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 66

Laser vs. Scalpel for Blepharoplasty

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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
4.8 out of 5 stars 39 reviews

Neither is better

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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 8 reviews

Laser surgery can heal with faster recovery

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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
Edison Oculoplastic Surgeon
5.0 out of 5 stars 12 reviews

Laser Blepharoplasty Vs. Surgery

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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

Laser is a tool, just like the scalpel

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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
4.9 out of 5 stars 114 reviews

The most important part of the surgery is the surgeon

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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. 

Eyelid surgery

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Cosmetic lower eyelid surgery has undergone a paradigm shift over the twenty years since I began my plastic surgery training, as has facial rejuvenation surgery as a whole. The trend has been to move away from highly invasive procedures that focus on skin and fat excision and pulling skin structures as tight as possible (which tends to make a patient look less youthful and more like a stereotypical ‘plastic surgery patient’), and towards procedures that accomplish not only soft tissue preservation but also soft tissue enhancement – in the form of structural fat grafting. A typical 1970-1980’s era lower blepharoplasty usually consisted of the surgical removal of large volumes of lower lid fat, pulling the lower lid skin very tight and anchoring the lid laterally in a manner that often distorts the natural anatomy of the lateral canthus (lateral corner of the eye). I suppose you could say that this matches a windswept, pulled tight facelift - but it is not in any way truly rejuvenating.

The trend has been towards limiting fat reduction to primarily older patients with very prominent lower fat pads. In many cases, the appearance of lower lid fat pad fullness can be effectively corrected by a combination of structural fat grafting of adjacent hollow areas like the tear troughs, elevation of the midface and smoothing of the lid – cheek junction by means of a High-SMAS facelift (if indicated), and tightening the orbicularis oculi muscles to the lateral orbital rim – which effectively restrains the fat pads and improves lower lid contour. Lateral orbicularis oculi muscle suspension is a very powerful means for reversing lower lid aging changes, and for doing so in a manner that does not distort natural lower lid external appearance.
Preserving lower lid fat as much as possible, and restoring fullness in adjacent hollow areas by means of fat grafting, is a truly rejuvenating approach to lower lid surgery. Preserving and adding fat serves to enhance the soft tissue support of the lower lid and helps to maintain an ideal and youthful lower lid position over time. The more support you provide for the lower lid, the less you have to rely on internal support measures such as canthopexy and canthoplasty, which are useful for very lax and for overly long lower lids, but which also may distort the natural anatomy of the lower lid and upper lid.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

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

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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
4.7 out of 5 stars 46 reviews

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

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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

No difference between laser and scalpel for blepharoplasty

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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
4.9 out of 5 stars 59 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.