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Transconjunctival lower blepharoplasty has gained interest because of less-invasiveness and fast recovery. This is a study about operative skill, strength, and weakness of transconjunctival lower blepharoplasty and a trial for suggesting the guidelines for patient selection. The authors reviewed the medical records and photographs of 530 patients (M:F=470:60) who underwent transconjunctival lower blepharoplasty with orbital fat reposition and subperiosteal septal reset, retrospectively. Most of the patients were satisfied with results for correction of orbital fat bulging and tear trough deformity. Eighteen patients (3.4%) developed relapse of fat bulging requiring revision with subsequent fat removal (seventeen patients) or fat reposition (one patient). Two patient (0.4%) developed entropion. One case was corrected with revisional surgery and the other case was recovered after an injection of triamcinolone. Delayed hematoma was developed in five patients. Surgical evacuation was required in 3 cases. Minor problems included postoperative swelling, bruise, and transient paresthesia that resolved spontaneously. Transconjunctival lower blepharoplasty is an excellent surgical choice for correction of orbital fat bulging and tear trough in the patients who have proper tension of soft tissue. Invisible scar, fast recovery, and low complication rate are merits of this method. (Archives of Aesthetic Plastic Surgery 17: 83, 2011)