Transconjunctival Hamra Procedure

Treatment details: Transconjunctival Hamra Procedure

In the Hamra approach the herniated fat is released and moved down over the orbital rim to fill the hollow below it, instead of being cut away. That matters because simple removal can leave the area looking sunken later. Working from inside the eyelid means there is no scar on the skin surface. Because the incision sits inside the lower lid there is no external scar, and the risk of the lid margin pulling downward is lower than with a skin approach. The one and three month photographs show the transition between lid and cheek continuing to smooth out.

The incision is inside the lower lid, so there is no external scar, but the conjunctiva becomes red and can swell into a clear blister that takes days to weeks to settle. Bruising and puffiness around the eyes last one to two weeks. Double vision from swelling of the eye muscles is temporary when it occurs. Undercorrection, residual hollowing, asymmetry, or downward pull of the lower lid can require revision. The contour keeps refining for three to six months.