Patients who have large amounts of loose skin are not usually candidates and need removal of skin in the usual way. This applies to most elderly patients, although a transconjunctival blepharoplasty is increasingly used even for this group of patients. See under MORE INFO below. The operation is done under either local or general anesthetic and unlike traditional lower lid blepharoplasty can be combined with resurfacing the skin. The length of time to recover is about the same but the amount of bruising and swelling may be less.
Complications are similar.
From the surgical perspective the main advantage is that the orbital septum, a fine layer which separates the tissues of the bony orbit from the eyelid tissue, does not have to be divided. This reduces the risks of surgery.