I am turning 50 next month and want to have an undereye procedure to remove the bags under my eyes. I've seen two plastic surgeons. One suggested laser blepharoplasty and the other an under eye incision. I'm confused now. Is laser blepharoplasty better than undereye surgery? I would appreciate any suggestions or clarification regarding these two procedures.
Answer: Happy Birthday! There are many ways to treat undereye bags Hello, you look great. The best "plastic surgery" is smiling, and your smile makes you look very young. Now as far as your under eye area - it is difficult to advise you based on this picture alone. If you have minimal fat under your eyes then a fractionated carbon dioxide laser such as Fraxel re:pair gives great results alone. If you have excessive skin, then it can be combined with a skin "pinch" excision. If you have a lot of fat protrusion then a transconjunctival approach (from inside your lower eyelid) incision is best to remove or in some cases reposition the fat. If there is hollowness under the eye that is creating the "bag", then carefully placed filler such as Restylane (temporary), or your own fat (permanent) can smooth out the bag and give you a youthful lower eyelid and cheek. "Laser" blepharoplasty can mean different things. When used as a cutting tool, laser blepharoplasty is not much different from "scalpel" blepharoplasty, other than using the laser as a scalpel. The laser can be used to make the transconjunctival incision or to make the lower eyelid incision. With the laser incisions there is initially less swelling and bruising, but by the second to third day, the healing, swelling and bruising is the same as scalpel incisions. Again, with the old traditional CO2 lasers and the new Fractionated CO2 lasers, laser resurfacing of the crepe skin of the lower eyelid gives great smoothing of the skin without any incisions in the skin. I began this answer by trying to make matters less confusing for you, but have likely made you more confused than ever. The most important thing that you can do is choose your surgeon most carefully and be sure that your expectations meet your surgeon’s expectations and ability. Be well and keep showing your beautiful smile. Dr. P
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CONTACT NOW Answer: Happy Birthday! There are many ways to treat undereye bags Hello, you look great. The best "plastic surgery" is smiling, and your smile makes you look very young. Now as far as your under eye area - it is difficult to advise you based on this picture alone. If you have minimal fat under your eyes then a fractionated carbon dioxide laser such as Fraxel re:pair gives great results alone. If you have excessive skin, then it can be combined with a skin "pinch" excision. If you have a lot of fat protrusion then a transconjunctival approach (from inside your lower eyelid) incision is best to remove or in some cases reposition the fat. If there is hollowness under the eye that is creating the "bag", then carefully placed filler such as Restylane (temporary), or your own fat (permanent) can smooth out the bag and give you a youthful lower eyelid and cheek. "Laser" blepharoplasty can mean different things. When used as a cutting tool, laser blepharoplasty is not much different from "scalpel" blepharoplasty, other than using the laser as a scalpel. The laser can be used to make the transconjunctival incision or to make the lower eyelid incision. With the laser incisions there is initially less swelling and bruising, but by the second to third day, the healing, swelling and bruising is the same as scalpel incisions. Again, with the old traditional CO2 lasers and the new Fractionated CO2 lasers, laser resurfacing of the crepe skin of the lower eyelid gives great smoothing of the skin without any incisions in the skin. I began this answer by trying to make matters less confusing for you, but have likely made you more confused than ever. The most important thing that you can do is choose your surgeon most carefully and be sure that your expectations meet your surgeon’s expectations and ability. Be well and keep showing your beautiful smile. Dr. P
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CONTACT NOW Answer: Traditional vs Laser Blepharoplasty Excellent question! I think unfortunately we as doctors often use confusing terminology which can make things more difficult to understand for our patients. It is unclear exactly what your surgeon meant by "laser blepharoplasty" because this could mean 1) they are using a laser to tighten the skin and not actually performing a blepharoplasty or 2) a blepharoplasty in addition to a laser tightening device or 3) using a laser to make the incision for the blepharoplasty. All of these are options, though I would not say any one of them is "better" than tradiational blepharoplasty. The second surgeon is referring to where the incision is placed during surgery which can be 1) under the eyelashes or 2) inside the eyelid. Both of these are good options based on your anatomy and alot of it is based on surgeon's preference. In general, if there is ever confusion of what exactly is being done during surgery, I would make sure you bring this to the attention of your surgeon. If they continue to give confusing answers or you don't feel comfortable, I would seek another surgeon. Hope this helps!Kyle Kimura, MDFacial Plastic and Reconstructive Surgery
