Very effective.
A transconjunctival blepharoplasty typically means that the removal of, or reduction of the three pockets of fat under the eyelid through an incision, a hidden incision that is inside the eyelid. So you see when I turn down the islet, you can see the red mucosa. We go in through there. It's scarless—leaving no visible scars.
And we can help to remove the fat. It's good in that sense, but it cannot shrink the skin. If you’ve got a big eyebag and you’re going to remove the fat, then the skin is loose. It cannot address loose skin on its own. And usually, you will need to do a pinch blepharoplasty.
Some doctors remove the fat in a pinch blepharoplasty, or they have other kinds of energy-based devices to tighten the skin. You can do a CO2 fractional or Fraxel or a carbon dioxide resurfacing for the outer skin to tighten the skin.
A subsidiary blepharoplasty is where we make the incision underneath the eyelash line. With this incision there, you can pinch some skin and trim it off if it's too loose. You can also remove the fat from the front, or do other more complicated things like fat repositioning.
The scar is very subtle and it will disappear. We can hide the scar in the eyelash line. It's not very obvious. So it's a good cosmetic approach. Both of them are very effective, but my opinion is that the subsidiary approach is better because we can just pinch and remove excess skin.
The Agnes procedure is a radiofrequency needle, which we can introduce through the skin to shrink the eye bag and the surface skin. For wrinkle reduction and skin tightening too, but it does this in a much more conservative way, so we sometimes might have to do two or three treatments to get the results we want. For more severe cases we might need to do multiple treatments. But it's very conservative. The improvements are usually incremental and there's no incisions required, obviously, so minimizing the risks of surgery.
