Eyelid Surgery: Cost, Photos, Rewiews, Q&A

Laser blepharoplasty or Classical surgery?

Blepheroplasty surgery can be both have great outcomes if done by an experienced surgeon no matters if it is laser or not.

Laser has some benefits like having less trauma during surgery when compared to classical surgery as no scalpel or anything touches the skin and laser has very less bleeding as it controls bleeding during surgery. So this means less trauma and less bruisings; less hematoma risk.

The other is by using laser, we don’t resect the muscle but just tighten it with laser so it also helps having less trauma during surgery; helping recovery much more faster as well.

When we think about removing fat deposits, we cut them with scalpel in classical surgery but by using laser, we vaporize them.

These all mean that technology helps us performing the surgery with less trauma and help our patients to have quicker and easier recovery period.

Other than these, I perform both techniques but I always prefer laser for years as this became a part of our surgeries, comfortable and easy to do.

The best will be to choose your surgeon who needs to be experienced in eyelid surgeries and trust him/her on his/her preference of the technique for you.  (Turker Ozyigit, MD, Turkey Plastic Surgeon)

If a surgeon is planning to use the laser as a knife (for cutting skin in the same fashion as a scalpel), then the only difference between the techniques is the marketing tactic being used. Both the laser and the knife will get the job done.

The longevity of the procedure depends on how the anatomy is re-arranged, and how your skin ages. (So avoid sun exposure and don’t smoke if you want to have it last longer!) Lasers burn the tissue slightly, so they automatically coagulate vessels and this is pushed as a benefit to having “less bruising”. It is more theoretical than practical.

You defiantly see more swelling when a laser is used due to the thermal injury. If the laser is being used for skin resurfacing, then it is a totally different technique that cannot fairly be compared with purely surgical techniques.

Laser resurfacing should be compared with chemical resurfacing (TCA peels), and the differences then come down to the experience of the surgeon with each technique. If you have fine skin wrinkles on the lower lid far away from your eyelash margin, the resurfacing route will likely be superior for you.

If you have corse wrinkles, then the surgical technique will be more effective. Ask your surgeons more questions about their plans. See if the laser proponent is using it as a tool to accomplish a specific task, or a marketing technique to make themselves look more high-tech. (Michael A. Bogdan, MD, FACS, Dallas Plastic Surgeon)

Laser or scalpel blepharoplasty

both techniques can offer excellent results when performed by an experienced surgeon. Pick the surgeon you are most comfortable with and the technique they are most experienced using. When considering eyelid surgery, there are 3 main components that may require to be addressed. Firstly – excess skin and skin laxity can be apparent creating fine lines and wrinkles.

Secondly the muscle town under the skin can be reduced creating the appearance of festoons and lastly the hermiation of fat deep to the muscle can create the appearance of lower eyelid fullness and bags. Patients suffer from these in various degrees, and it is important for the surgeon to assess all 3 components. Both surgical and laser treatments are recognised treatments for eyelid surgery but laser tends to address the superficial layer i.e the skin only. It can create some skin tightness to reduce the fine lines and wrinkles but will not address either the muscle or the fat. With surgery the incision is made under the eye lashes and into the crow’s feet. This allows excess loose skin to be removed and it also provides access to re-drape the fat underneath and tighten the muscle of the lower eyelid, creating a more harmonious outcome and thus reducing the appearance of bags and fullness of the lower eye lid. (Flora Levin, MD FACS, Westport Oculoplastic Surgeon)

Laser can be used to resurface skin, making the surface of the eyelids appear smoother and tighter. This does not address other issues such as fat pockets that cause puffiness or loosening of the deeper structures of the eyelid. Sometimes surgeons utilize a laser to perform the incisions for eyelid surgery, but in my opinion there is little benefit to doing so. In my opinion, eyelid surgery using a scalpel is usually the best technique to give you the results you are seeking. Only surgery can fully restructure the eyelids into a more youthful appearance. (Larry S. Nichter, MD, MS, FACS, Orange County Plastic Surgeon)

Laser has benefits besides cutting.

A carbon dioxide (CO2) laser used in modern blephroplasty can offer several benefits that a scalpel can’t offer. Immediate coagulation of vessels during cutting, which optimizes hemostasis (minimizes bleeding). Pinpoint accuracy in resection of fat without pulling. Pulling and taking fat below the bony orbit can lead to a hollow look, but if the surgeon isn’t aggressive enough in fat reduction, then patients may see a big enough improvement from the blephroplasty. Using laser allows one to resect the fat in it’s natural state without pulling on the fat or surrounding tissues.

Defocusing the laser allows heating of deeper tissues and results in contracture or shrinking of the tissues, which tightens the skin.

Resurfacing the skin after the procedure allows tightening of lower skin laxity that isn’t improved by fat resection alone. It also can smooth out bumps (syringomas, etc) or other textural irregularities such as scars.

