TRANSCONJUNCTIVAL BLEPHAROPLASTY WITH CHEMOEXFOLIATION

Transcutaneous blepharoplasty has been the standard for improving the overall appearance of the lower eyelid, as it addresses skin, muscle, and pseudoherniated orbital fat. Postoperative problems, including poo r scarring, scleral show, and even frank ectropion, have led many surg eons to alternate techniques. Transconjunctival blepharoplasty is know n to be a reliable method of removing lower eyelid fat, but has been t outed as inadequate for those possessing excessive skin and has even b een cited as being responsible for increasing lower eyelid wrinkling. Chemoexfoliation, utilizing trichloroacetic acid and phenol, was perfo rmed simultaneously with transconjunctival blepharoplasty in 146 patie nts, whose data are retrospectively reviewed. Excellent results were o btained in lower eyelid skin appearance and pseudoherniated fat in the majority of patients, without an external lower eyelid scar.