By Dr Davin Lim
Cutis Dermatology
Dermatologist, Brisbane
Blepharoplasty summary; Davin’s Tips
Here are my tips for treating eyelid laxity-
- For moderate to severe upper eyelid laxity, a surgical blepharoplasty is best.
- For mild to moderate laxity, lasers are best.
- For lower eyelid laxity, laser or surgery can be performed.
- For general eye area rejuvenation, including wrinkles, injectables such as Botox or fillers can be effective.
- Injectables do not have any downtime/recovery.
There are several ways to treat hooded eyes, including both surgical and non-surgical options:
- Blepharoplasty: also known as eyelid surgery, is a surgical procedure that can remove excess skin and fat from the upper and lower eyelids to create a more open and youthful appearance.
- Laser resurfacing: is a good non-surgical option to address both upper and lower lid laxity.
- Combination of laser and surgery; my favored procedure to address both laxity and skin quality.
- Tixel; is a non-laser method to tighten skin via super-heating of the dermis.
- Radiofrequency: is a non- surgical treatment for mild skin laxity.
- Botox: small amounts of Botox can be injected into the muscles that lift the eyebrows, which can help to open up the eyes and reduce the appearance of hooding.
- Microneedling
- Fillers: dermal fillers can be used to add volume to the upper eyelids to help smooth out wrinkles and create a more youthful appearance.
- Makeup: using makeup specifically made for hooded eyes can help to create the illusion of a more open eye.
- Lifestyle changes: reducing puffiness and bags under the eyes can help to create a more open and youthful appearance. Drinking plenty of water, getting enough sleep, and avoiding salty foods can help to reduce puffiness.
What does surgical blepharoplasty entail?
Surgical blepharoplasty, also known as eyelid surgery, is a procedure that involves the removal or repositioning of skin, muscle, and fat from the upper and/or lower eyelids. The procedure is typically performed to improve the appearance of the eyelids by addressing issues such as sagging skin, wrinkles, puffiness, and bags under the eyes. It also improves vision for some people whose upper eyelids droop enough to cover their eyelashes and impede vision.
The procedure can be done on both the upper and lower eyelids, or just one. The specific technique used will depend on the individual’s needs and the surgeon’s preference.
Upper eyelid blepharoplasty:
During upper eyelid blepharoplasty, an incision is made in the natural crease of the upper eyelid. The surgeon will then remove excess skin, muscle and fat and may reposition the remaining tissue as necessary.
Lower eyelid blepharoplasty:
During lower eyelid blepharoplasty, an incision is made just below the lower lash line, or in some cases, inside the lower eyelid. The surgeon will then remove excess skin, muscle, and fat and may reposition the remaining tissue as necessary.
After the procedure, the incisions are closed with sutures, and the recovery time is typically one to two weeks. It’s important to follow your surgeon’s instructions for post-operative care to ensure proper healing and optimal results.
What lasers are there for lax eyelid skin?
There are several laser treatments that can be used to treat heavy eyelids, including:
- CO2 laser resurfacing: uses a laser beam to remove the outermost layer of skin, which can help to reduce wrinkles, lines, and sagging skin around the eyes.
- Erbium laser resurfacing: similar to CO2 laser resurfacing, but uses a different wavelength of light that is more effective for treating fine lines and wrinkles.
- Fractional laser resurfacing: uses a laser beam to create tiny columns of injury in the skin, which can help to stimulate collagen production and improve skin elasticity.
- Non-ablative laser resurfacing: uses a laser beam to heat the skin, which can help to stimulate collagen production and improve skin elasticity.
- Pico lasers for fine lower eyelid wrinkles.
These treatments may not address the structural problem of the eyelid, such as drooping or excess skin, in those cases a blepharoplasty might be the best option.
My MO is to combine lasers with surgery. Most often an upper surgical blepharoplasty with lower eyelid laser rejuvenation. My go to laser is CO2. In 95% of cases only one session is required, albeit 5-9 day downtime.
What does laser blepharoplasty entail?
Laser blepharoplasty, also known as laser eyelid surgery, is a non-invasive or minimally invasive alternative to traditional blepharoplasty, or eyelid surgery. It uses laser technology to improve the appearance of the eyelids, by addressing issues such as sagging skin, wrinkles, puffiness, and bags under the eyes. The procedure can be done on both the upper and lower eyelids, or just one.
