Transconjunctival surgery is a specialized surgical technique primarily used in ophthalmology and facial plastic surgery. This approach involves accessing anatomical areas, particularly around the eyes, through an incision made on the inside surface of the eyelid. By operating internally, surgeons can address underlying issues without creating visible external skin incisions. This method offers a distinct cosmetic advantage.
What Transconjunctival Means
The term “transconjunctival” translates to “through the conjunctiva.” The conjunctiva is a clear, thin membrane that lines the inner surface of the eyelids and covers the white part of the eyeball. When a surgeon uses a transconjunctival approach, the incision is made on this internal membrane, typically inside the lower eyelid. This internal access point means that the procedure avoids any cuts on the external skin, preventing visible scarring.
Where Transconjunctival Surgery is Used
Transconjunctival surgery is frequently used for lower eyelid procedures, especially blepharoplasty. This technique addresses “bags” under the eyes, often caused by bulging fat pads. The procedure removes or repositions these excess fat deposits, leading to a smoother, more refreshed appearance. It is beneficial for individuals with prominent fat pockets but minimal excess skin, often chosen for younger patients with isolated fat prominence.
The transconjunctival approach is also used in reconstructive surgery, such as repairing certain orbital fractures. For cosmetic purposes, it can be combined with other treatments like laser therapies or chemical peels to address skin texture, looseness, or wrinkles on the outer eyelid. This allows for comprehensive eye area rejuvenation while maintaining the scar-free advantage. The method’s tissue-sparing nature avoids disrupting the orbicularis muscle and eyelid septum, important structural layers of the eyelid.
How Transconjunctival Surgery is Performed
Anesthesia is administered before the procedure, ranging from local with sedation to general, depending on patient needs and surgeon preference. A protective plastic shield is placed over the cornea to safeguard the eye during the operation. The surgeon then makes a small incision, typically about 1 to 1.5 centimeters in length, on the inside surface of the lower eyelid.
Through this internal incision, the surgeon gains access to the deeper structures of the lower eyelid, including the orbital fat pads, ligaments, and orbital septum. The excess fat causing the under-eye bags is carefully removed or sculpted and repositioned to create a smoother contour. This ensures a natural-looking result while avoiding injury to surrounding tissues and blood vessels. Once the necessary adjustments are made, the incision on the conjunctiva often heals on its own without the need for stitches, or sometimes with tiny, dissolvable sutures.
Post-Surgical Healing and Outcomes
Following transconjunctival surgery, patients can expect some swelling and bruising around the eyes, which is a normal part of the healing process. This typically subsides significantly within the first week, with most visible bruising resolving within 7 to 10 days. Mild discomfort is common but generally well-managed with over-the-counter pain medication.
Patients are often advised to apply cold compresses to the treated area to help reduce swelling and to keep their head elevated, especially during sleep, to minimize pressure. Most individuals can return to work and light daily activities within 7 to 10 days post-surgery. Strenuous activities should be avoided for a few weeks to ensure proper tissue healing. A notable outcome of this technique is the absence of a visible external scar, contributing to a natural and refreshed appearance. Full healing and the final aesthetic results typically become apparent over a few months.