This is Dr. Emilio Justo from the Arizona Eye Institute and Cosmetic Laser Center. I'm here to talk to you a little bit about laser eyelid surgery, also known as laser blepharoplasty.
Now I'm very proud of the fact that I've been using the CO2 laser since the mid 1990s exclusively for all of my blepharoplasties. I've done well over 15,000 eyelid surgeries with laser and I'm looking forward to doing yours.
Now first of all, the upper eyelid blepharoplasty, which is very common, quite often we can obtain medical authorization to do upper eyelid blepharoplasty if it's deemed medically significant and bad enough, and in other cases, we do it strictly as a cosmetic procedure.
Basically, upper eyelid blepharoplasty, as a free standing procedure, is done just under local anesthesia with or without a little oral Valium if you're feeling a little edgy at the time of the surgery. But basically you don't have to be put under or be put to sleep as it's a very, very gentle procedure. And even those patients who are feeling antsy, we can easily walk them through it without a problem.
What are we doing with laser blepharoplasty of the upper eyelids? Well, basically we're removing the excessive skin and fatty tissue that's coming down on top of the lashes. That skin and fatty tissue is removed with the CO2 laser.
The beautiful thing with the laser is that it coagulates and cauterizes the blood vessels at the same time that it's removing the tissue. Once the skin and fatty tissue is removed, we then put one delicate, continuous weaving stitch across the upper eyelid crease. That stitch is then removed at your follow-up visit the following week.
Now how about if you also have excess fatty tissue or bunching of skin on the lower lids? Then we would do a lower eyelid blepharoplasty. Now there are some differences however. When we do lower eyelid blepharoplasty, certainly that is never covered under insurance. That is considered a cosmetic procedure.
Another big difference is that with lower eyelid surgery, that does require more pushing and pulling so to speak, and that's kind of code for "It's a little uncomfortable." So hence 100% of the time when we do lower eyelid surgery, we do it under anesthesia so that you're under IV sedation with our anesthetist and you won't feel or remember anything, which makes it a very smooth procedure.
The majority of patients for lower eyelid surgery, I use a two-step process. Step one is using the CO2 laser to make an internal incision on the inside of the lower eyelid, also known as a transconjunctival incision, to remove and tease out the fat pockets, which create the puffiness of the lower lids. That internal incision is a mucous membrane incision. It's not skin. So remember, that does not require any stitches. It self-seals literally within a few days.
Step two, once the fat pockets have been removed is I use the same CO2 laser in a different manner in what's called a resurfacing mode. You may have heard of the term laser peel or laser resurfacing. So we use the laser to sweep across the lower eyelid out to the crow's feet or smile lines and then sweep across the bridge of the nose.
That laser peel actually creates texturization of the skin, which helps reduce fine lines. It helps give a little tightening to the skin by stimulating collagen production. It's a wonderful adjunct to lower lid blepharoplasty, which I do pretty much almost universally.
So that's how we do laser upper eyelid surgery and laser lower eyelid surgery, and I look forward to performing your surgery in the very near future. Thank you.