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At the Midwestern Section meeting of the American Academy of Facial Plastic and Reconstructive Surgery, Cincinnati, Ohio, Steven W. Perkins, MD, Indianapolis, Ind, presented his experience with the transconjunctival approach to lower eyelid blepharoplasty. He recommends the procedure in patients with excessive lower eyelid fat, poor lower eyelid tone, revision blepharoplasty, and patients who object to a lower eyelid scar. Compared to the transcutaneous approach, the transconjunctival approach has resulted in no round-eye deformity, ectropion, or bleeding in the perioperative period. The transconjunctival approach can be combined with a "pinch" technique to remove lower eyelid skin or a simultaneous lower eyelid chemical peel since there is no disruption of the blood supply to the lower eyelid skin.—