Laser blepharoplasty is an elective cosmetic surgery procedure performed on the upper and/or lower eyelids to remove sagging skin above the eyes, bags under the eyes, or to create an epicanthic fold on the upper eyelid. It is contrasted to straight blepharoplasty, which uses scalpels instead of lasers to open the lids and gain access to accumulations of fat or other tissue above or below the eyelids. Plastic surgeons are divided on which method they prefer; laser surgery has been performed since 1980, but many physicians still employ the scalpel method. Those undergoing blepharoplasty are advised to have some sense of each type of the procedure before choosing a doctor with a specific preference.
Traditional scalpel blepharoplasty uses scalpels to cut through the lids and remove tissue. This may cause significant puffiness and sight discomfort for three to four days after the procedure. Scarring is minimal, but some plastic surgeons also note that especially on the lower lid, the procedure may produce a “hound dog” appearance in the eyes.
In contrast, laser blepharoplasty tends to minimize scarring and swelling, and recovery time after a procedure is slightly shorter, though physicians may not even agree on which procedure has the least recovery time. The laser can cauterize as it cuts, so bleeding is reduced and the surgical field is more visible. The eyes may have a brighter look than that produced with scalpel blepharoplasty, but this can also depend on the skill of the surgeon.
Not all surgeons stick to one form of this surgery. Some use a laser for blepharoplasty on saggy eyes, but prefer a scalpel for procedures that create an epicanthic fold, if the skin of the eye is still relatively tight. Preference and skill varies from surgeon to surgeon.
Surgery is usually performed on an outpatient basis, and may take one to two hours depending on its extent. Patients are usually given the preference of different types of sedation. They can opt for general anesthesia or moderate or conscious sedation while laser blepharoplasty or the scalpel variety is performed. Many patients like the idea of laser procedures because they may slightly shorten recovery time.
There is still no consensus on which surgery is better initially or over the long term. Physicians often agree that surgical skill is more important than method. A poorly skilled doctor using a laser can cause burning or damage of tissue; so laser blepharoplasty is in no way a guarantee of greater precision. Surgical candidates should also understand that while either method can address sagging skin, neither addresses wrinkling skin. If a patient is attempting to regain a more youthful appearance, he or she may need additional surgical corrections.