Upper & Lower Eyelid Laser Surgery (Laser Blepharoplasty)

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

• The latest CO2 Laser Technology
• Over 25 years of Laser Eyelid Surgery experience!
• No Scalpel
• Safer
• Faster recovery
• No visible scars with lower eyelids

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 ‘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 get 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 by CO2 laser and there are significant differences between the two techniques that warrant your consideration before you decide on which one to have.

The laser technique holds 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.
• Extra safety due to the reduced 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 virtually eliminates the chances of the following lower eyelid deformities that sometimes occur after scalpel surgery:
  • ‘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 with the laser technique.

Unfortunately, because of the high cost of these lasers only a minority of surgeons have one. If you wish to avail yourself of all 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 Dr Mayson. The laser technique is believed to reduce this risk.	Reportedly 1:40,000 – 1:100,000

How is it 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 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.

In the case of the Upper Eyelids, an incision is made in the natural crease of the upper lid and all excess skin, muscle and fat are removed.  The skin is then sutured with ultra-fine sutures which are removed 5-7 days later.  The final scar of the upper eyelid incision should 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 as soon as the sutures are removed after 7-8 days.

With Lower Eyelids, TWO approaches are possible:

1. The Traditional Scalpel (‘Trans-Cutaneous’) Technique involves making an incision all the way across the skin of the lower eyelid, and down through muscle and the orbital septum in order to reach the protruding fat ‘bag’. Traversing all these layers of tissue naturally leaves a scar in each layer and it is the later contraction of all these scars that can produce the deformities of the lower eyelids described above.
2. In contrast, with the Laser technique, the 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 ‘inside’ and thereby avoids any cutting of the skin, muscle or orbital septum – the subsequent scarring of which tissues 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 easily end up even looser after removal of the fat. Generally, 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.  Dr Mayson will assess this skin elasticity at your initial consultation and advise whether an additional procedure such as Laser Skin Resurfacing or excision of the excess skin should be done at the same time as the Blepharoplasty. In some cases, notwithstanding the aforementioned advantages, the Trans-Cutaneous technique may be the preferred option.

 

CONSUMER AWARENESS GUIDE

HOW TO CHOOSE YOUR BLEPHAROPLASTY SURGEON

Once you have decided on your preferred technique, the next step is to choose where to have it done.  Don’t be afraid or embarrassed to seek straightforward answers to the following important questions:

• • • How long has he/she been doing Blepharoplasty?
    • How many Blepharoplasty procedures has he/she done?
    • If you prefer Blepharoplasty by laser, can they provide this?
    • What complications have they seen?
    • Have they been the subject of any litigation in that procedure?  If so, how many times?
    • Does he/she hold hospital accreditation? Hospital accreditation is an important criterion.  Although Blepharoplasty does not need to be done in a hospital, for a doctor to have hospital accreditation is an indication that the doctor in question has satisfied a Hospital Accreditation Committee as to his surgical skills, training and experience.  And Blepharoplasty is certainly a surgical procedure!

 

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