Posted .

Transcutaneous vs. Transconjunctival?  2 very effective eyelid surgeries.  Use the snap test to determine which procedure is appropriate.

Q:  I had a couple of consultations for lower eyelid surgery and I got 2 recommendations.  One doctor recommended the transcutaneous approach and another the transconjunctival approach.  How do I know which one is the best choice for me?

A:  Either approach to your lower lids will result in an improvement.  In order to determine the best surgical option, it is important to evaluate your skin changes – are there fine lines, wrinkles, capillaries, etc?  Another factor that helps us to determine the best approach is the resilience of the lower lid when it is pulled away from the eye ball – the snap test.  If the skin is smooth and the lower lid snaps back as soon as it is released then the transconjunctival approach would be my choice.  Very little bruising associated with this approach.  If there are multiple fine lines with a good snap test then I would suggest laser resurfacing in addition to the transconjunctival approach.  If you have a poor snap test then I would recommend a transcutaneous approach with a tightening procedure for the lower lid – a canthopexy.