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CONTACT NOW Answer: Traditional vs Laser Blepharoplasty Excellent question! I think unfortunately we as doctors often use confusing terminology which can make things more difficult to understand for our patients. It is unclear exactly what your surgeon meant by "laser blepharoplasty" because this could mean 1) they are using a laser to tighten the skin and not actually performing a blepharoplasty or 2) a blepharoplasty in addition to a laser tightening device or 3) using a laser to make the incision for the blepharoplasty. All of these are options, though I would not say any one of them is "better" than tradiational blepharoplasty. The second surgeon is referring to where the incision is placed during surgery which can be 1) under the eyelashes or 2) inside the eyelid. Both of these are good options based on your anatomy and alot of it is based on surgeon's preference. In general, if there is ever confusion of what exactly is being done during surgery, I would make sure you bring this to the attention of your surgeon. If they continue to give confusing answers or you don't feel comfortable, I would seek another surgeon. Hope this helps!Kyle Kimura, MDFacial Plastic and Reconstructive Surgery
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April 2, 2020
Answer: Lower Eyelid Blepharoplasty Hi Friends, Lower Eyelid Blepharoplasty (regardless of technique) aims to primarily address bulging fat with dark circles and excess skin of the lower eyelid. When performed correctly, it also smoothens the transition from the eyelid to the face. There is no noninvasive procedure to date like BOTOX, fillers, peels, ultrasound, radiofrequency, etc that can markedly, reliably and safely improve the lower eyelid appearance. So what do terms like CO2, Laser, Pinch, etc signify? Some of these terms represent a brand name, or tout "technology" or fantastic results. Be skeptical! There seems to be a lot of deceptive advertising or just coined terms by plastic surgeons but all of these are just slight modifications of the traditional blepharoplasty. Ultimately, if you are thinking seriously about a lower eyelid blepharoplasty, please seek the advice of a well-trained plastic surgeon.
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Answer: Lower Eyelid Blepharoplasty Hi Friends, Lower Eyelid Blepharoplasty (regardless of technique) aims to primarily address bulging fat with dark circles and excess skin of the lower eyelid. When performed correctly, it also smoothens the transition from the eyelid to the face. There is no noninvasive procedure to date like BOTOX, fillers, peels, ultrasound, radiofrequency, etc that can markedly, reliably and safely improve the lower eyelid appearance. So what do terms like CO2, Laser, Pinch, etc signify? Some of these terms represent a brand name, or tout "technology" or fantastic results. Be skeptical! There seems to be a lot of deceptive advertising or just coined terms by plastic surgeons but all of these are just slight modifications of the traditional blepharoplasty. Ultimately, if you are thinking seriously about a lower eyelid blepharoplasty, please seek the advice of a well-trained plastic surgeon.
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December 13, 2019
Answer: Happy Birthday! Hi and Happy Birthday! Like most techniques, there are many options depending on the clinical presentation and plastic surgeons’s preference. Lower eye lid surgery is one of the most common anti-aging procedures we perform. There are usually 3 aspects of the lower eyelid that we address: “eye bags” which is herniation or orbital fat, wrinkles which is caused by excess skin, and lower eyelid margin laxity. There are 3 fat compartments in our lower eyelid. Depending on patients, we either remove them or transfer some of the fat to fill in the hollow aspect just underneath the fat protrusion which we call tear trough region. This can be accomplished from either “inside”(through inicision in the inner mucosal lining of the lower lid) or “outside “(through an incision on the skin just below the lower eyelashes). The skin can be addressed by either cutting out the extra redundant skin or resurfaced through ablative laser or chemical peel. This is really dependent on the patient’s clinical state. In most aging patients who we excise skin, they will benefit from some form of reinforcement of the lower eyelid margin which we call either canthopexy or canthoplasty. Some surgeons use lasers not just to resurface skin but also as a tool for incision instead of knife. I think most plastic surgeons believe that knife is same or superior to lasers as a cutting instrument in terms of skin trauma and subsequent scar formation. I hope this helped.
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CONTACT NOW December 13, 2019
Answer: Happy Birthday! Hi and Happy Birthday! Like most techniques, there are many options depending on the clinical presentation and plastic surgeons’s preference. Lower eye lid surgery is one of the most common anti-aging procedures we perform. There are usually 3 aspects of the lower eyelid that we address: “eye bags” which is herniation or orbital fat, wrinkles which is caused by excess skin, and lower eyelid margin laxity. There are 3 fat compartments in our lower eyelid. Depending on patients, we either remove them or transfer some of the fat to fill in the hollow aspect just underneath the fat protrusion which we call tear trough region. This can be accomplished from either “inside”(through inicision in the inner mucosal lining of the lower lid) or “outside “(through an incision on the skin just below the lower eyelashes). The skin can be addressed by either cutting out the extra redundant skin or resurfaced through ablative laser or chemical peel. This is really dependent on the patient’s clinical state. In most aging patients who we excise skin, they will benefit from some form of reinforcement of the lower eyelid margin which we call either canthopexy or canthoplasty. Some surgeons use lasers not just to resurface skin but also as a tool for incision instead of knife. I think most plastic surgeons believe that knife is same or superior to lasers as a cutting instrument in terms of skin trauma and subsequent scar formation. I hope this helped.
