A Non-Surgical Approach to Total Eyelid Rejuvenation? Most of you know friends or relatives who have had cosmetic eyelid surgery, know as an “eyelift’, or medically as “blepharoplasty”. While this surgery has been proven safe over the last 30 years, requires little recovery time and often minor sedation/anesthesia, it has some negative issues associated with it. Most commonly, there can be prominent scarring, most noticeable along the lashline of the lower eyelid. For this reason, most savvy surgeons don’t attempt the lower eyelid “lift” at all, and instead simply remove the fat pad below the eye, thereby reducing the undereye “puffiness” but not the “loose skin” of the lower eyelid. For many, especially younger individuals in their late 30’s through early 50’s (depending on genetics) this surgery has never been completely satisfactory. This is because at best, they are left with a physically tight upper eyelid (and a hopefully invisible scar), but sagging lower eyelid. This result can actually look worse in some individuals, who then possess a “wide-eyed” look with therefore more prominent undereye “bagginess”, or sagging. At worst, this surgery can change the entire shape of the eye, causing the aperture, (or width of the visible eye) to narrow, the corners of the eyes to lift unnaturally, or the entire eye to seem unnaturally “wide open”, due to contracture scarring of either the upper or lower eyelids. For these reasons, many of us are more reticent about undergoing cosmetic eye surgery than even full facelifts. We see celebrities who have undergone “eyelifts” who look like completely different people, and we back away from the procedure. I have been telling my patients, for the last 3 years that the CO2 (carbon dioxide) “fractionated” resurfacing lasers will better their technology so that they actually tighten skin. I believe that day is finally here, but mostly for the earliest laxity (sagging) of very light weight eye skin in younger individuals, aged 35-65. Most of the better oculoplastic surgeons are incorporating this laser into their bepharoplasty surgery procedures to improve their results and reduce the possible negative consequences mentioned earlier. The medical literature over the last 12-18 months also reflects the effectiveness of this laser procedure, both with and without accompanying surgery, depending on the specific anatomy of the patient. All of this data has convinced me to introduce the “CO2 fractionated” or “carbon dioxide Fraxel®” laser procedure into my practice in September 2010. Ask me at your next visit (or tell your friends to see me) for my (always) honest and unbiased opinion to see if this newest “laser eyelift” is appropriate for you. If you are in your 30’s -60’s and are starting to become troubled by your increasingly “saggy” eyelids, this procedure may be perfect for you. It will not eliminate the undereye fat pad, but I can determine by examining you if this simple laser treatment can address your eyelid rejuvenation issue, or if you really need blepharoplasty with undereye fat pad removal with a trusted oculoplastic surgeon I can personally recommend. Depending on individual anatomy one may need 1-3 treatments, spaced at least 2-3 months apart. Recovery time is usually 7-10 days, and consists of a marked redness of the eyelids, with only the first 3 days requiring no makeup coverage. Currently, only lighter-skinned patients are the recommended candidates for this procedure, and complete
sun avoidance is recommended 2 weeks prior and 1 month after laser treatments to avoid skin color changes in the treated area. After much research and thought, I have decided not to include my own before and after photos in this email, because of patient privacy issues associated with my practice. Future emails will include my patient before and after photos, as soon as I am able to get consent to show them. Most of the photos from the laser company websites and the current medical literature show individuals who have had either surgery, multiple laser treatments, or other procedures (dermal fillers, etc.) simultaneously with their laser treatments, and so I felt that they did not showcase this laser’s potential when performed as a single treatment. Other out-of-state physician’s websites do show many photos, but I cannot show them here, for obvious copyright reasons. I encourage you to google “Madonna Eyelift” and you will find more photos than you can imagine! (According to the media, Madonna underwent this procedure in the summer of last year.) So if the appearance of your eyelids has been troubling you, ask me at your next visit if the new carbon dioxide Fraxel® is right for you!