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Despite its effectiveness for the facial rejuvenation, blepharoplasty has been associated with several adverse effects. One of the most common side effects of this surgery is eyelid malposition and scleral show which is not suitable from esthetic point of view. Although some techniques have been used for the blepharoplasty of the lower eyelid, the effect of these techniques has not been defi nitely identifi ed in the incidence of scleral show. The present study compared the effects of lower eyelid blepharoplasty with transconjunctival and transcutaneous approaches in the incidence of scleral show in patients. 22 candidates of the lower eyelid blepharoplasty were studied. The patients had no history of systemic disease, previous lower eyelid blepharoplasty, trauma or dry eye syndrome. The patients were randomly assigned in 2 methods of transconjunctival and transcutaneous approaches. The surgeries were perform on 2 eyelids of the left and right sides and in total, 44 eyelids were subjected to blepharoplasty surgery in both sides of the patients in 2 approaches. The incidence of scleral show in both modalities was studied 2, 4 and 6 months post-surgery. In this study, 22 patients were included for eyelid blepharoplasty (44 eyelids). In the transconjuctival approach, 4 males and 7 females with average age of the 57.09 years old were included. For transcutaneous approach, 5 males and 5 females average age of the 56.18 years old were included. According to the results, no scleral was showed using transconjuctival approach after 2 months. Two months after transcutaneous approach only 2 (9%) scleral was observed (P<0.8). No

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