Upper vs. lower blepharoplasty and the transconjunctival method

Upper and lower blepharoplasty address different problems even though both work around the eyes. Upper blepharoplasty targets excess sagging skin of the upper eyelids, which can be both aesthetic and functional - a heavy overhang can narrow the field of vision. Fat pockets are removed as well when needed.

Lower blepharoplasty addresses under-eye bags, fat herniation, puffiness and an overall tired appearance. The goal is a smoother, more rested transition between the eyelid and the cheek.

Sometimes it makes sense to treat both eyelids at once, other times one is enough - it depends on the individual finding that the surgeon assesses at the consultation.

Transconjunctival blepharoplasty is an approach to the lower eyelid from the inside - the incision is made on the conjunctival side, not through the external skin. As a result there is no visible external scar.

This method is suited mainly to cases where fat under the eyes needs to be removed or redistributed but the lower eyelid skin is not in excess. If there is significant excess skin, an external approach may be needed instead. Which option to use is decided by the surgeon based on the specific finding.

For the upper eyelids the scar follows the natural crease of the upper lid, where it becomes almost invisible over time. For the lower eyelids with the transconjunctival approach no external scar forms, because the incision is made from the inside.

At BEAUTYSHAPE we work with a radiofrequency scalpel, which is gentle to the tissue, and microsurgical sutures. Stitches are usually removed on day 5 to 10 and makeup can generally be applied after 2 to 3 weeks.

BEAUTYSHAPE uses a radiofrequency scalpel, which is gentler to the surrounding tissue than a classic scalpel. The procedure is performed under local anaesthesia, on an outpatient basis, and takes about 45 minutes. No hospitalisation is needed - the patient goes home the same day.

A tissue-sparing approach supports a comfortable recovery and a natural result aimed at a more rested appearance rather than a changed face.

The choice between upper, lower or combined blepharoplasty, and between the transconjunctival and external approach, depends on the main problem - whether excess skin predominates, or fat pockets and bags. The decision therefore always belongs to the surgeon, based on the findings.

At the clinic in Prague 2, blepharoplasty is performed by MUDr. Zuzana Prochazkova (oculoplastics, 10 years of experience), MUDr. Stanislav Kolbach (upper and lower blepharoplasty, graduate of the 2nd Faculty of Medicine, Charles University) and MUDr. Marcela Richterova (oculoplastics). The surgeon recommends a suitable method at the consultation; a non-binding online consultation can be arranged free of charge.