle is cut, minimizing soft tissue damage.
• Protects lower eyelid structure: Preserves the ligament and supporting muscles, reducing the risk of eyelid eversion.
• Natural results: Precise adjustment of muscles and excess fat suits the delicate eyelid skin.
• Short procedure time: The total procedure takes only 30–45 minutes. Hospitalization is not required due to minimal invasiveness and local anesthesia.
• High safety: Internal access reduces the risk of corneal or blood vessel injury.

Choosing a reliable eyelid surgery clinic in Vietnam is essential to ensure proper assessment and safe planning before undergoing this technique.

Preparing Before the Surgery

To ensure a smooth and safe beauty journey, you only need to spend some time preparing carefully according to the following guidelines:

• Consult a specialist: Meet directly with a cosmetic doctor to examine your eyes, assess fat pads, excess skin, and overall health. The doctor will advise whether transconjunctival lower eyelid blepharoplasty is suitable for you.
• Comprehensive health check: Do blood tests, measure blood pressure, and check cardiovascular and eye health to ensure there are no contraindications. This helps minimize risks during and after surgery.
• Stop medications and stimulants: Discontinue blood-thinning drugs such as aspirin, ibuprofen, vitamin E, and iron supplements at least 7–10 days before to prevent bleeding. Also, avoid alcohol and smoking for at least 1–2 weeks to support wound healing.
• Prepare mentally and schedule support: Understand the procedure, recovery time, and arrange for someone to assist you. Additionally, get enough rest the night before surgery to be in optimal condition.
• Clean the eye area: Wash your face thoroughly, do not wear makeup or contact lenses on the day of surgery. Bring sunglasses and a hat to protect your eyes when you return home.

The surgical technique of transconjunctival lower eyelid blepharoplasty

Transconjunctival lower eyelid blepharoplasty is a delicate technique that uses a hidden approach to adjust fat pads without affecting the surface skin. The procedure is performed meticulously under local anesthesia, ensuring safety and precision.

During the Surgery

Transconjunctival lower eyelid blepharoplasty is performed under local anesthesia with strict sterile technique. The entire procedure takes only 30–45 minutes and does not require hospitalization. The steps include:

• Lower eyelid eversion and anesthesia: The doctor uses a corneal protector, everts the lower eyelid, and injects anesthesia directly into the conjunctiva to eliminate pain. The anesthesia spreads quickly and remains effective throughout the surgery.
• Conjunctival incision: A small 8–10 mm incision is made just below the tarsus using electrocautery or laser, providing access to the orbital fat compartments without touching the outer skin. The incision is completely hidden inside.
• Accessing and treating excess fat: The septum is gently opened. The surgeon inserts instruments into the three fat compartments to remove or reposition excess fat using precise coagulation techniques. Fat is adjusted carefully to avoid hollows.
• Closing the conjunctiva: The incision is sutured with 6.0 or 7.0 absorbable stitches, which do not require removal and heal on their own within 5–7 days without leaving any trace.

After the surgery?

Immediately after the procedure, the eye area is lightly bandaged and iced to reduce swelling. The patient rests in the recovery room for 30–60 minutes before going home. At this time, doctors will also guide you through steps to support recovery, such as:

• Vision and reflex check: The doctor checks that the eyelid moves naturally, there is no eye discomfort, and vision is unchanged.
• Medication guidance: Prescribe antibiotic eye drops, oral painkillers, and anti-swelling medication for 3–5 days.
• Cold compress: Apply an ice pack for 10 minutes, rest for 10 minutes, and repeat during the first 48 hours to minimize bruising.
• Follow-up appointments: Schedule a check 3 days later to examine the conjunctival sutures and 1 week later to evaluate initial results.

Aftercare instructions for recovery

Finally, follow post-operative care instructions correctly to help the wound heal quickly, minimize complications, and achieve optimal aesthetic results within 1 week. Specific guidelines include:

• Apply drops on time: Use antibiotic and artificial tear drops 4–6 times a day as prescribed by your doctor. Wash your hands before applying.
• Avoid water and dust: Do not wash the eye area directly for 48 hours. Gently wipe with a damp cloth and wear sunglasses outdoors to protect your eyes.
• Sleep with head elevated: Use a pillow at a 30–45 degree angle for the first 3 nights to reduce swelling. Avoid sleeping face down.
• Avoid strenuous activity: Do not rub your eyes, wear makeup, or use contact lenses for 2 weeks. Limit exposure to screens for 3–5 days.
• Diet: Avoid spicy food, seafood, alcohol, and supplement with vitamin C, A, and protein to promote wound healing.

