AimThe aim of this study is to evaluate the safety, effectiveness and aesthetic results of transconjunctival lower eyelid blepharoplasty associated with skin excision using the Pinch Technique.Materials and Methods58 patients (45 female and 13 male) aged between 32 and 76 showing the following were selected: prominent eyelid fat pads, anterior lamella laxity and normal eyelid tone; all expressed a desire not to change the shape of their eyes. In all patients the position of the lower eyelid in respect to the limbus in the primary position, in up and low gaze, was evaluated. Lower transconjuctival eyelid blepharoplasty associated with skin excision was performed on all patients using the technique described by Rosenfeld.ResultsIn all patients a satisfactory reduction of fat pads and an improvement in skin laxity were achieved; results met patients’ expectations. There were no cases of eyelid retraction either imediately postoperatively or in later follow-ups.DiscussionTransconjunctival lower eyelid blepharoplasty has gained in popularity among opthalmoplastic surgeons over the past decade principally because it results in natural appearance and the absence of eyelid retraction. This technique was initially combined with chemical peeling and later with laser resurfacing techniques to achieve an improvement in the skin. These techniques, however, led to complications such as persistent erithema and hyperpigmentation. In our experience, the technique, recently described by Rosenfeld, of associating transconjunctival blepharoplasty with skin excision, makes it possible to correct eyelid fat pads and reshape skin effectively and without complications since it leaves the middle lamella untouched.