Eyelid Rejuvenation: Blepharoplasties & Lower Eyelid - Crow’s Feet Laser Resurfacing

The UltraPulse CO2 laser blepharoplasty and skin resurfacing has revolutionized cosmetic surgery for eyelids and the face. This exciting technology allows for excellent cosmetic results in upper eyelid blepharoplasty and transconjunctival lower eyelid blepharoplasty. Enhanced surgical visualization is permitted by a relatively bloodless field, resulting in a more precise and rapid surgical procedure.

The focused CO2 laser technique, using a special focusing handpiece, seals small blood vessels and lymphatics. This results in significantly less post operative bleeding (bruising) and swelling.

Patient recovery is rapid and positive patient response is tremendous. At the same time as the blepharoplasties, if needed, laser resurfacing of the lower eyelids and “crow’s feet” areas plus Botox results in increased patient satisfaction.

Pre-Op Instructions

1. NO ALCOHOLIC BEVERAGES 24 hours prior to surgery, and NO ASPIRIN, VITAMIN E, OR CHINESE HERBS OR TEA one week prior to surgery. They may increase bleeding during and after surgery. Have nothing to eat or drink after midnight the night before your anticipated surgery if you are going to be sedated as discussed with Dr. Remington's nursing staff. These diet restrictions apply only if your surgery is planned for the morning hours.
2. Wash your hair and face the night before surgery and do not wear any makeup the day of surgery.
3. Wear a short-sleeved top and avoid clothing that must be pulled over your head.

Post-Op Instructions:

1. A light meal may be eaten after surgery, with a soft diet for 7 days. Ensure that plenty of fluids are taken (6 -8 glasses per day).
2. Keep head elevated on 2 pillows while sleeping, and try to sleep on your back for 10 days.
3. No bending, stooping or straining for 7 days.
4. Avoid strenuous exercise for 2 weeks and swimming for 6 weeks.
5. Sutures will be removed after the fifth day of surgery, usually day #6.
6. Swelling and bruising varies between individuals, but is generally gone by 1 -2 weeks. Most individuals are back to work in 1-2 weeks.
7. Complete healing may take 3 -6 months.
8. To help the incisions heal faster, we encourage the application of Polysporin Ophthalmic ointment twice daily on the sutures. The Polysporin or equivalent is used only the first week. Marcelle eye care cream for 2 to 3 months after.
9. To help reduce swelling and bruising during the first 48 hours, use ice packs for 20 minutes per hour during the day and once or twice during the night. Frozen peas in a baggy make great ice packs.
10. Makeup may be applied following the removal of sutures.
11. We encourage patients to be up and about the day after surgery, wearing sun glasses to camouflage their eyes.
12. Prescriptions given post operatively are for pain and the reduction of swelling.
13. Please call the office should you have any further questions or problems.

Special Features of Lower Eyelid Blepharoplasty (Transconjunctival):

1. Head elevated by 30 to 45° for 5 days.
2. Ice packs for 20 minutes per hour x 24 hours. Frozen peas are the best ice packs.
3. Artificial tears (Liquifilm [Allergan]), twice a day, or Hypotears.
4. No lifting, smoking, stress or strain for 7 days.

COSMETIC FACIAL SURGERY
Complications from Blepharoplasty

Remember that each individual is unique, therefore each post-operative recovery may be slightly different than discussed with you. Each eyelid surgery places incisions with a special surgical laser above the eyelids in the natural fold of the eyelids. Even though this is done with a specialized surgical laser these scars will be red for a while and swollen, then gradually change into a pink colour, assuming more normal skin colour over several months. A feeling of numbness may occur about the eyes which is usually temporary, turning normal after several months. Bruising and swelling occur to some degree in each eyelid procedure with 80% of the swelling gone in the first 8 weeks.

Complications and imperfect results are not very common but they can occur. The goal of this specialized treatment is improvement, not perfection. Complications are really uncommon but can occur with any type of surgery, including laser blepharoplasty. Bleeding, an uncommon collection of blood underneath the skin, infection, nerve damage causing temporary loss of feeling of the eyelid, asymmetry of the eyelids (they don't look exactly the same to the patient), and abnormal drooping of the eyelids can all occur. The above complications are a general list and are really uncommon but it is possible for these to occur.

Advantages of UltraPulse CO2 Laser Upper Eyelid Blepharoplasty over Regular Surgery Without the Laser:

1. Little or no bleeding.
2. Less surgical time.
3. More precise - without the bleeding and oozing; eyelid anatomy is easily identified.
4. Less trauma to tissues.
5. Rapid patient recovery.
6. Most important - very little or no bruising after the surgery, thus less swelling.

Advantages of UltraPulse CO2 Laser Focused Transconjunctival Lower Eyelid Blepharoplasty Compared with Regular Non-laser Eyelid Surgery:

1. Very precise, fairly quick, easy procedure compared to conventional surgery where much of the time is spent finding the bleeders and cauterizing them.
2. Orbital septum is not interfered with.
3. No visible skin incision is required.
4. Less irritation and trauma to the eyelid is required because of less traction on the eyelid.
5. Fewer complications.
6. Less likely to change the shape of the lower eyelid.
7. Very low incidence of post operative bleeding and thus none or only subtle bruising noticed by the patient after surgery. This is a large plus for blepharoplasties.

Disadvantages of Laser Blepharoplasty

1. Very expensive equipment.
2. Technically challenging to surgeons not thoroughly experienced with laser surgery. It is an art form, not a science; the laser artist must have extensive hands-on laser training.