laser, eyelid, surgery, sydney, dr mayson, laser, eyes

Upper & Lower Eyelid Laser Surgery (Laser Blepharoplasty)

for upper lid ‘hooding’ & lower lid ‘bags’!

  • Sophisticated CO2 Laser Technology
  • Over 25 years of Laser Eyelid Surgery experience!
  • No Scalpel
  • Faster recovery
  • No visible scars in the case of Lower Eyelids
  • Can be combined with Laser Skin Resurfacing of loose lower eyelid skin if required

In terms of your face, your eyes are your most important asset. When your eyes look bright and youthful, so do you. When your eyes look “tired”, you do as well.

As we age, the eyelids can also develop signs of ageing such as:

  • ‘Hooding‘ on the upper eyelids due to an excess of skin – sometimes in association with a variable degree of muscle laxity and excess fat.  Such ‘heaviness’ of the upper eyelids can be made worse if there is also a degree of brow ptosis (droop). It is important for the surgeon to assess at your initial consultation if you have an element of brow ptosis contributing to your upper lid ‘heaviness’.  If there is, a Brow Lift may be required as well. ‘Hooding’ of the upper eyelids with obliteration of the youthful crease between the eyelid and brow, is what produces the look commonly described by patients as ‘tired- looking’ eyes.
  • ‘Bags’ with or without loose skin on the lower eyelids. These ‘bags’ are actually protrusions of the normal fat in the eye socket around the eyeball. These fatty protrusions, normally held back by the soft tissues, herniate forward when these soft tissues become weaker with age.

These changes most commonly appear from the mid-30’s onwards but they can appear much earlier, even in the mid-20’s. They also tend to run in families with similar appearances often found in siblings and in one or both parents.

Removal of these changes to create a more youthful look is known as Blepharoplasty and it can dramatically improve the appearance of one’s eyes and face.

How we do it differently

Firstly, it is important to realise that Blepharoplasty can be performed either by scalpel or CO2 laser and there are significant differences between the two techniques that warrant your consideration before you decide on which technique to have.

The laser technique offers distinct advantages over the scalpel technique by reason that a CO2 laser seals the tiny blood vessels as it cuts. As a result there is virtually no bleeding during the surgery. This in turn means:

  • Less post-operative bruising and swelling.
  • A quicker recovery and return to work and social activities.
  • Less risk of post-operative bleeding (unchecked post-operative bleeding can cause permanent blindness) and;
  • In the case of lower eyelids, the laser incision can be placed on the inside of the eyelid thereby avoiding any external scar on the skin!
  • This placement of the incision on the inside of the lower eyelid also dramatically lessens the chances of the following lower eyelid deformities that sometimes occur after the scalpel approach through the skin:
    • ‘Rounding’ of the eyelid margin
    • ‘Scleral show’ (too much ‘white of the eye’ showing under the cornea)
    • Ectropion (eversion of the lower eyelid)

Reassuringly, we have never seen any of these complications after the laser approach on the inside of the lower eyelid.

Unfortunately, because of the high cost of these lasers only a minority of surgeons have one. If you wish to avail yourself of the advantages of the laser technique, you need to locate an experienced Blepharoplasty Surgeon with a CO2 Laser.

Dr Mayson originally trained in Laser Blepharoplasty in the USA in 1994 and has used this technique ever since with great success and quicker recovery times for his patients. You may also take comfort in the fact that Dr Mayson has the enviable distinction of never having had a single instance of litigation in any procedure, including Blepharoplasty, over his entire career!

In 1998, Dr Mayson was invited to present before/after segments on a Laser Blepharoplasty patient on Channel Nine’s Midday Show with Kerri-Anne Kennerley.

In summary, the essential differences between the two techniques are:

Laser Technique Scalpel Technique
Post-Operative Bruising & Swelling Minimal More
Recovery Period Upper lids: about 7 days
Lower lids: about 4 days
2-3 weeks is not uncommon
Final Scar Upper lids: same
Lower lids: NO external scar (unless skin is also removed)
Upper lids: same
Lower lids: permanent external scar under the eyelashes
Risk of  Deforming the Lower Lid Negligible Possible
Risk of Blindness from Post-Operative Bleeding into the Eye Socket Never seen by us. The laser technique is believed to significantly reduce this risk. Reportedly 1:40,000 – 1:100,000

How is Laser Blepharoplasty done?