I find the best and most natural results are with a supracilliary approach to lower eyelid blephroplasties, which allows beautiful fat resection without any scars on the skin. In additional, using local anesthesia avoids (Jose E. Barrera, MD, FACS, San Antonio Facial Plastic Surgeon)

Laser Blepharoplasty (cosmetic eyelid surgery)

Like many questions in cosmetic surgery, different doctors will give you different opinions. We have used the CO2 laser to perform eyelid surgery for the past 20 years.

We feel that the laser offers many benefits and no disadvantages for the type of surgery you are considering. The real advantage of the laser is that it seals blood vessels during surgery. That fact means that you are less likely to bruise during the surgery. A bruise isn’t a tragedy. However if the eyelid becomes bruised and swollen during surgery it is more difficult for the surgeon to make fine tuned decisions about how much fat to remove.

In other words, the laser allows for more precise decision making by the surgeon. It is important to note that many fine cosmetic surgeons do not use the laser and you can get a great result that way as well. (Marc Cohen, MD, Philadelphia Oculoplastic Surgeon)

For the additional cost to the patient, laser blepharoplasty may not provide any added benefit in the long term. What is important is the experience and skill of your surgereon with either modality. Lasers for other facial rejuvenation (e.g. laser skin resurfacing), can provide a tremendous added benefit and can often be performed at the time of blepharoplasty or other facial surgery. (Malena Amato, MD, Austin Oculoplastic Surgeon)

Lasers when used for blepharoplasty are used exactly the same as a surgical scalpel. If there is any advantage, it will relate to the lack of immediate bleeding only when making the incisions. Remember that there are many ways to gently control the bleeding that occurs regardless of the instrument used. I have experience using the scalpel as well as the laser and personally prefer the “cold” or scalpel technique.

The most critical factor will be finding an experienced surgeon who is knowledgable about your individual needs and performs eyelid surgeries frequently.(Todd Christopher Hobgood, MD, Phoenix Facial Plastic Surgeon)

Laser is simply another way to make incisions and control bleeding. The technique that is used is not as important as your surgeon’s experience with the chosen technique and the success they have had with it.  There is no evidence to suggest that either technique is superior over the other or leads to longer-lasting results. The skill of your surgeon has much more to do with the success of your blepharoplasty. (Angela Sturm, MD, Houston Facial Plastic Surgeon)

While laser and scalpel can both be used and essentially both produce the same end results, its gonna be up to your surgeon on which method he/she prefers and which produces the best results for them. They both last the same amount of time(10-15 yrs). While the laser generally causes less bruising and swelling it does cause more tissue damage than scalpel. All in all the final outcome with either instrument is essentially the same. “Dr.D” (Edward E. Dickerson, IV, MD, Fayetteville Facial Plastic Surgeon)

Both are acceptable if used to cut tissue. The result however, is based on the technique and expeirence of the surgeon. the skill and experience of the doctor is most important. what technique will be used. skin removal, fat removal, repositioning, set back. muscle suspension, canthopexy. this is all more important (Raj S. Ambay, MD, Tampa Plastic Surgeon)

Early in my career, I used the laser technique. Now, I have switched back to the blade because I have found that patients heal faster, with less risk of wound separation.

Both techniques will last for the same period, the differences are in the acute period of wound healing. There is no proven evidence that there is less bruising and swelling with the laser. (Patrick Flaharty, MD, Bonita Springs Oculoplastic Surgeon)

instead of a scalpel, a surgeon can use the carbon dioxide laser to make the incisions. I used to use it a lot in the late 90’s but went back to a scalpel for the upper lid skin incision and cautery or scalpel for the lower lid incision inside the lid. I occasionally use the laser now on the lower lid. Other than a little less bruising, there is no advantage and the wounds take longer to heal. (Stuart H. Bentkover, MD, Boston Facial Plastic Surgeon)

The Laser is just a tool, in this case acting like a cautery. Your surgeon’s skills and experience are what matters most. Laser blepharoplasty is sometimes touted as being superior becasue of people’s perception of Lasers as High-tech devices which provide superior results. Although this perception is sometimes used for marketing purposes, it is not warranted, certainly not in the case of blepharoplasty. In my opinion blepharoplasty with a scalpel is likely to be associated with less swelling following surgery, because Lasers (the CO2 Laser used in the case of blepharoplasty) heat tissues and therefore cause more swelling that takes longer to recover. In the end, the result will depend on your surgeon’s judgement and skills rather than the tool used to cut the skin at the beginning of the procedure. Therefore, your choice of surgeon will be the most important consideration.  (Mark Samaha, MD, Montreal Facial Plastic Surgeon)

Blepharoplasty how to perform the surgery laser vs. knife

There is no advantage in performing a blepharoplasty with a laser. The skin must be cut with either process and the fat removed.

