Introduction

In the history of medicine, the laser marks a before and after effect due to its precision and minimally invasive nature. Currently, the most advanced eyelid surgery is laser blepharoplasty.

State-of-the-art laser technology to achieve comprehensive eye rejuvenation is now available in the most advanced clinics in the country.

What is laser blepharoplasty?

Laser-assisted blepharoplasty is the most advanced technology to correct excess skin and fat pockets on the eyelids. Laser eyelid surgery is called laser blepharoplasty, or blepharoplasty. The laser used in surgical mode makes the incision of the tissues by vaporizing the tissues with hardly any heating, and there is no thermal damage. It provides a lot of precision in the cut and better control of bleeding. As inflammation and bruising are minimal, in a few days, they can return to regular activity.

Also, the CO2 laser can be applied in fractional mode on the skin of the eyelids and eye contour to perform laser resurfacing, also known as laser blepharoplasty, without surgery. Its objective is the renewal, regeneration, and improvement of skin laxity.

According to a statement, “Laser blepharoplasty has great advantages over traditional surgery. The intervention is minimally invasive, it is performed with greater precision, with more delicate maneuvers, and the control of bleeding during surgery is almost perfect. This makes laser surgery safer and swelling and bruising are minimal in the postoperative period compared to traditional blepharoplasty, with a very comfortable and much faster recovery. In addition, at the end of the eyelid laser surgery, we perform a periocular laser resurfacing to achieve smoother, smoother, shiny skin ”

Who is the candidate?

Blepharoplasty is the solution to both aesthetic and functional needs. Around the eyes, in the so-called periocular area, the skin is fragile so that very soon dark circles, bags, and folds appear on the eyelids, wrinkles, drooping of the eyebrow, etc. These signs translate to tiredness, sadness, and greater aging of the real one. This reduces their self-esteem, affecting the quality of life of these patients for whom cosmetic blepharoplasty is the solution.

The main reason for consultation is usually that for some time, they see in the photos or the mirror a sad and tired look that makes them seem older than they are. It is a blepharoplasty for aesthetic reasons. Although most do it to feel better, it is not done to look more handsome, but to look like ten years before, and with a completely natural appearance.

In other cases, blepharoplasty is functional since excess skin on the upper eyelid or the existence of a drooping eyelid can obstruct vision. A real drooping of the upper eyelid (Ptosis), or the sagging and excess skin of the upper eyelid (pseudo-ptosis), causes the edge of the upper eyelid to cover part of the pupil of the eye, thereby reducing notably the field of view. Blepharoplasty for a functional problem that affects the visual field is covered by insurance companies, although they do not usually pay the extra for laser blepharoplasty.

Patients with Retinal problems or glaucoma do not have a problem performing blepharoplasty. Also, for the patients who have been operated on for cataracts or myopia, or presbyopia. But you have to keep them in mind, and if you are in the hands of an eyelid surgery specialist who is also an ophthalmologist, it will give you more confidence and security.

How do I choose my surgeon?

Before choosing a specialist, the professional’s experience, specialization, and devices should be assessed. When choosing a professional for eyelid surgery, you would probably look for qualities such as:

That is doctor and surgeon.
That he is a specialist in this matter: eyelid surgery.
That you have access to the latest technology, such as lasers.
Better if you are an ophthalmologist than if you are not.

Oculoplasty or ocular plastic surgery is a subspecialty within ophthalmology that deals with all aesthetic or functional problems related to periocular structures.

According to experts, an ophthalmologist must be the one who operates around the eyes. It has many advantages in any procedure, surgical or non-surgical. By having the eye very close, complications can be avoided by choosing a good professional. Specialists in plastic and aesthetic eye surgery who are also ophthalmologists are used to working in this delicate area and know how to treat possible complications such as the dry eye.

What is the first appointment with the surgeon like?

Before laser blepharoplasty, an ophthalmological review is always necessary to determine any ocular pathology and eyelid problems such as ptosis or droopy upper eyelid, eyelid laxity, lowering of the eyebrow, sagging of the lacrimal gland, etc.

Before surgery, a tear production test is essential. This is important because all eye and eyelid surgeries affect tear function. Your surgeon, if he is an ophthalmologist, will treat you before and after surgery for any tear dysfunction known as Dry Eye. They will also be taken into account if you wear glasses or contact lenses, take any medication and have any health problems and allergies.

At this appointment, the specialist will clarify if it would be necessary to operate on the lower and upper eyelids or if it would also be necessary to complement it with some other treatment to achieve better results and achieve a global harmony of the face.

In this same visit, he will also detail how the procedure is performed, the type of anesthesia, the possible risks, the postoperative care, and the price. It will also tell you how to prepare for surgery, what foods to eat, and important information about alcohol, tobacco, and medications. Remember that it is essential to help the healing process, not to smoke at least two weeks before surgery.

