Abstract: Objective To evaluate the application of lower eyelid blepharoplasty via the transconjunctival approach combined with autologous fat derivative transplantation in mid-face rejuvenation.Methods A total of 96 patients who underwent mid-face rejuvenation in Department of Plastic Surgery, the Affiliated Hospital of Xuzhou Medical University from June 2017 to February 2021 were enrolled. They underwent transconjunctival blepharoplasty. Granular fat with different diameter was obtained by liposuction needles and filled into the tear trough and different areas of the mid-face, according to the manifestations of aging. Patient satisfaction was scored based on the improvement of eye bags, sunken parts of the mid-face, skin color and texture, and overall rejuvenation of the mid-face.Results All the patients showed primary healing in surgical incisions, and there was no report concerning infection, ulceration, and scar hyperplasia. The injection area was slightly swollen after surgery, which subsided spontaneously within one week. There were 3 cases of mild bruising in the sub-zygomatic area, without treatment, which subsided about 10 days after operation. Furthermore, 2 patients had local induration in the sub-zygomatic area, which disappeared after self-heating. There were no complications such as infection, ulceration, and fat liquefaction in the injection area of other patients. During the follow-up visits within 12 months after operation, each evaluation index was >7 points, and the overall rejuvenation of the mid-face was satisfied.Conclusions Lower eyelid blepharoplasty via the transconjunctival approach combined with autologous fat derivative transplantation has little trauma and fast recovery. It can solve multiple mid-face aging manifestations by one operation, with high patient satisfaction.