Both transcutaneous and transconjunctival blepharoplasty are regarded as substrative procedures in which the fat and redundant skin and muscles are removed. These are time-tested methods of correcting the undesirable sequelae of the aging eye. However, excess removal of the fat or skin and muscles can give rise to poor aesthetic results. One of these is hollow appearance of the eyes from excessive fat excision.
The above diagrams show the effects of excessive
fat removal.
This patient has excessive fat removal resulting in hollow appearance.
The treatment of choice is volume replacement with filler
or autologous fat transfer.
Desirable effect of transcutaneous blepharoplasty
without excessive fat removal.
Post transcutaneous bepharoplasty without excessive fat removal.
However, this patient has faint tear troughs which could be
removed with fat repositioning or filler.
