Laser Blepharoplasty

The surgical correction of excess fullness or bagginess of the upper eyelid, or of 'bags' beneath the eye

As we age, the delicate skin of the eyelid loses its elasticity and may hang down in a fold, giving a hooded look to the eyes. In the most extreme cases, the sagging skin rests on the eyelashes and partially obscures peripheral vision. In the lower eyelid, the pocket of fat that normally sits behind the eye protrudes forward through a weakened septum, causing the "bags" under the eyes. This is commonly an inherited tendency and may cause an appearance of perpetual tiredness. The upper and lower eyelids may be affected separately or together, but the lower lids are frequently worse.

The procedure

Upper Eyelids

An incision is made in the natural crease of the upper eyelid. Excess skin and protruding fat are removed, and the skin edges are closed with fine, dissolving stitches. A very fine scar results, which fades with time and is hidden in the eyelid crease.

Lower Eyelids

The technique for the lower eyelids is different for scalpel and laser. The scalpel method involves an incision along the lower eyelid margin, then excess skin and fat are removed, and the skin edges are closed with fine stitches. This sometimes drags down the lower eyelid and produces an unusual appearance. Laser blepharoplasty of the lower eyelid has the advantage of having no skin incisions or stitches. Excess fat is removed through the inside surface of the lower eyelid. Wrinkles or crow's feet beneath the eye may be removed very effectively by resurfacing this area with the laser. The deepest expression lines at the sides of the eyes may be softened but not totally removed by this method.

Blepharoplasty procedures are performed in a day surgery or small hospital under a light general anaesthetic. You may go home following the procedure accompanied by a friend, but you are often advised to stay overnight in hospital. You should not drive on the day of the surgery.

The use of lasers for eyelid surgery

A laser is a very powerful light beam that is able to be used as a precise cutting tool or to remove fine layers of tissue. Used in blepharoplasty procedures, its advantages over the scalpel technique are that:

• it leaves no visible scar on the lower eyelid;
• no ectropion (dragging down of the eyelid) occurs, which is common with other methods;
• there is virtually no bleeding with the laser, and therefore minimal bruising or swelling;
• a shorter recovery time is required, allowing for an early return to work and social commitments.

The healing process

Normal activities may usually be recommenced two-three days following the lower eyelid procedure and eye make-up may be worn after this time. Stitches in the upper eyelid either dissolve or are removed by 7 days, and one or two weeks off work may be required.