Lower eyelid malposition is a feared complication after lower lid blepharoplasty and may be associated with scleral show and ectropion of various degrees. These complications tend to limit the success of the transcutaneous blepharoplasty technique. To this end, the use of a posterior transconjunctival technique has been explored. By avoiding scarring at the anterior lamella and lower eyelid septum, retraction of the eyelid and ectropion can be avoided. Accordingly, the posterior transconjunctival approach has gained in popularity and acceptance. The transconjunctival incision through the fornix seems to offer less risk for postoperative lid malposition and provides for the best exposure to the orbital fat.
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