What are pros and cons re blepharoplasty on using a scalpel vs laser? (Photo)

Question

I'm 68 and have droopy lids. Likely best to do both upper and lower although I do not have much bags on lower. Is sedation best for surgery when doing both? Is laser faster to heal, less bruising, less painful? Thank you.

Kenneth D. Steinsapir, MD · Answer

It is the design of the surgery that makes the difference.  Lasers are often used as a marketing ploy to make up for surgeon's who do not really do a nice blepharoplasty.  Lasers are not superior instruments for performing the blepharoplasty.  From a surgeon stand point they seem to cause less bruising but this is not really established by scientific studies.  Unfortunately the laser devitalizes the skin edges and it takes much longer for the skin to heal than surgery with the scalpel.  This means the sutures need to be left in longer and that often compromises the way the eyelid heals.

Thomas Trevisani, MD · Answer

Both tools are designed to excise the skin. With that said- the quality of final outcome will depend on many factors-  such as-great experienced Surgeon, your healing capacity etc. You do appear to be a great candidate for upper lid blepharoplasty. Seek an experienced Board Certified Plastic Surgeon for in person exam/consultation. For more info re/this procedure you can view this link:

John J. Martin, Jr., MD · Answer

Eyelid surgery can be done with laser or scalpel.  As a surgeon I like using the laser as there is less bruising and swelling.  However the result should be good either way.  You have a ptosis of the upper lids, so will need more than a bleph.  You should consult with an oculoplastic surgeon for this repair.  Also may want to consider laser resurfacing around the eyes to help improve the skin texture.

Jed H. Horowitz, MD, FACS · Answer

Eyelid surgery techniquesScalpel vs laser is up to the surgeon. Results are the same for both  with maybe less swelling with a laser in the first two to three days.Laser can also be used to treat the texture on the surface of the eyelids to tighten and smooth the skin.. This is a different purpose.

Naveen Somia, MBBS, PhD, FRACS · Answer

Despite scientific studies, there is no evidence to suggest laser is better than scalpel for eyelid surgery.Often it is used a 'marketing' tool to sell the procedure as 'laser' is perceived to be 'hi tech' and hence better.Sedation or not will depend on your Surgeon.Uppers Definitely, lowers its upto youAll the best

William Marshall Guy, MD · Answer

Hello Lucy761,A laser is useful for tightening the skin to a small degree.  It is commonly used on the lower eyelid skin when the fat bags are addressed through a transconjunctival incision (through the pink part of the eye).  Given your degree of skin laxity in that photo you would be best serve with removing the excess skin surgically.  As far as sedation that depends on your surgeon and anesthesiologist's preference.  It can be performed under general sedation or simply using local anesthesia for the very selective patient.  I would recommend you consult with a facial plastic surgeon, plastic surgeon, or oculoplastic surgeon who offers both options so you can have both options discussed.  I hope this helps and good luck.

William Portuese, MD · Answer

A laser is a cutting tool just like a knife and scissors. The laser might have a slight amount of less bruising, but there is more swelling since it is a thermal burn to the skin and requires the sutures to be in place much longer. Proper protection of the cornea is also extremely important to prevent a burn to the eyeball. It is more important to look at your surgeon's before and after results, than what kind of cutting tool they perform a blepharoplasty procedure with.

Omar Fouda Neel, MD, FRCSC, FACS · Answer

many laser blades are homeostatic so it minimizes bleeding and depending on the laser could be used to shrink the issue, both techniques in reality work well and at the end there is no difference on the long term outcome. You are welcomed to come and visit our practice on downtown montreal and discuss in person the best option for you Dr. Fouda Neel

Roger Bassin, MD · Answer

Great question! I actually studied the effects of healing using different modalities to cut skin. When using a laser for skin incisions, we found that the sutures needed to be left in longer due to the extended time it took to heal. The reason behind this was the laser created a 'char' or burned area which your body needed to heal through. With a regular scalpel there is no char, and thus the incisions heal quicker. Although using a laser to cut skin sounds 'sexy' I would still recommend the good old steel scalpel blade!

Steven Wallach, MD · Answer

Whether one uses a scalpel or a laser to cut the skin, there really is no difference in my opinion in the long term.  Best of luck.

What are pros and cons re blepharoplasty on using a scalpel vs laser? (Photo)

Answers (13)

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