Risks and complications

Transconjunctival lower eyelid blepharoplasty is a safe technique with a low complication rate (<2%) when performed by experienced surgeons following strict sterile procedures. However, like any surgical intervention, there are some risks you should know to prevent and manage them promptly:

• Bleeding or hematoma: This can occur if small blood vessels in the fat compartments are not properly cauterized. Minor hematomas usually resolve within 1–2 days or may require aspiration if large.
• Infection: Rare if preventive antibiotics are taken as prescribed. Signs may include redness, increasing pain, or pus. You should return for examination immediately for proper management.
• Prolonged swelling and bruising: Swelling typically decreases in 5–7 days, but improper cold compress use may extend it to 10–14 days. Monitor closely and consult your doctor if swelling does not improve.
• Dryness or eye discomfort: Temporary eye irritation or dryness may occur due to conjunctival irritation. Artificial tears can help relieve this.
• Fat irregularities (hollows or excess): This may happen if fat is unevenly removed or over-resected. Adjustment may be needed 3–6 months after surgery.
• Corneal injury: This risk increases if the surgery is performed by an inexperienced surgeon. Symptoms include pain or blurred vision, requiring immediate ophthalmologic examination.

Make a list of questions about transconjunctival lower eyelid blepharoplasty before visiting us.

Preparing a list of questions before meeting the doctor not only helps you better understand transconjunctival lower eyelid blepharoplasty but also ensures a safe choice suitable for your eye condition and personal expectations. These questions clarify the procedure, risks, realistic results, and aftercare plan, reducing anxiety and increasing confidence when deciding to undergo surgery in Vietnam.

Here are some suggested questions to ask your doctor before the procedure:

• Is the transconjunctival approach truly suitable for my fat pads and excess skin, or do I need a combination with other techniques?
• How many cases of this surgery have you performed, and what is the satisfaction rate among international patients?
• Can I see before-and-after photos of similar cases?
• What is the actual recovery time so I can travel or fly home safely?
• What does the total cost include: surgery, medication, follow-up, or revisions if needed?
• How can I minimize the risk of dry eyes or fat irregularities after surgery?
• What activities should I avoid in the first 2 weeks, and when can I wear makeup again?
• If the results are not as expected, what is the policy for free or paid revisions?
• Are there any special tests required for international patients before surgery?
• What type of sutures and hemostasis techniques will you use to ensure no scars or hematomas?

Conclusion: Is Transconjunctival Lower Eyelid Blepharoplasty Right for You

Transconjunctival lower eyelid blepharoplasty is an ideal choice for those who want to remove under-eye fat, rejuvenate the lower eyelid area, avoid scars, and recover quickly. Here are the suitable cases with specific reasons:

• Only fat pads, skin still elastic (ages 25–45): The method only repositions or removes excess fat through the conjunctiva without cutting skin, preserving natural tension and avoiding eyelid eversion.
• Fear of pain, scars, or hospitalization: Performed under local anesthesia, it is painless, does not require hospitalization, and leaves no external scars, meeting the demand for minimally invasive aesthetics.
• Small eyes, shallow tear trough, do not want to alter skin/muscle structure: The technique protects ligaments and supporting muscles, only adjusting fat, keeping the natural eyelid appearance.
• Good overall health: No eye diseases (glaucoma, severe dry eyes), no bleeding disorders, not pregnant or breastfeeding. Normal blood tests, blood pressure, and heart check results are required before surgery.

Transconjunctival lower eyelid blepharoplasty is not only a modern aesthetic solution but also a journey to bright, natural eyes with high safety and fast recovery. In Vietnam, you can experience advanced technology combined with highly skilled surgeons, reasonable costs, and dedicated care for international clients. If under-eye fat makes you feel insecure, let this technique help you regain a youthful look without worrying about scars or complications. Book a consultation today—a radiant pair of eyes awaits you!