Which blepharoplasty is better and where is it best to start the transformation: from the upper or lower eyelids?

Laser blepharoplasty is eyelid surgery using a laser, which allows patients of all ages to restore youth and beauty to the eye area.

In the photo: a patient before and after circular blepharoplasty of the upper and lower eyelids 1 week after surgery

The laser helps make blepharoplasty surgery less traumatic and virtually bloodless, because it cauterizes small vessels and minimizes the appearance of hematomas and swelling after surgery.

Laser eyelid blepharoplasty has become popular due to the high degree of patient satisfaction with the results of the operation compared to traditional surgery.

If you want to restore youth to your eyes , are tired of bags under your eyes, puffiness, wrinkles and drooping eyelids - sign up for a free consultation - this is how you will take the first step towards perfection.

Blepharoplasty of eyelids - before and after

In the photo: Blepharoplasty of the upper eyelids before and after
Circular blepharoplasty, The result is presented 1 week after surgery

In the photo: Blepharoplasty of the upper eyelids, 3/4 view

See more photos before and after eyelid blepharoplasty in the photo gallery

Features of the SMAS lifting procedure

The Ultroformer 3 device uses HIFU (High intensity focused ultrasound) technology - high-intensity focused ultrasound penetrates several levels of the skin and reaches the muscular aponeurotic layer (SMAS). Under the influence of ultrasonic waves, the temperature of soft tissues at a microthermal point at a given depth increases to 60–70°C.

Directed radiation triggers the processes of contraction and compaction of SMAS, tissue repair, lipolysis, and also activates collagen production. Thermal damage stimulates the synthesis of a new collagen matrix, the renewal of which is completed in 3–4 months.

Who can benefit from blepharoplasty? Indications

Blepharoplasty may help if you have:

• Excess fat deposits on the upper or lower eyelid that cause puffiness
• Weak skin of the upper eyelid that hangs over the eyeball
• Bags and dark circles under the eyes
• Sagging and age-related changes in the lower eyelids
• Wrinkles in the paraorbital area
• The desire to change the shape and shape of the eyes, for example - Europeanization of Asian eyes

In the presence of severely drooping outer corners of the eyebrows, it is more effective to combine upper eyelid blepharoplasty with a forehead and eyebrow lift.

Laser blepharoplasty of the upper eyelids

Laser blepharoplasty is performed to reduce the amount of excess skin and fat in the upper eyelid area, thereby eliminating sagging and puffiness in this area.

The method has virtually no differences from the traditional one, with the exception of the use of a laser instead of a scalpel during the operation.

The surgeon makes an incision in the natural crease of the upper eyelid, then removes excess skin, muscle and fat, then closes the incisions with thin sutures that leave invisible scars.

Video of upper blepharoplasty surgery. Surgeon Zharkova S. N.

Features of the laser resurfacing procedure

The laser beam, penetrating deep into the skin, is divided into many microbeams, which create pinpoint microscopic damage in the skin. In areas of damage, intensive recovery processes are launched, since the ability of skin tissue to regenerate is very high. The targeted effect provides a sufficient supply of healthy cells (that have not been exposed to micro-rays), which serve as a source for the creation of new collagen and elastin. At the same time, the skin significantly contracts and tightens - pinpoint areas of damage “evaporate” micro areas of the skin. Due to these processes, the skin of the eyelids is tightened and wrinkles around the eyes are smoothed out.

Laser blepharoplasty of the lower eyelids

Blepharoplasty of the lower eyelids is performed to correct and eliminate excess skin, wrinkles, bags and swelling under the eyes. It can rejuvenate your lower eyelids for a long time, restoring your beauty and self-confidence!

Lower eyelid blepharoplasty can be performed through an external incision or through an incision in the inner part of the eyelid (transconjunctival blepharoplasty). When using the “suture” method, the skin is incised along the natural line of the eyelid just below the eyelash line, which avoids conspicuous scars. The incision removes excess fat and excess skin that cause bags under the eyes.

