Scottsdale – Some seven years ago, when I was faculty in the plastic surgery section at the Louisiana State University Health Sciences Center, I published an article on cosmetic eyelid surgery in the Annals of Plastic Surgery. We called the surgery the TUB technique. The article featured a transconjunctival approach for the removal of excess fat in upper eyelid rejuvenation.  I continue to use this technique even after all this time with good success.

The transconjunctival upper blepharoplasty was a relatively new technique at the time. It is still used today by the authors of the article, including myself. I reserve the procedure who have had blepharoplasty and still retain some fat tissue in the upper eyelid. Many of these patients do not want their surgeon to open up the healed eyelid incision. This operation offers a pathway to the fat pad from the inside – via the conjunctiva of the upper eyelid, avoiding re-operation on the external scar. It is a safe and reliable technique.

A gentle laser or chemical peel can be performed to tighten the skin during the TUB technique. This procedure continues to be an effective method of removing medial upper eyelid fat with minimal risks.