Take advantage of this to clarify all your doubts with the surgeon. Besides, they will usually take pictures of you and talk about the expected results.

How it is performed?

Experts tell us how in his clinic performed blepharoplasty surgery Co2 laser step by step.

Before the surgery

All surgery requires good planning. It begins by drawing on the skin of the eyelids, the area of excess skin, and the location of the bags of fat to be removed. Special importance is placed on drawing the incision in the eyelid’s natural crease so that the scar is hidden and disappears completely over time.
Then the anesthesia is applied that will make you not feel pain during the entire surgery. The anesthesia is topical (in droplets on the eye) and local (infiltrating the eyelids, without pain). If the patient has a greater degree of anxiety or in surgeries that take longer, the anesthetist will perform light sedation for the patient’s greater comfort. It is conscious sedation. The patient is not asleep but does not feel pain, and he is relaxed without anxiety.
Before starting, to avoid eye damage from the laser, titanium eye protectors are placed under the eyelids as contact lenses. After disinfecting the area well and preparing the sterile surgical fields, we are ready to begin.

Surgery

First, the blepharoplasty of the upper eyelids ( upper blepharoplasty ) is performed. Excess fat and skin are removed through an incision covered by the natural furrow of the skin, in the fold of the eyelid itself. When necessary, the laser also thins and retracts excess orbicularis muscle without having to resect it as we would do in traditional blepharoplasty. Finally, the incision is closed with very fine stitches so that the scar is not noticeable.
In the lower eyelids (lower blepharoplasty), the incision is made inside the eyelid, thus avoiding the external scar and giving stitches. This is not a problem for a surgeon who is an ophthalmologist. They are located, and excess fat is repositioned or eliminated. Fat bags have many blood vessels, which is where the laser plays its fundamental role. It steams the tissue, and the surgery is cleaner, with minimal bleeding and maximum precision. The maneuvers are more delicate and allow to act on issues that are difficult to access.
Lower and upper blepharoplasty can be performed separately or combined with other surgical techniques to correct other problems such as ptosis or droopy upper eyelid, eyelid laxity, and lower eyebrow, sagging of the lacrimal gland, etc.
At the end of the surgery, Resurfacing is performed: We change the surgical terminal of the CO2 laser for a laser handpiece with a scanner to pixelate the skin of the eyelids and eye contour.
The stitches in the upper eyelid are removed after seven days. In the lower eyelid, when making the incision inside the eyelid, there are no stitches.

Resurfacing

Resurfacing is a regeneration technique, renewal, and treatment of skin laxity after applying laser, nonsurgical fractional mode. At the end of the surgery, we change the surgical terminal of the CO2 laser for a laser handpiece with a scanner that makes a laser pixelation of the skin of the eyelids and the contour of the eyes using multiple impacts of laser light.

The laser resurfacing numerous brings advantages. According to a statement, for patients who have more marked bags in the lower eyelids, with the traditional blepharoplasty, remove the fat, an excess of skin remains that requires its removal through another incision in the external area of the lower eyelid (Canthopexy). On many occasions, this produces a very unnatural stretching or lifting effect on the look. Laser resurfacing avoids having to perform this surgery. The skin is retracted, improving the small excesses of skin and folds of the eyelids and the small wrinkles. The renewal of the superficial layers makes the skin smoother, smoother, and more luminous.

Non-surgical techniques combined with laser blepharoplasty

Ideally, put yourself in the hands of professionals who have the more “tools,” the better. Only clinics that have all the techniques, surgical and non-surgical, will be able to offer you the best solution for your particular case, and many times they are associated.

Botulinum toxin, hyaluronic, growth factors, or the fat itself, etc.: They are used to correct frown lines and crow’s feet, as well as furrows and dark circles that blepharoplasty surgery does not correct, neither traditional nor laser. They can be associated with surgery to improve the overall result.
Laser resurfacing. It is a laser blepharoplasty technique without surgery that we can do independently or combine with surgery. Its objective is the regeneration, renewal, and treatment of skin laxity.

At the end of the surgery, the surgical terminal of the CO2 laser is exchanged for a laser handpiece with a scanner in laser blepharoplasty. Various impacts of laser light are emitted to generate thermal columns that enter different depths of the skin. In this way, the skin is pixelated with an infinity of tiny points where the aging skin vaporizes. Still, they are surrounded by surrounding intact tissue for rapid recovery and renewal of the most superficial layers of the skin. Simultaneously, due to the sub-thermal effect of the laser, which does not burn the tissue, the production of elastin and collagen in the deeper layers is stimulated. The result is smoother and brighter skin, and small wrinkles and excess skin are corrected.

Periocular laser resurfacing is applied to the eyelids and eye contour, but we can extend it to other facial areas.

