Non-surgical Lower Blepharoplasty Procedure Using a Laser

Question

Laser is called 'EyeTight' (laser company web site at www.lasertight.com). It is supposed to get rid of bags under the eyes. Does it work? Can it be used after a surgical lower blepharoplasty to tighten undereye skin to reduce wrinkles? If not, what can be done to reduce wrinkles and a remaining malar mound? Thanks. I had a lower blepharoplasty over 3 months ago. I am left with a lot of undereye wrinkles that I never had before and a left undereye malar mound that I thought would go away. I am wondering if this EyeTight (LaserTight) would help.

Brent Moelleken, MD · Answer

Apparently you have experienced malar swelling or wrinkles after a lower blepharoplasty.  Your next step will be very important.
First, only 3 months have elapsed.  It is best to wait at least six months until contemplating any revisions, even in my opinion lasering of the lower eyelid and cheek areas.  Things may still change, and you may be treating something that may change, so best to wait.
Also, for malar bulges or wrinkles and loose skin below the eyelid, you may want to consider a cheeklift operation, such as the superficial cheeklift.  THis procedure tightens the ksin below the eyelid while preserving (or restoring) the natural eyelid shape.  There are minimal incision alternative cheeklifts now.
Or, hopefully, maybe nothing more will need to be done.
In any event, be very careful before taking that next step.  A plastic surgoen certified by the American Board of Plastic Surgery with experience and interest in the midface, lower eyelids and resurfacing lasers may be your best bet.

Jed H. Horowitz, MD, FACS · Answer

Laser can be very effective for this purpose,   either fractionated or erbium can both work well to tighten skinRevision eyelid surgery should be done at least 6 months
after the initial surgery to allow time for healing and tissues to soften.  Asymmetries, excess skin, fat rolls,  fat malposition can all be improved.  Other treatments may include laser or
chemical peels to tighten skin and improve texture

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question which is not uncommon to hear. Often patients who had transconjunctival blepharoplasty performed without skin removal complain of wrinkles post surgery. The solution is laser skin resurfacing. I like to use an erbium laser (LightPod Era) because it has a low complication rate and excellent results. See an experienced oculoplastic surgeon for evaluation and discussion of options.

Etai Funk, MD · Answer

Laser resurfacing of the lower eyelid will significantly improve the fine wrinkles of the lower lid and and tighten the skin in this area. However, it will not treat the bulging fat, heavy bags, or dark circles under the eyes. Blepharoplasty (eyelid surgery) will help address these issues.

Andrew Miller, MD · Answer

Hello,
It is important to get the terminology correct.  A blepharoplasty is a surgical procedure to remove fat and/or skin and to sometimes lift up and remove excess skin.  There is no such thing as a non-surgical blepharoplasty.
Often times, I will use a laser (a well established machine without a gimmicky name) to tighten skin and remove wrinkles at the same time.  This can be done to improve your situation.  It will have no effect, however on the malar mound.  This is an extremely difficult area to improve, and often times requires a cheeklift and fat contouring to minimize it.  Be sure to talk about your concerns clearly with your surgeon before undergoing any more procedures.  Good luck.

Kenneth D. Steinsapir, MD · Answer

Dear Sueesquisite,
This company is selling a machine that is for laser assisted liposuction. The cannula contains a 980nm diode laser beam that is intended to disrupt fat. Over the years, there have been a number of attempts to melt lower eyelid fat using various means, through a small incision either in front of the eyelid or behind. However, these types of procedures do not permit inspection of the orbital fat after the manipulation. This can lead to bleeding behind the eye and blindness.
As a result, most eyelid surgeons prefer an open sky approach to modifying orbital fat in the lower eyelid either through a skin incision or behind the eyelid through a transconjunctival incision. This approach allows the surgeon to throughly inspect the orbital fat and reduce the risk of unnoticed bleeding that could result in blindness.
So, the so-called eye tight procedure is laser-assisted lipolysis, and as an eye plastic surgeon, I would not recommend this approach as it could cause a vision-threatening problem. Contrast this with actual laser resufacing or chemical peeling. These procedure directly tighten skin and can reduce the appearance of lower eyelid wrinkles.
Regarding your particular situation, generally, it is best to wait a full six months before doing more surgery. However, at three months I would agree with you that lower eyelid winkles present at his point will likely need to be dealt with in some fashion but not by laser assisted lipolysis.

David Shafer, MD, FACS · Answer

Please be careful around your eyes. You just had surgery three months ago. It may seem like a long time to you, but there is still swelling to resolve and the tissues have not completely gone through the maturation phase. Also, I would avoid "new" procedures until they have been fully tested. There are different ways to use a laser for "blepharoplasty." The can be used externally for skin tightening and internally (similar to Smartlipo) to melt the fat and contract the dermis. If you go to someone for one of these procedures, please make sure they are very experienced. Good luck.

Christopher L. Hess, MD · Answer

Removal of fat during a blepharoplasty without removal of the skin can leave you with more skin and thus wrinkles.  This is because the fat has been pushing against the skin causing it to stretch.  When the fat was removed you're left with the excess skin. 
Some lasers are better than others.  The "gold standard" is the CO2 laser.  Unfortunately this left patients red for weeks to months.  The newer frational CO2 lasers (and there are many companies that make these) have less down time.  These are ablative lasers meaing that they remove skin to create tightening.  They do work but again there's the down time.
Other lasers with wavelenghts in the 1500's can create tightening but you will have to undergo 4-5 treatments.  A wavelenght in the 900's won't do anything.

Scott E. Kasden, MD, FACS · Answer

Lasers will tighten the skin in all directions. You are still recovering from your surgery, and now may not be the best time to decide if you like the results (they are not final), or to do something else. The thing that may be a problem with the laser is that it may shrink the skin in such a way that you may have trouble closing your eye, or the lid may sag, exposing the sclera "white of your eye".
Lasers are great (as are many less invasive peels) at smoothing sun damaged skin, but not at treating the deeper structures such as muscles, fat pads, malar bags, etc. Whatever you decide, please, please, please, get clearance from your surgeon first. Also, see if he may have a solution for the malar bag!

Paul C. Zwiebel, MD (retired) · Answer

Laser resurfacing can work great for fine lines.  BOTOX in small doses can help, sometimes.

	Laser resurfacing ("non-invasive laser Blepharoplasty") does not remove bulges or fat bags. You can see a very short term (days to weeks) improvement in bulges or bags due to skin tightening effect.

	There are several techniques for improving the malar (cheekbone) contours, from injectable fillers to mid-face lift. Which would be best for you should be determined during individual consultation.

	Wait at least 6 months before another procedure to allow adequate healing, unless your surgeon specifically feels it OK to do a mild treatment for fine lines or fillers for the cheeks.

Non-surgical Lower Blepharoplasty Procedure Using a Laser

Answers (13)

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