Transconjunctival blepharoplasty: further applications and adjuncts.

Recent enthusiasm for transconjunctival blepharoplasty (TCB) has encouraged us to extend the technique not only to patients who need removal of excess orbital fat, but also to those with fine wrinkles, excess skin, and redundant or ptotic orbicularis muscle. We describe our technique that combines the transconjunctival removal of fat with a trichloroacetic acid--Jessner's solution chemical peel, a phenol peel, a skin pinch excision, or lateral canthoplasty performed at the same time. The combined procedures require minimal operative time and there is less morbidity during recovery than with the standard external approach. The procedure has produced eyelids with a rejuvenated, natural, and unoperated on appearance.