※電話受付時間:月~水・金・土 10:00~19:00

cosmetics surgery blog






2. 目の下のクマ(くま)は、目の下の色素を強調する下眼瞼皮膚の下垂を引き起こす解剖学的構造の不具合が原因であり、その治療は”脱脂”のみならず、下眼瞼皮膚を挙上させるべく、下眼瞼構造の改変が必要である。
3. 目の下のクマ(くま)は、下眼瞼皮膚の下垂や過剰脂肪の存在だけではなく、皮膚自体の色素沈着が原因となる場合もある。
4. 従来まで中高年層以降や症状の強い症例目の下のたるみ症例は、皮膚切開を用いた下眼瞼形成術でなければ改善しないとされていた。だが、皮膚切開を用いない経結膜的下眼瞼形成術で、こういった症例でも十分良好な結果がえられることがわかった。
5.経結膜的下眼瞼形成術に伴う合併症について調べたところ、下眼瞼の凹み、しわの発生率はそれぞれ5%, 8%だった。しかし、そのほとんどが一時的な症状であり、治療後3ヶ月以内に自然治癒した。
8.今回検証した経結膜的下眼瞼形成術はもちろんのこと、美容外科手術は緊急性を要しない、いわゆる”elective surgery(随意意志による手術)”なので、 安全性を最優先にした 後遺症が生じない手術を第一選択とすべきである。


Treatment Result of Lower eyelid Blepharoplasty Using Conjunctival Approach

Takayuki Kubo M.D Ph.D

Ginza Cuvo Clinic

In our country, surgical treatment for lower eyelid symptoms such as eye bag or darkness of skin color was carried out using skin incision method. The main reason why skin incision approach was commonly utilized is that we believed lower eyelid symptoms were derived from skin condition itself rather than defective anatomical structure of lower eyelid.In addition to that, the fact that skin incision approach is easier than conjunctival one has also made skin incision approach more popular in this treatment. However, most patients are reluctant to undergo skin incision approach because they are afraid of suffering side effect such as residual scar or ectropion. Since aesthetic surgery is so-called elective surgery, which is far different from  imminent surgery for life-saving, sequelae related to aesthetic surgery  has to be avoided absolutely.In our clinic, we essentially utilized conjunctival approach for lower eyelid blepharoplasty and succeeded in obtaining good results in most cases. As this approach is recognized as a good method, customers began to visit to our clinic from all over Japan. We will manifest the effectiveness of the lower eyelid blepharoplasty with conjunctival approach by analyzing the results accumulated in my clinic.

Therefore, we developed new procedure based on transconjunctival lower blepharoplasty to resolve those symptoms. 1044 patient(female 936, male 108 average age 41.2 year old, Range19-75, SD 9.88) underwent this procedure during one year(from 2007/4/1 until 2008/3/31). 200 patients were followed up after the surgery and subjective satisfaction rate was evaluated. The data showed that 28% was excellent, 56% was good, 13% was fair, 3% was poor. Majority of the satisfied patients said that they felt very happy being free from an inferiority complex incurred by lower eyelid symptoms. 

Until now, it was believed that conventional incisional blepharoplasty was the only one method to improve relatively older generation with server symptom. However, modified transconjunctival lower blepharoplasty was proved to have satisfactory result for sever cases. In addition to that, not only lower eyelid symptoms, but also upper eyelid symptoms such as sunken eyes or blepharoptosis were also improved.


  1. 三宅伊豫子,平賀義雄.美容外科に必要な眼瞼の解剖.形成外科 1995;38: S65-71.
  2. 仁木裕.市田正成,谷野隆三郎,保阪善昭.美容外科手術プラクティス.東京:文光堂,2000:72-74.
  3. 久保田潤一郎. 若返り美容医療の実際.東京:永井書店,2004:214−223.
  4. Netscher, DT, Patrinely, JR. Transconjunctival versus transcutaneous lower eyelid blepharoplasty. Plast REconstr Surg 1995; 96:1053-1060.
  5. Tomlinson.F.B., Hovey,L.M. Transconjunctival lower lid blepharoplasty for removal of fat.Plast Reconstr Surg 1975; 56:314-318.
  6. 谷野隆三郎.美容外科診療における医療安全と医事法制(I).日美外会誌 2008;45: 281-290.
  7. Zarem, HA, Resnick, JI. Operative technique for transconjunctival lowerblepharoplasty. Clin Plast Surg 1992;19: 351-356.
  8. Loeb,R. Fat pad sliding and fat grafting for leveling lid depressions. Clin Plast Surg 1981; 8(4):757-776.
  9. Fagien S. Discussion: Traditional lower blepharoplasty: is additional support necessary? A 30-year review. Plast Reconstr Surg. 2011;128(1):274-277.
  10. Trelles, M.A., Baker, S.S., Ting,J., et al. Carbon dioxide laser transconjunctival lower lid blepharoplasty complications.Ann PlastSurg 1996;37:465-468.
  11. Mack WP.Complications in periocular rejuvenation. Facial Plast Surg Clin North Am. 2010;18(3):435-456.
  12. Massry GG. Comprehensive lower eyelid rejuvenation. Facial Plast Surg. 2010;26(3):209-221.
  13. Han K, Choi T, Son D.Skin color of Koreans: statistical evaluation of affecting factors.Skin Res Technol. 2006;12(3):170-177.
  14. Martires KJ, Fu P, Polster AM, Cooper KD, Baron ED. Factors that affect skin aging: a cohort-based survey on twins. Arch Dermatol. 2009;145(12):1375-1379.
  15. Momosawa A, Kurita M, Ozaki M, et al.Combined therapy using Q-switched ruby laser and bleaching treatment with tretinoin and hydroquinone for periorbital skin hyperpigmentation in Asians.Plast Reconstr Surg. 2008;121(1):282-288.





〒104-0061 東京都中央区銀座1-16-1 東貨ビル1階

山手線 有楽町 中央口 徒歩10分

銀座線 京橋 1番出口 徒歩3分

有楽町線 銀座一丁目 11番出口 徒歩3分

都営浅草線 宝町 A3出口 徒歩2分