Learn more about lower eyelid blepharoplasty

UltraPulse - ultrapulse fractional CO2 laser

UltraPulse is the most powerful of all CO2 lasers for aesthetic medicine.
Thanks to the unique ultra-pulse mode, it is able to solve the most complex problems in rejuvenating and smoothing the skin texture. UltraPulse allows you to penetrate the skin to a depth of up to 4 mm without stacking, which is important for the treatment of scars, at the same time, this laser is convenient to use for the most delicate resurfacing procedures with short rehabilitation. More details about the device

Transconjunctival (sutureless) blepharoplasty

The essence of the operation is that the surgical incision is located along the line of the conjunctiva, that is, on the inside of the lower eyelid. Hence the second name - “sutureless”, since sutures are not required after transconjunctival blepharoplasty: the dissected area located on the mucous membrane heals on its own.

In this regard, laser blepharoplasty is more profitable than traditional blepharoplasty - the surgeon removes excess fatty tissue through small punctures, which he makes with a laser beam. Under the influence of laser radiation, cellular processes are activated, provoking more intense tissue regeneration.

Accordingly, the rehabilitation period is significantly reduced: complete recovery occurs in three days, minor swelling and bruising disappear on their own within a week and a half.

In addition to all of the above, the laser is used by the surgeon to renew the skin of the lower eyelids, eliminate facial wrinkles and the first age wrinkles: after completing work on eliminating the hernia formation, the doctor performs laser resurfacing of the eyelids.

Laser transconjunctival blepharoplasty allows you to perform two operations in one operation: to eliminate a cosmetic defect in the form of fatty hernias and to tighten, make the skin of the lower eyelids more elastic and smooth.

It is recommended only for those patients who have not yet been diagnosed with age-related ptosis (tissue drooping) in the area under consideration, characterized by a significant amount of excess soft tissue.

To correct age-related aesthetic deficiencies in the periorbital area, more complex techniques are recommended that require large-scale surgical intervention using traditional surgical instruments.

You can learn more about transconjunctival blepharoplasty here

Progress of laser blepharoplasty surgery

The duration of the procedure is from 30 to 90 minutes (on average 45 minutes) and depends on the complexity and volume. Before performing the operation, I will select the appropriate technique to obtain the best results, taking into account your wishes, physiological characteristics and health status.

Step 1 - Anesthesia

Usually a combination of local anesthesia and light intravenous sedation is used, however, with a large volume of surgical intervention, the choice may fall towards general anesthesia. In our clinic, pain relief is always carried out under the guidance of one of the best anesthesiologists in the country, which guarantees your safety and the absolute safety of your health.

Step 2 - Cuts

The incision lines depend on the type of plastic surgery performed and are always located in the natural folds of the skin, which makes the seams and scars completely invisible to the prying eye!

Step 3 - Closing the Cuts

Sutures are usually closed:

• Removable or absorbable threads
• Leather glue
• Surgical tape
• When performing “seamless” laser transconjunctival plastic surgery, no sutures are required.

In the video: a 54-year-old patient diagnosed with hernias and excess skin of the upper and lower eyelids. Atony of the lower eyelids. In addition, the patient has a scleral gaze and a negative vector. In general, the conditions for blepharoplasty “cannot be worse.” Severe excess skin, hernias of the upper and lower eyelids are also visualized. The planned operation includes: circumferential blepharoplasty with myopexy and canthopexy in the lower eyelid area. This volume of surgery will minimize the risk of postoperative complications. A prerequisite for successful rehabilitation in such situations is anti-scar physiotherapy. As a rule, this is ultraphonophoresis with longidase.

Stages of the procedure

At the initial stage of the procedure, all impurities are removed from the surface of the face using an antiseptic, and the skin is disinfected. Then the eyelids and adjacent soft tissues are treated with a gel with a local anesthetic effect. The doctor begins laser treatment, paying special attention to problem areas with severe ptosis.

Depending on the nature of the cosmetic defects, all manipulations last from 30 minutes to an hour. At the final stage, a gel is applied to the skin to relieve swelling and redness and accelerate tissue regeneration.

Benefits of laser blepharoplasty

The laser blepharoplasty procedure is performed using a CO2 laser, which has a number of obvious advantages compared to a scalpel:

• 
  Its beam is transparent, which allows the surgeon to fully see the operated area (unlike traditional blepharoplasty, when the surgeon partially covers the operated area with a scalpel).

