Transconjunctival Lower Lid Blepharoplasty Made Easy by Everting the Eyelid

Purpose: To evaluate the transconjunctival lower lid blepharoplasty using a Desmarres lid retractor to evert the eyelid. Design: Prospective study. Methods: Twenty-one cases of inferior blepharoplasty in 11 patients, performed through a transconjunctival approach are reported. The author describes the surgical technique with Radio Frequency surgery, the use of a Desmarres lid retractor to evert the eyelid and the results. Results: Radio Frequency surgery and the use of a Desmarres lid retractor appear to give excellent results in transconjunctival lower lid blepharoplasty. Everting instead of retracting the eyelid provides excellent access to the fat pockets in the lower lids with less bleeding thanks to the traction on the eyelid. The transconjunctival approach has a lower complication rate than the classic transcutaneous approach, with no visible scar and less risk of postoperative scleral show or ectropion. Conclusion: Radiosurgically assisted transconjunctival blepharoplasty of the lower lid with the use of a Desmarres lid retractor is associated with a good functional and cosmetic outcome.