There is little or no tissue damage with a knife while with a laser there is thermal tissue damage. I would advise you to choose your surgeon who has the best reputation and results. (Gary H. Manchester, MD (retired), San Diego Plastic Surgeon)

When looking at blepharoplasty, the surgeon is the most important variable not the equipment used. Lasers can be dangerous, as they cause heat and heat can lead to burns that can distort the eyelids or injure the eyeball. Make sure your surgeon has experience, significant experience, before he/she does your surgery. Sometimes, both techniques can be used together, using the laser to tighten the skin of the lower eyelid instead of removing it. (Julius W. Few, MD, Chicago Plastic Surgeon)

While there may be a difference in some surgeons’ experience, I’m not sure a good study (randomized, double-blinded study) has ever been done to answer this question objectively. I think most agree that the long-term results are the same. The term “laser” is often used as a marketing tool and in some arenas (like skin resurfacing) it has been more than just hype. Be careful as a consumer. (Anand D. Patel, MD, Brookfield Facial Plastic Surgeon)

Less bleeding with laser, but more swelling and takes longer to heal

A laser is just an instrument for performing the same surgery as with a scalpel. It is safer to use a scalpel than a laser light beam. If the laser were to come in contact with the eye it could immediately blind a patient.

The exact same surgery is being performed with a laser versus a scalpel as the laser is only a cutting tool, just like a scalpel. The only advantage is there is less bleeding at the time of the surgery. The disadvantage is that because it is a thermal burn to the skin it takes longer to heal, with more swelling. For many examples of eyelid surgery done in a traditional fashion, please see the link below (William Portuese, MD, Seattle Facial Plastic Surgeon)

Bleph with laser or scalpel

It is not the want but how it is used. Whether one uses a laser to burn or a scalpel to cut, a Blepharoplasty can be performed either way. It really is no big deal, but more likely a marketing tool by the doctor with the laser. (Steven Wallach, MD, New York Plastic Surgeon)

The most important tool in any facial plastic surgey procedure in the surgeon. His or her experience and results will be the deciding factor in your outcome and you don’t want to base your decision on whether someone uses a laser or a scalpel to make the incision. Studies have shown that the results with the same person suturing up both a laser and scalpel incision are the same. (Andrew Miller, MD, Edison Facial Plastic Surgeon)

Laser is hype

The blepharoplasty requires cutting. The blade or the laser will do it equally well. The laser sounds cool and new, so in the end, it is all about the HYPE! (Robert M. Freund, MD, New York Plastic Surgeon)

The simple and short answer is that there is no advantage of using a laser during a blepharoplasty. In fact, heating the tissue can result in thermal damage which would negatively affect scaring. The time test approach of using a scalpel to make the incision is still the standard. (Amir M. Karam, MD, San Diego Facial Plastic Surgeon)

The upper eyelid blepharoplasty is best and almost always done by scalpel. In my office they are done under local anesthesia and take 15 minutes each eye. The lower eyelids however can often best be done by erbium laser especially if the problem is mostly skin and not fat bags. This not only gets rid of the excess skin but smooths out the fine wrinkles nicely.

This approach can be combined with a transconjunctival blepharoplasty to remove the fat. This combined approach of transconjunctival blepharoplasty and erbium skin laser gives the best results of all.and leaves no incision. (Richard Galitz, MD, FACS, Miami Facial Plastic Surgeon)

Personally I prefer a scalpel but essentially these are just to ways of doing the same thing. It is similar to using a nail gun to put a piece of wood together or a hammer. It really matters what the worker is most comfortable with.

The laser theoretically has less bleeding because it burns as it cuts but if the surgeon is comfortable with a scalpel then the results are essentially the same. The surgery should last the same with both techniques. Some surgeons will tighten the orbital septum with a laser during the blepharoplasty and that can increase the length of results. I only do that for a small group of patients though  it is for patients with minimal fat protrusion or displacement. (Benjamin Caughlin, MD, Chicago Facial Plastic Surgeon)

Scalpel or laser makes no difference for blepharoplasty

The laser acts as a cutting tool similar to a cautery or knife. Surgeons will use whatever they are comfortable with as the cutting tool. There is no difference in any as far as outcome. There are other surgical considerations that matter. (Christopher L. Hess, MD, Fairfax Plastic Surgeon)

 Laser or Scapel Blepharoplasty

Just like every powerful tool, the impact comes from the craftsman, not the tool. The laser, like the scalpel is a cutting tool. Studies have shown less bleeding during the procedure, and less swelling the first two days when the laser is used. The ultimate healing and results are the same given that the surgeon is skilled. Bleeding is well controlled with scalpel blepharoplasty. Choose your surgeon based on results, other patients recommendations, and your gut feeling. You want a cosmetic surgeon with the “eye” or aesthetic vision of what looks great, the “hand” or skill to safely and effectively perform the operation, and the “heart” to care about you and the commitment to excellence. Good luck and choose your surgeon most carefully, don’t worry so much about the tool used to get there. (Michael A. Persky, MD, Encino Facial Plastic Surgeon)