• It cuts the tissue layer by layer (the depth of each cut is 2-3 mm), which significantly reduces the risk of damage to the eyeball, cornea and eyelashes.
• It has pronounced coagulating properties: the radiation “seals” small blood vessels at the incision sites, minimizing bleeding of the operated area. This not only reduces the recovery period, eliminating swelling and bruising, but also helps the surgeon during the operation. The absence of blood allows him to clearly see the operated area, which makes laser blepharoplasty safer and faster than traditional blepharoplasty.
• Under the influence of laser radiation, cellular processes are activated, provoking more intense tissue regeneration, which reduces rehabilitation time by almost 2 times
• If there are fine wrinkles in the lower eyelid area, the procedure may be accompanied by laser resurfacing. The combination of these procedures makes it possible to achieve comprehensive rejuvenation of the lower eyelid area, which is not achievable with traditional intervention. Laser eyelid resurfacing is a technology of the future that is in service at our clinic.

Despite the obvious advantages, there are opponents of this method of eye rejuvenation. Basically, they appeal to the fact that the scalpel allows you to make a more even cut.

As a rule, I combine different techniques and I must note that despite the fact that the recovery period after laser blepharoplasty is shorter, the result of the operation, no matter how it is performed, will be the same.

Eyelid surgery can be performed either in combination with other anti-aging procedures (for example, facelift) or independently.

Patient reviews

Below are some patient reviews. If you have something to say, leave your feedback in the comments below the article, it will be useful to our readers.

“ I decided to have laser blepharoplasty at the age of 46 .

I had a choice - to do cheaper traditional blepharoplasty or laser, and I chose the second option, since it leaves practically no traces.

In practice, the scars, of course, remain, but if you don’t look closely, they are not noticeable from the outside.

Overall, I'm pleased with the result. Of course, the skin doesn’t look the same as it did when you were twenty, but at my age it’s already stupid to want a perfect youthful face .”

Kristina Pozhogina, 50 years old.
“I was
forced to undergo laser blepharoplasty to remove fatty hernias under my eyes . The procedure scared me: I was afraid not only of pain, but also of negative consequences, but fortunately everything went well.

True, I have very thin skin from birth, so rehabilitation took longer than expected (about a month).”

Lyubov Balakireva, Kamyshin.

Rehabilitation after eyelid surgery

After eyelid surgery under local anesthesia, you can go home almost immediately; if you use general anesthesia, you can go home the next day.

Primary recovery takes 7-14 days.

Stitches (if any) are removed on days 4-7. It depends on the amount of work done, the type of seam and your skin type.

• It is advisable to periodically apply cold compresses to the operated surface. Scars are noticeable at first, but become almost invisible after three weeks.
• Bruising and swelling depend on the individual characteristics of the body. They can last up to 2 weeks. The bruises disappear within a week. Redness in the eyeball due to a burst vessel goes away within 2 weeks.
• You can apply makeup after 10 days
• Most patients return to work within 7-10 days
• Some patients experience tearfulness or, conversely, dry eye syndrome. This can last several weeks - extremely rarely more than three months. Using eye drops significantly shortens the recovery period.

In the video: the patient immediately after surgery. In this form, the patient usually leaves the hospital for further outpatient observation.

The result of blepharoplasty after rehabilitation

In the photo: Patient before and after blepharoplasty of the upper and lower eyelids

Advantages and disadvantages of the method

It is worth noting! Laser blepharoplasty is preferable to conventional blepharoplasty for the following reasons:

1. The incision made with a laser than during surgery. Therefore, healing occurs faster , and after time there are no scars left on the patient’s face.
2. The laser beam performs several functions in addition to making an incision ( cauterization of affected vessels, disinfection of treated tissues).
3. Since there are no hemorrhages during laser blepharoplasty, swelling does not form .
4. The procedure does not require a long hospital stay for the patient.
5. The effect that can be achieved by this method is observed over the next 5-10 years.

Stay up to date! The main disadvantages of laser intervention are its possible consequences, including:

• burns ;
• development of dry eye syndrome due to laser damage to the lacrimal glands (but this can be considered a normal consequence that goes away over time);
• eyelid asymmetry;
• the appearance of hematomas and paraorbital edema .

To be fair, it should be said that the risk of developing such consequences is minimal, and they are possible only if the specialist acts incorrectly.

Blepharoplasty: stitches and scars after surgery

Regardless of the type of blepharoplasty chosen, the incisions are made in natural folds, due to which, after healing, the seams become almost invisible.

• 
  The method of classic upper eyelid surgery involves excision of overhanging skin in such a way that after healing the suture is hidden in the new fold of the eyelid. The incision is precisely measured down to millimeters, thanks to which the patient after the operation receives an open and youthful look without visible scars.

