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No Touch Blepharoplasty

At one time all lower eyelid blepharoplasties were performed through an incision in the skin. One well-known potential problem following surgery is the possibility for malposition of the lower eyelid; this is known as ectropion or bowing of the lower lid. This can lead to disturbance of tear function, dry eyes, prolonged swelling, or chemosis, and an unattractive appearance. To address these issues techniques have been developed that avoid disturbing an important area of the lower eyelid that includes the orbicularis oculi muscle. This muscle is responsible for eyelid closure and it provides important support for the lower lid. These advanced techniques are known as no touch blepharoplasty. Because they do not disturb orbicularis muscle or retractor system function, the risk of lid malposition with its attendant problems is greatly reduced. Sometimes the procedure can be performed without any external scar whatsoever.

Dr. O’Connell was one of the first plastic surgeons to utilize the techniques of no touch blepharoplasty. His article in 2000 outlined fat removal via the transconjunctival approach combined with pinch blepharoplasty and erbium laser resurfacing. Dr. O’Connell subsequently published an article in 2002 outlining his technique of transconjunctival fat removal combined with pinch excision and laser resurfacing with a combination of carbon dioxide and erbium. Some would call Dr. O’Connell the father of no touch blepharoplasty.

Today the techniques of no touch blepharoplasty are well accepted and have evolved to include non-invasive options such as fractional resurfacing and radio frequency treatment such as TheriSmooth®. Dr. O’Connell is at the forefront of these advanced techniques and in most cases blepharoplasty is performed in our licensed on-site outpatient surgical facility without need for general anesthesia. When fat removal is not required the procedure can be performed with just local anesthesia.

Our Westport practice, convenient to Greenwich, Fairfield, Darien, New Canaan and other towns in Fairfield County, offers cosmetic eyelid surgery, also known as blepharoplasty, for patients with sagging, loose or puffy skin and wrinkling around the eyes.

No Touch Blepharoplasty FAQs

  • What is a no touch blepharoplasty?

    The term no touch blepharoplasty refers to lower eyelid rejuvenation without disturbing the orbicularis oculi muscle and so-called middle lamella.

  • How is no touch blepharoplasty performed?

    When “bags” are present, the fat responsible for their formation is removed from an internal or transconjunctival approach. Excess wrinkled skin is treated separately with pinch blepharoplasty and/or with laser resurfacing.

  • What are the advantages of no touch blepharoplasty?

    Because the orbicularis muscle and adjacent tissues in the middle lamella are not disturbed, support for the lower eyelid is better maintained. Recovery is quicker, with less disturbance to tear function and a reduced risk of dry eye.

  • What is the no touch blepharoplasty recovery period?

    Recovery time for no touch blepharoplasty is similar to traditional blepharoplasty and will vary slightly depending upon the exact techniques used. No touch blepharoplasty is an outpatient procedure and our patients resume sedentary activities the following day.

  • What is the price of no touch blepharoplasty?

    Pricing for no touch blepharoplasty is usually less than traditional lower lid blepharoplasty when there is no need for fat removal. When bags are treated prices will vary depending upon anesthesia needs.

  • What are the risks of no touch blepharoplasty?

    Like all surgery, no touch blepharoplasty carries risk of complications such as bleeding and infection. A full discussion of all potential risks and alternative treatments is an important part of the preoperative process at The Aesthetic Center.