Two common types of blepharoplasty exist: transcutaneous (with incision going through the outer skin) and transconjunctival (requiring incisions from the inside of the eyelid).
Surgeons perform transcutaneous blepharoplasty by cutting through the eyelids from the outside, usually below lower eyelids lashes, where scars would be less visible. A well-placed incision can be virtually invisible when fully healed.
This approach often includes making incisions and flaps of the orbicularis oculi muscle. The fragile orbicularis oculi muscle is crucial as it supports the lower eyelid. If the integrity of the muscle is compromised, the shape of the eye can be changed.
When drooping and sagging is notable, the incisions may stretch out towards the temples where they would be concealed by crow’s feet. The surgeon then separates the skin from muscle and fatty tissue, removing excess fat and trimming loose skin and muscle.
Unlike transconjunctival blepharoplasty, the transcutaneous kind requires sutures to cover the incision. Transcutaneous eyelid surgery is most suitable for patients who have bulges and wrinkles.
Patients considering a transcutaneous blepharoplasty should be aware that darker skin may result in darker pigmentation (hyperpigmentation) along the incision line.