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September 25, 2018
Answer: Laser Blepharoplasty vs Traditional Blepharoplasty Thank you for your question and I think many patients can be confused by the terminology here. First of all, "laser blepharoplasty" can mean different things depending on how one intends on using the laser. Lasers can be used in two main ways for lower eyelid rejuvenation. It can be used for skin resurfacing (erbium or CO2) for fine lines and improving texture, or it can be used to make an incision in the skin (typically CO2) just like a scalpel would make an incision to initiate the surgical approach in a blepharoplasty. Therefore, if the surgeon is simply referring to how the incision is made, there is really no difference in outcomes or results if this incision is made with a laser or a scalpel. Most surgeons prefer a scalpel (including me) but that doesn't mean one is necessarily better than the other. What's more important is the skill and experience of the surgeon using the technique that works best for him or her. For under eye bags, this is usually due to excessive fat in the lower eyelid, or sometimes areas of volume loss that accentuates fat pockets or depressions in the skin giving the appearance of bags. When this is the case, laser resurfacing will not be beneficial. It takes surgical intervention to remove and/or reposition the fat or filler (or autologous fat) injected into areas of hollowing to address changes or issues with volume. Laser resurfacing is performed to improve the texture and quality of the lower eyelid skin. This is very different from and would not be considered a blepharoplasty. If someone is marketing the use of laser to reduce fine lines and improve the texture of lower eyelid skin and calling it a "laser blepharoplasty", I would consider this terminology misleading and inaccurate. It's not a bad procedure, but if you have true under eye bags from fat pockets, laser will not help with this. Sometimes bags can be caused by excessive sagging skin, or at least be a major component of it. When this is the case, skin will typically have to be surgically removed and laser will not be adequate to achieve these results. When this is the case I like to combine laser to improve skin quality and surgical excision to address the extra skin. I hope this is helpful for you and others who might be confused by this language. Good luck!
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CONTACT NOW September 25, 2018
Answer: Laser Blepharoplasty vs Traditional Blepharoplasty Thank you for your question and I think many patients can be confused by the terminology here. First of all, "laser blepharoplasty" can mean different things depending on how one intends on using the laser. Lasers can be used in two main ways for lower eyelid rejuvenation. It can be used for skin resurfacing (erbium or CO2) for fine lines and improving texture, or it can be used to make an incision in the skin (typically CO2) just like a scalpel would make an incision to initiate the surgical approach in a blepharoplasty. Therefore, if the surgeon is simply referring to how the incision is made, there is really no difference in outcomes or results if this incision is made with a laser or a scalpel. Most surgeons prefer a scalpel (including me) but that doesn't mean one is necessarily better than the other. What's more important is the skill and experience of the surgeon using the technique that works best for him or her. For under eye bags, this is usually due to excessive fat in the lower eyelid, or sometimes areas of volume loss that accentuates fat pockets or depressions in the skin giving the appearance of bags. When this is the case, laser resurfacing will not be beneficial. It takes surgical intervention to remove and/or reposition the fat or filler (or autologous fat) injected into areas of hollowing to address changes or issues with volume. Laser resurfacing is performed to improve the texture and quality of the lower eyelid skin. This is very different from and would not be considered a blepharoplasty. If someone is marketing the use of laser to reduce fine lines and improve the texture of lower eyelid skin and calling it a "laser blepharoplasty", I would consider this terminology misleading and inaccurate. It's not a bad procedure, but if you have true under eye bags from fat pockets, laser will not help with this. Sometimes bags can be caused by excessive sagging skin, or at least be a major component of it. When this is the case, skin will typically have to be surgically removed and laser will not be adequate to achieve these results. When this is the case I like to combine laser to improve skin quality and surgical excision to address the extra skin. I hope this is helpful for you and others who might be confused by this language. Good luck!
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July 12, 2018
Answer: Eye bags There are many ways to deal with eye bags. - Traditional open surgery- possibly more immediate result - Scarless fat removal and repositioning- less risk then open but need something separate for skin. - Scarless fat removal and repositioning and skin tightening with laser.- less immediate and less risk but slower and result not as definite as surgery. All of the above have advantages and disadvantages and cost differences. Wish you the best in your journey, Dr Leo Kim, Specialist Plastic Surgeon in Sydney
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CONTACT NOW July 12, 2018
Answer: Eye bags There are many ways to deal with eye bags. - Traditional open surgery- possibly more immediate result - Scarless fat removal and repositioning- less risk then open but need something separate for skin. - Scarless fat removal and repositioning and skin tightening with laser.- less immediate and less risk but slower and result not as definite as surgery. All of the above have advantages and disadvantages and cost differences. Wish you the best in your journey, Dr Leo Kim, Specialist Plastic Surgeon in Sydney
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