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Laser Blepharoplasty Vs. Surgery

I want to have Blepharoplasty for the upper and lower eyelids. I have 2 choices of technique: by laser or by scalpel. Which one is better and last longer?

Doctor Answers 56

Laser vs. Scalpel for Blepharoplasty

A laser can be used as a cutting tool just like a scalpel. A laser placed in the wrong hands can produce major problems, but in the proper hands can be safely used as a tool in blepharoplasty. Therefore, one is not necessarily better than the other. Lasers seem elegant to the general public and are generally marketing ploys to attract patients for blepharoplasty (and other) surgery. The experience of the surgeon is a more important factor in surgery than the tool employed!

Champaign Plastic Surgeon
4.5 out of 5 stars 24 reviews

Laser Blepharoplasty Vs. Surgery

A good Blepharoplasty can be performed using the laser or scalpel.  There are also other instruments that can be used like an Ellman unit or Colorado needle.  The ultimate goal is to get the best result with the least amount of bleeding and swelling.  The most important factor is your surgeon.  Your surgeon probably has tried multiple techniques and uses the one that gives him the best results with the least complications.  Ultimately, your surgeon needs to make that decision.

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon
4.5 out of 5 stars 16 reviews

Neither is better

The method of making the incisions matters less than the surgeon who makes them.  The results will last the same regardless if it's the laser or scalpel. You should have the surgery performed by the surgeon you feel most comfortable with and have it performed by the method he or she prefers.

Katrinka L. Heher, MD
Boston Oculoplastic Surgeon
5.0 out of 5 stars 5 reviews

Laser vs. Scalpel: It's the Surgeon's Skill That Matters Most

It is rare that either laser or scalpel will have special advantage in Blepharoplasty: this has been studied widely and there is no appreciable difference in quality of results or recovery time, even though there have been claims that seem to indicate otherwise.

The skill (and therefore, the preference) of your surgeon is what matters most in assuring you the best possible results.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.5 out of 5 stars 19 reviews

Laser surgery can heal with faster recovery

I have been using the CO2 laser for eyelid surgery since 1992. It coagulates as it cuts, and so there is definitely less bruising after surgery. Studies have shown less bruising and faster recovery, but an equal outcome after the passage of time. I think doctors who feel that laser surgery is no better than scalpel surgery should not give an opinion if they have not had experience with both modalities. I have done both, and still do scalpel surgery when teaching the residents how to do eyelid surgery at hospitals that do not have a CO2 laser. I would not go back to scalpel surgery unless I had to. I find the surgery much more simple and elegant, with better visualization of what I am doing, and a faster recovery with less bruising. There is essentially NO laser-related complication when the surgeon is used to using this tool.

Jeffrey Schiller, MD
Staten Island Oculoplastic Surgeon
5.0 out of 5 stars 10 reviews

Laser is a tool, just like the scalpel

A laser is simply a surgical tool. It is used to cut skin and coagulate blood vessels. Both can be done with various surgical instruments (scalpel or laser) equally well. It really depends on the type of tools your surgeon prefers to use. I would make your decision about which surgeon to choose based on which one you feel understands your goals and most specializes in this type of surgery. Ask to see before and after photos and speak to friends who have had the procedures, before you make your decision.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
5.0 out of 5 stars 78 reviews

The most important part of the surgery is the surgeon

There are many devices on the market which can be used to assist blepharoplasty. They are all effective and give good results. It is more important to have a good surgeon perform the operation. The instrument your physician feels most comfortable using is the right one in his hands. Good luck. 

Results from "Laser" blepharoplasty is the same as scalpel.

Blepharoplasty has the same reults whether done with laser or scalpel as the "cutting" instrument. The technique your surgeon has the most experirnce with will probably give the best results.

Debra Irizarry, MD
Crestone Plastic Surgeon
5.0 out of 5 stars 3 reviews

No difference between laser and scalpel for blepharoplasty

The idea of using a laser instead of a scalpel for blepharoplasty has been around for at least 15 years, and no real benefits have been convincingly demonstrated with the laser. There are a number of uses for lasers that do justify the additional expense, but this probably isn't one of them.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 36 reviews

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 

Michael Howard Swann, MD
Springfield Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.