The specific technique used will depend on the individual’s needs and the surgeon’s preference.
Upper eyelid blepharoplasty: During upper eyelid blepharoplasty, a laser beam is directed at the upper eyelid to remove excess skin and reshape the eyelid.
Lower eyelid blepharoplasty: During lower eyelid blepharoplasty, a laser beam is directed at the lower eyelid to remove excess skin and reshape the eyelid.
The procedure is usually done on an outpatient basis, and recovery time is typically shorter than traditional eyelid surgery. There is less swelling and bruising, and patients can return to normal activities more quickly. However, it is important to understand that laser blepharoplasty may not be suitable for everyone.
How long does it take to recover from blepharoplasty?
Recovery time after blepharoplasty, also known as eyelid surgery, can vary depending on the individual and the type of procedure performed. Generally, patients can expect to take one to two weeks off work and avoid strenuous activities during the recovery period.
Immediately after the procedure, patients may experience swelling, bruising, and discomfort around the eyes. These symptoms are typically at their worst in the first few days after the procedure, and then begin to subside. Cold compresses and over-the-counter pain medication can be used to manage discomfort.
Most patients are able to return to work and normal activities within one to two weeks after the procedure, but it’s important to avoid strenuous activities and direct sun exposure for at least two weeks. It can take several weeks to several months for the final results to be visible, as the swelling and bruising subsides.
Laser blepharoplasty has a longer recovery time compared to surgery. It often takes 5-8 days for skin to heal during the initial phase, whilst redness may take an extra 3-8 weeks to resolve.
What is radiofrequency skin tightening for eyelids?
Radiofrequency (RF) skin tightening is a non-surgical cosmetic procedure that uses radiofrequency energy to heat the deeper layers of the skin. This heat causes the skin to contract and tighten, which can help to reduce wrinkles, lines, and sagging skin.
When it comes to the eyelids, RF skin tightening can be used to address issues such as droopy eyelids, wrinkles and fine lines, hooded eyes and excess skin. The procedure is typically done by a trained professional, who will use a RF device that delivers energy to the deeper layers of the skin. The heat causes the skin to contract and tighten, which can help to reduce wrinkles, lines, and sagging skin.
The procedure is generally considered to be safe and has minimal side effects. It can be used as an alternative or complementary treatment to other eyelid rejuvenation treatments, such as blepharoplasty or microneedling. It is important to note that RF skin tightening results may vary depending on the severity of the wrinkles, and other factors like sun exposure, smoking, and skin type. It may need multiple sessions to see improvement. My goto devices include Pelleve/Tempsure, NuEra RF, e2, eMatrix, Genius RF and Infini RFM.
What is Tixel skin tightening for eyelids?
Tixel is a non-surgical cosmetic treatment that uses a device that delivers heat to the skin, similar to radiofrequency (RF) skin tightening, but uses a different technology. The device uses heat-conducting tiles to deliver heat to the skin, which causes the skin to contract and tighten, helping to reduce wrinkles, lines, and sagging skin.
When it comes to the eyelids, Tixel can be used to address issues such as droopy eyelids, wrinkles and fine lines, hooded eyes and excess skin. The procedure is typically done by a trained professional, who will use the Tixel device to deliver heat to the skin. The heat causes the skin to contract and tighten, which can help to reduce wrinkles, lines, and sagging skin.
Tixel is considered safe and has minimal side effects. It can be used as an alternative or complementary treatment to other eyelid rejuvenation treatments, such as blepharoplasty or microneedling. It is important to note that Tixel results may vary depending on the severity of the wrinkles, and other factors like sun exposure, smoking, and skin type. It may need multiple sessions to see improvement. Additionally, it’s important to consult with a qualified and licensed professional before undergoing any procedure. 2-4 sessions of Tixel are recommended for best results.
What about plasma pen eyelid tightening?
Plasma pen eyelid surgery, also known as plasma lift or plasma skin tightening, is a non-surgical cosmetic procedure that uses ionized gas (plasma) to create small, variable, non-selective burns on the upper and lower eyelid skin. This process causes the skin to tighten and lift, which can help to reduce wrinkles and lines, and improve the overall appearance of the eyelids. Scarring is not infrequently encountered with plasma pen eyelid rejuvenation.