The surgery is performed in the privacy of our Clinic’s Operating Theatre Clinic under a combination of Local Anaesthesia and Sedation administered by our Specialist Anaesthetist. You can go home 1-2 hours after your procedure in the company of a responsible person but you cannot go home alone.  Post-operative discomfort is minimal and easily relieved with simple analgesics such as Panadol or Panadeine.

Upper Eyelids: An incision is made by laser in the natural crease of the upper lid and then all excess skin, muscle and fat are removed.  The skin is then sutured with ultra-fine sutures which are removed 7 days later.  The final scar of the upper eyelid incision should eventually be an inconspicuous, thin white line in the natural crease of the upper eyelid. Owing to the laser’s ability to minimise bruising and swelling, you should be able to return to work and social activities after the sutures are removed 7 days later.

Lower Eyelids: In contrast, with the Trans-cutaneous Scalpel Approach through the skin, the laser incision is made on the INSIDE of the lower lid. This is known as the ‘Trans-Conjunctival’ Approach. Its advantage is that it allows immediate access to the protruding fat bag from the ‘inside’ and thereby avoids any cutting of the skin, muscle or orbital septum – the subsequent scarring of which can cause lower lid deformities. As well as virtually eliminating the risks of the lower lid deformities described above, this internal approach also avoids any external scar on the skin.  No sutures are necessary with this approach as the edges of the incision come together other as soon as surgery is completed and the eyelid returns to its normal position.  If you only have small or medium-sized ‘bags’ of fat, and your lower eyelid skin still has good elasticity without looseness or significant wrinkles, nothing more needs to be done.

If, however, you have:

      • large fatty ‘bags’ with stretched eyelid skin over them; or
      • medium-sized ‘bags’ with reduced skin elasticity; or
      • any size ‘bags’ with excessively loose or wrinkled skin…

… the skin could end up even looser after removal of the fat. Skin has an inherent ability to shrink to a new shape but the older we get, the less able is the skin to shrink.   Whether your skin can do so, and to what degree, cannot be predicted and will basically depend on your skin’s elasticity at the time.  Your doctor will assess the skin’s elasticity at your initial consultation and advise whether Laser Skin Resurfacing or scalpel excision of the excess skin should be added at the same time as the Blepharoplasty to avoid the skin ending up looser. In some cases, notwithstanding the advantages of the Trans-Conjunctival Approach, the Trans-Cutaneous technique by Scalpel may be the recommended option.

 

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

 

Frequently Asked Questions

What are the advantages of Laser over the Scalpel Technique?

The main advantage is that the CO2 Laser is able to cut the skin and deeper tissues without any bleeding. This means minimal to no bruising, less risk of post-operative bleeding, and less swelling – all of which lead to a faster recovery and quicker return to work and social activities.

Why is the Laser better than a Scalpel for Lower Eyelid Bags?

With the scalpel technique, an incision is made right across the lower eyelid skin just under the eyelashes and therefore will always leave a scar. Also, this approach can sometimes cause deformities of shape and position of the lower eyelid. In contrast, the Laser can make a bloodless incision on the inside of the lower lid which avoids any visible scar on the external skin. This internal approach also avoids shape deformities of the lower eyelid sometimes seen after the scalpel technique.

How is it done?

Laser Eyelid Surgery is performed in the privacy of our own Clinic’s Theatre under Local Anaesthesia & Light Sedation administered by our Specialist Anaesthetist. You can go home shortly after but you must have someone collect you.  You cannot go home alone.

What is the average downtime?

Lower lids: 3-4 days

Upper Lids: 7 days

What is the cost?

Upper OR Lower Eyelids: Surgical Fee $3,630, Theatre Fee $1,100, Anaesthetist $990

Total cost: $5,720 incl gst

Before and After photos

Click on Images to Enlarge
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