Take a look at how a blepharoplasty works...

*According to the 2017 American Society of Plastic Surgeons® Statistics Report

We are proud to offer laser eyelid surgery, an advancement on traditional blepharoplasty, to patients in Phoenix, Scottsdale, Sun City, Sun City West, and beyond. This state-of-the-art procedure involves the use of a carbon dioxide (CO2) laser to remove excess skin and fatty tissue.

After making small incisions (sometimes on the inside of the lid, other times within the natural crease to camouflage them), the UltraPulse Encore laser instantly and precisely ablates tissue around the upper and lower eyelids. The laser beam tightens loose, sagging skin, and eliminates bags beneath the eyes. Since the laser beam cauterizes the blood vessel as it reshapes the tissue, it prevents bleeding during the procedure and allows Dr. Justo to visualize exactly how much tissue to remove. This makes the surgery quicker, safer, and more effective than traditional blepharoplasty.

Benefits of Laser Blepharoplasty

The benefits of laser eyelid surgery include:

• No scalpels or knives
• Greater precision
• Greater access to small and delicate areas
• Reduced chance of post-operative swelling
• Quicker recovery than the traditional procedure
• Less risk than with traditional blepharoplasty
• Quicker and more effective when compared to traditional methods
• Simultaneous laser skin resurfacing for the treatment of lines, wrinkles, and crow's feet around the eyes

Insurance Coverage

Like many patients, you may want to eliminate drooping skin to improve your vision. However, you may be worried that you will not be able to afford the surgery. Fortunately, functional upper eyelid surgery is often covered by insurance. We will take extra steps to help you obtain the coverage you deserve.

Before beginning treatment, Dr. Justo will conduct a visual field test to determine if your drooping lids have significantly impaired your eyesight. If he establishes that blepharoptosis is affecting your vision and quality of life, he will submit your test results and photos to your insurance company to obtain treatment authorization.

Upper eyelid surgery is often authorized by insurance providers as medically necessary because droopy lids can impair your peripheral vision, lead to eye fatigue, and cause brow strain.

Global Fee

Because we operate our fully accredited surgery center right here on site, you can always count on the Arizona Eye Institute & Cosmetic Laser Center to quote you one global fee for any cosmetic procedure not covered by insurance, with no surprises or additional fees. Any cosmetic procedures provided by Dr. Justo have one single global fee which includes the professional surgery fee, the facility fee (operating room, nurses, surgical supplies) and the anesthesia fee all bundled together so as to minimize any confusion for the patient.

Unlike many plastic surgeons in the area, there are no hidden fees at our practice serving patients from Phoenix, Scottsdale, and throughout the Valley.

Many adults notice that the skin above their eyes has slowly drifted down to cover part or most of the pupil. Common causes of this issue include the aging process, muscle weakness of the elevating muscle of the upper eyelid, or in some cases, familial or genetic predisposition.

Droopy eyelid skin caused by muscle weakness is known as “true blepharoptosis.” More commonly, drooping lids are caused by the overhang of excess upper eyelid skin and fatty tissue, which is known as “pseudo-blepharoptosis.”

If we determine that muscle weakness is causing your droopy eyelids, two separate surgeries can be utilized to correct this issue: a muellerectomy or a levator resection.

Dr. Justo performs the large majority of his upper eyelid “muscle tightening” procedures using a procedure known as conjunctival-muellerectomy surgery. This 15-minute outpatient procedure is performed under local anesthesia with minimal discomfort. The procedure involves a small, hidden incision underneath the upper eyelid, followed by placement of an absorbable suture that dissolves in approximately 10 days.

The primary advantages of such a procedure are:

• Short operation time
• Minimal post-operative bruising and swelling
• High degree of accuracy, reproducibility, and symmetry
• Avoidance of post-operative “notching” of the upper eyelid
• Avoidance of any skin incision or scar

The main disadvantages of a muellerectomy are:

• Limited degree of elevation of the eyelid in cases of severe eyelid droop (blepharoptosis)
• Does not correct any skin sagging that may co-exist with the muscle weakness
• During your initial consultation, Dr. Justo will discuss your options in detail and help you decide on your best course of action.

If you show signs of marked muscle weakness with the eyelid clearly falling below the level of the pupil, or you require a secondary (repeat) muscle-tightening procedure, Dr. Justo will recommend a traditional levator aponeurosis advancement and tightening procedure. This procedure is also performed using local anesthesia although it is more time-intensive and requires a skin incision through the natural crease of the upper eyelid. The main advantages of the levator resection procedure are:

• It can elevate the upper eyelid to a much higher degree than a muellerectomy procedure
• An upper eyelid blepharoplasty (removal of skin and fat) can be performed simultaneously using the same external skin incision through the upper eyelid crease

The primary disadvantages of the external levator resection approach are:

• Requires longer surgical time, approximately 20-40 minutes per eyelid
• Typically results in greater post-operative bruising and swelling than the muellerectomy procedure
• Small risk of “lid notching” of the upper eyelid which can sometimes result in a slightly less than natural lid contour

Trans-Conjunctival (Internal) Incision Lower Eyelid Blepharoplasty

For Dr. Emilio Justo, approximately nine out of ten of his lower eyelid blepharoplasty procedures are performed using the trans-conjunctival or internal technique. With the patient having IV sedation such that he/she is under a deep twilight anesthesia, Dr. Justo uses the Ultrapulse CO2 Laser to make a small cut on the inside of the lower eyelid thru the conjunctiva, which is a mucous membrane tissue. Dr. Justo then teases out and removes the protruding fat pockets causing the external puffy appearance. This internal incision does not require any sutures as it heals very quickly in a matter of days.

In general, this technique results in minimal bruising and swelling. In the vast majority of such cases, Dr. Justo will at the same time use the Ultrapulse CO2 Laser to perform a “laser peel” or laser resurfacing technique over the skin surrounding the eyes (peri-ocular) to help provide gentle tightening of the skin and to texturize any fine lines or wrinkles. The patient is discharged home the same day after this 30-minute procedure.

Sub-Ciliary (External) Incision Lower Eyelid Blepharoplasty

In a much smaller percentage of his lower eyelid blepharoplasties, Dr. Justo will use an external incision beneath the lash line extending from the inner corner of the eyelid and ending just beyond the outer corner of the eyelid. Using this technique, Dr. Justo will excise and remove a thin strip of skin from the lower eyelids for those patients in whom he feels that the internal incision technique in combination with the laser peel may not be sufficient to create the desired appearance.

With the external incision technique, the procedure takes at least twice as long, and the patient is subject to more bruising and swelling compared to the internal technique. Also, Dr. Justo does not perform a laser peel of the “peri-ocular” skin at the same time the external incision is performed so as to avoid creating skin which is too tight and not natural looking. This external incision technique is very beneficial for those patients who clearly demonstrate a significant amount of baggy or loose skin in the lower eyelids.

Benefits 

• Diminish or eliminate baggy fat pockets underneath the eye resulting in a more youthful and "less tired" appearance.
• Reduce any excess skin or tissue that is creating baggy lids or skin.
• Can smoothen and texturize fine lines and wrinkles both beneath the eyes and around the “crow’s feet” area.

While you may only have lower eyelids that are troubling you, it is not uncommon for the upper eyelids to be impacted by droopy skin or excess tissue at the same time. During your consultation, Dr. Justo will examine both your upper and lower eyelids.  If you are a candidate for blepharoplasty on both your upper and lower eyelids, Dr. Justo will review with you the option of having both procedures completed during a single surgery.