Benefits of laser blepharoplasty

The oculoplastic surgeon dedicated to the eyelids in cosmetic surgery, and laser surgery expert, considers it vitally important to rely on the latest technological advances. “The advantages of CO2 laser blepharoplasty over traditional scalpel and electric scalpel surgery are very clear.”

Laser surgery is safer since it is a minimally invasive surgery, with maximum precision, and minimum bleeding.
Recovery is more comfortable and faster since the inflammation is less, there are hardly any bruises, and in a few days, they can return to regular activity.
The Resurfacing laser complements and improves the final result. That rejuvenates the skin of the eye area, smoother, smooth skin and light are achieved, and the skin is retracted and prevented external incision of the lower eyelid.
The result is a comprehensive and more natural rejuvenation of the look.

How is the recovery?

The surgery is ambulatory so that the patient returns home immediately after the intervention. However, they will remain in the clinic for about 30-60 min with their eyes closed, applying cold using ice-cold gels and a compression bandage to reduce inflammation. Then he returns home with his eyes uncovered but wearing sunglasses that we give out at our clinic.

In CO2 laser eyelid surgery, there is little or no swelling and bruising, or minimal, compared to traditional blepharoplasty. Recovery is very comfortable, painless, with minimal discomfort, and with slight swelling that disappears after two or three days. At first, the patient is likely to see a little blurry from the ointment that is applied.

Recovery is speedy, and after 48 hours, you can read, watch television, or even telework. You can usually return to your regular job after a long weekend or a week after the procedure.

It is important to follow the medical indications, and after the Blepharolaser surgery plus Resurfacing, they recommend the following guideline:

Antibiotics and anti-inflammatories are prescribed. Some pain relievers may be necessary on the first day, but generally, there is no pain. You may notice slight discomfort due to swelling of the eyelids.
On the first day, it is recommended to sleep with your head raised to reduce inflammation.
Apply cold on the eyelids to reduce inflammation in the first days.
Relative rest of 24 hours. Do not make intense physical efforts and keep your head elevated during the first week.
Don’t rub your eyes.
Do not use contact lenses for the first two weeks.
On the first day, the periocular resurfacing area shows redness, which can be camouflaged with sunglasses to go outside. Makeup can be used from the 10th day.
The stitches in the upper eyelid are removed after seven days. In the lower eyelid, when making the incision in the inner part of the eyelid, you do not need stitches.
Avoid sun exposure for the first three months. Protect yourself from the sun with suitable glasses, and use 50 moisturizers and sunscreen for 3-6 months.

Will I have to take sick leave?

The period of sick leave is variable. Incorporation into everyday life will always depend on the type of work and the individual response of each patient regarding the degree of swelling and bruising they have. The disability of a traditional blepharoplasty is between 7 and 15 days, depending on the intensity of the bruises. But in CO2 laser eyelid surgery, there is little or no swelling and bruising, or minimal, compared to traditional blepharoplasty.

According to experts, patients who undergo blepharoplasty surgery on a Wednesday go to work the following Monday. At 24-48 hours, you can read, and even telecommute. The period of disability is concise, and you can return to routine activity after about 4-7 days.

Low-performance sports activities can be carried out one week after the intervention, and routine activities 15 days later.

Are there any complications or side effects?

In general, a blepharoplasty can be performed from the age of 35, although sometimes, it can also be performed in younger patients due to genetic issues. Candidates for blepharoplasty are people in good physical and psychological health.

It is important to tell your surgeon if you have a disease such as high blood pressure, vascular disease, diabetes, and allergies.

Before blepharoplasty, an ophthalmological review will be necessary to determine any associated pathology. It is essential to rule out other eyelid problems before undergoing eyelid surgery, such as ptosis or droopy upper eyelid, eyelid laxity, lowering of the eyebrow, sagging of the lacrimal gland, etc. The dreaded incomplete eyelid closures occur when more skin is removed than due, and most complications from blepharoplasty, are easily avoidable by an ophthalmologist who specializes in eyelid surgery.

It may be contraindicated in patients suffering from severe dry eyes, as it could aggravate the problem. If he is an ophthalmologist, your surgeon will know better than anyone how to avoid or treat this problem.

What are the results of laser blepharoplasty?

With laser blepharoplasty, a clearer, more open, and rejuvenated look is achieved. The results are not immediate, and they are best appreciated once the inflammation resolves. Patience is key. Thanks to the laser, there is almost no inflammation left when it comes to removing the stitches, but a large part of the definitive recovery occurs after several weeks.

In most patients, a good result can already be seen within a month. In any case, the result will be better with each passing month, and it can be definitive after six months.

The results are very long-lasting and permanent in most cases, but blepharoplasty cannot stop natural aging.

Frequent questions

In most patients, a good result can already be seen within a month. In any case, the result will be better with each passing month, and it can be definitive after six months.

The results are very long-lasting and permanent in most cases, but blepharoplasty cannot stop natural aging.