LASER EYELID SURGERY

M. TAVALLALI, M.D.

A more youthful appearance to the area around the eyes can be achieved by the surgical procedure of blepharoplasty. The eyes are a central part of our faces, and proportionately when we look at each other, we spend more time looking in this area than in any other area of the face.

The aging process affects the eyes in two main ways: its effect on the fat around the eyes, and its effect on the skin of the eyelids. The eyes are surrounded by a protective cushion of fat as they rest within the eye sockets. With age, and sometimes as a result of a genetic predisposition or “family trait”, the tissues under the lower eyelids become weak and allow for the herniation, or protrusion of the fat leading to “bags under the eye”. In fact, this weakness is also seen in the upper lids, and fat can also protrude, usually in the areas closest to the nose. Relief from this condition is achieved by the judicious removal of the fat that has protruded, the tightening of the wall of the eyelid pushing the fat back, or a combination of the two techniques. The procedure can be performed with incisions either inside the eyelid, or on the skin directly under the eyelashes, depending on the quality of the skin of the eyelids.

The affects of time and the environment affect our skin in several ways on a microscopic level as well as the changes that are readily apparent. The skin of the eyelids is the thinnest skin of the body, and shows these changes faster than many other areas. The skin, and underlying muscle, lose elasticity and tend to sag and fold over; wrinkles appear where there were none. These conditions in the upper lids can become so severe as to actually block vision when heavy folds of eyelid skin fall in front of the eye. Although surgical removal of the excess skin will correct the problem of sagging lids, it will not provide a relief from the finer wrinkles that appear around the eyelid area. It is in the eradication of fine wrinkles around the eye, that the advent of laser resurfacing of the skin with a carbon dioxide laser has made a revolutionary change to the operation of blepharoplasty that has been performed for over one hundred years.

The de-focused carbon dioxide laser essentially removes wrinkles from the skin by causing a superficial, controlled burn. As the skin heals over the five to seven days following the procedure, it tightens and so removes the wrinkling. The same technique is used to remove wrinkles from other parts of the face in so called “laser facelifts”. The area that has been lasered will remain red for several weeks but this can be camouflaged with make up within a week. Focusing the laser beam allows it to be used as an incisional instrument, and some claims have been made that surgery performed with the laser in this manner lead to decreased post-operative pain and less bleeding.

After the blepharoplasty operation, some patients may notice that extra folds of skin still exist in the upper lid areas. In these patients the occurrence of such folds usually represents excess brow skin, which like all skin will tend to sag with time. Your surgeon may point out this excess of skin pre-operatively and recommend a brow lift at the same time as the blepharoplasty to ensure the best result.

Irrespective of the techniques that Dr. Tavallali uses to perform blepharoplasty, most procedures can be done as an outpatient in the doctor’s office or surgical center, and often with local anesthesia. Initial recovery time is usually between three to seven days depending on whether a laser resurfacing is done or not, and minimal discomfort is associate with the procedure. It should be noted however that it may take several months for all the swelling to decrease in the region of the eyelids. Other risks inherent in the procedure include bleeding and infection, drying of the eyes, and pulling of the eyelids in a downward direction; these conditions can be treated or improve spontaneously with time.

Eyelid surgery can be very gratifying for the patient and is a useful and rewarding operation in counteracting the effects of the environment and time in this area of the face. Dr. Tavallali will be able to give you more information and address your specific questions should you be contemplating this type of surgery.

Hopefully, this information has given you a better understanding of laser eyelid surgery. Please feel free to call our offices at 703-876-9400 or 301-907-3838 to schedule a complimentary consultation with Dr. Tavallali. We look forward to seeing you soon.

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