Plasma pen eyelid surgery can be used to address issues such as droopy eyelids, wrinkles and fine lines, hooded eyes and excess skin. It is important to note that plasma pen eyelid surgery is a relatively new procedure and more research is needed to evaluate the long-term safety and effectiveness of the treatment. The procedure is most frequently performed by untrained non-professionals, who will use a cheap handheld device bought online. Plasma emits a plasma arc to create small burns on the skin. The procedure is generally considered to be less invasive than traditional eyelid surgery or lasers. In my practice, plasma is best used to treat warts, not eyelid skin.
Microneedling, also known as collagen induction therapy, is a cosmetic procedure that uses small needles to create tiny punctures in the skin. These punctures stimulate the skin’s natural healing process, which can lead to the production of collagen and elastin. Collagen and elastin are important proteins that give the skin its structure and elasticity.
Microneedling; how does it compare with surgical & laser blepharoplasty?
When it comes to the eyelid wrinkles, microneedling can be used to improve the appearance of fine lines and wrinkles around the eyes by stimulating collagen production. It is much less effective than laser or surgical blepharoplasty.
The procedure is typically done by a trained professional, who will use a microneedling device, such as a dermaroller or dermapen, to create the punctures in the skin. Topical serums, such as hyaluronic acid, vitamin C, or growth factors, can be applied after the microneedling procedure to enhance the results.
Microneedling is generally considered safe and has minimal side effects. Also, it is important to note that microneedling results may vary depending on the severity of the wrinkles, and other factors like sun exposure, smoking, and skin type. It requires multiple sessions to see improvement. Adding up the costs and downtime following this procedure, laser and surgical blepharoplasty are far more effective, with faster recovery and often cheaper costs.
What is microneedling PRP for eye rejuvenation?
PRP (Platelet-Rich Plasma) therapy is a non-surgical cosmetic treatment that uses a person’s own blood plasma, which is rich in platelets, to promote healing and rejuvenation of the skin.
When it comes to eye rejuvenation, PRP therapy can be used to address issues such as dark circles, wrinkles, and fine lines around the eyes, and improve the overall appearance of the eyelids. The procedure is typically done by a trained professional, who will take a small sample of the patient’s blood, which is then processed to separate the platelet-rich plasma. The PRP is then injected or applied topically to the area around the eyes.
PRP therapy is considered safe and has minimal side effects. It can be used as an alternative or complementary treatment to other eyelid rejuvenation treatments, such as Botox, surgical blepharoplasty, laser resurfacing, or microneedling. Though we perform microneedling PRP at Cutis Dermatology, we rarely advocate this method for eye rejuvenation- it simply underperforms in comparison to other treatment methods.
What is the difference between a brow lift and blepharoplasty?
A brow lift, also known as a forehead lift, is a surgical procedure that is used to improve the appearance of the forehead and eyebrows. Blepharoplasty addresses the eyelids. Some patients require both procedures.
The procedure involves making incisions in the hairline above the forehead, and then lifting and repositioning the skin, muscles, and tissues of the forehead. This can help to reduce wrinkles and lines on the forehead, lift sagging eyebrows, and open up the eyes for a more youthful and refreshed appearance.
The procedure can be done in several ways, including the traditional open brow lift, endoscopic brow lift, and the temporal lift. The traditional open brow lift is the most invasive and requires a long incision across the top of the forehead, while the endoscopic lift uses small incisions and a camera to lift the skin and muscle. The temporal lift is a less invasive version and only requires a small incision in the temporal area.
The recovery time for a brow lift is typically one to two weeks. It is important to understand the risks and benefits of the procedure and consult with a qualified surgeon to see if this procedure is right for you.
How do I know what the best procedure is for me?
A thorough examination of the eye area is required. I take into consideration your age, ethnicity (especially with lasers), your goals and expectations, budget and medical history. The eye area is by far the most complex area to rejuvenate as there are multiple factors to consider, including the degree of skin laxity, volume loss, pigmentation, and the positioning of key elements such as the eyebrow and lashes.