• When performing lower blepharoplasty, the incision is made under the eyelash edge, also in a natural fold, in order to hide the plastic surgery performed after healing.
• The transconjunctival blepharoplasty method does not leave any visible scars after surgery. The essence of the operation is to make an incision on the inside of the eyelid.

Each specific type of eyelid surgery helps to get rid of sagging skin, remove folds, wrinkles or fat bags, but, nevertheless, this operation is considered the least traumatic and fastest to heal.

If you choose a competent specialist and perform a high-quality operation, the stitches will be invisible even upon close examination.

Visible scars after healing are a sign of poor quality work by a plastic surgeon or non-compliance with recommendations by the patient, except in isolated cases.

Circular blepharoplasty photo

In the photo: a patient after circular blepharoplasty

Memo to the patient after blepharoplasty

What you need to know and follow after blepharoplasty to achieve an excellent result:

• It is necessary to sleep on your back or side with your head elevated
• Minor postoperative pain may occur, which can be easily relieved with regular painkillers. If you experience significant pain, you should notify your surgeon immediately.
• Cold compresses should be applied for 15 to 30 minutes at least 6 times a day
• Important! Do not take aspirin or medications containing aspirin. For the upper eyelid, apply a special ointment 3 times a day. The doctor will give recommendations.
• For the lower eyelids, use eye drops (usually 1 drop 4 times a day)
• Do not use mascara, eyeliner, or eye shadow until cleared by your doctor (usually 10 to 14 days). Minimal makeup can be applied to areas of bruising on the lower eyelid, but is not acceptable for the upper eyelid, much less incision areas.
• Strenuous exercise and sports should be avoided for at least 3 weeks
• Avoid high temperatures (saunas or steam baths), as well as exposure to ultraviolet radiation (solarium or tanning) for a month
• When performing transconjunctival lower eyelid surgery, it is necessary to use sunscreen for a month after surgery.

How is the operation performed?

The operation lasts relatively short time - usually from half an hour to an hour. Most often, our anesthesiologists use intravenous anesthesia or general anesthesia. With minor corrections, local anesthesia is possible.

Upper blepharoplasty begins with an incision along the natural crease. The amount of skin tissue and subcutaneous fat to be removed is determined on an individual basis. It is important here not to leave excess or create excessive tension on the skin. The orbital orbicularis muscles may also be involved at the surgeon's discretion.

Lower blepharoplasty is performed through an open or closed approach. If it is necessary to excise excess skin, the incision is made from the outside, and if it is only necessary to remove fatty hernias and the skin has good elasticity, the surgeon “selects” through the conjunctiva. Sometimes it becomes advisable to redistribute subcutaneous fat (Loeb operation).

Contraindications

The main contraindications are the same for any surgical intervention. This:

• any acute illness
• acute and chronic diseases of the eyes, lacrimal glands and ducts
• blepharospasm
• conjunctivitis
• bleeding disorder
• blood diseases
• chronic disease in the acute stage
• diabetes
• venereal diseases

You can find out the full list of contraindications during a free consultation.

Prices for blepharoplasty in Moscow

The cost of blepharoplasty depends on the complexity, the chosen method, the qualifications of the plastic surgeon, the level of service in the clinic, anesthesia and consumables. As a rule, everything is included in the price, except for tests, which you can pre-take either in the clinic itself or in any place convenient for you. Blepharoplasty is one of the most affordable anti-aging facial surgeries in Moscow.

In our clinic, the cost of blepharoplasty starts from 60,000 rubles. In your specific case, it will be possible to announce the price of blepharoplasty only after examination during a face-to-face consultation.

The consultation is free , sign up by calling +7 and 7 (495) 225-95-41 or using the feedback form in the site header.

Preparing for surgery

Preparation for blepharoplasty begins with a consultation with an ophthalmologist. The specialist carefully listens to the patients’ complaints, conducts an initial examination, and studies the medical history.

The next stage of preparation is taking traditional tests:

• general blood and urine analysis;
• blood biochemistry;
• determining the amount of glucose in the blood;
• analysis for HIV, hepatitis B and C, and other infections;
• determination of blood group and Rh factor.

After receiving the results of a comprehensive diagnosis, the specialist receives detailed information about the patient’s health status. This allows you to decide on the further technique of the operation or postpone surgical intervention for a certain period.