Kim Dong Yeon, Han Hye Ju, Sohn Bo Seong, Shim Hyung-Sup
Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-Daero, Paldal-Gu, Suwon-Si, Gyeonggi-Do, Republic of Korea.
Santaclaus Aesthetic Clinic, Seoul, Korea.
Lasers Med Sci. 2023 Feb 27;38(1):78. doi: 10.1007/s10103-023-03739-9.
Laser lipolysis may be considered for selective removal of excess orbital fat via minimally invasive lower blepharoplasty. To control the energy delivery to a precise anatomic location while avoiding complications, ultrasound guidance can be utilized. Under local anesthesia, a diode laser probe (Belody, Minslab, Korea) was introduced percutaneously to the lower eyelid. The tip of the laser device and changes in orbital fat volume were carefully controlled with ultrasound imaging. A 1470-nm wavelength was used for orbital fat reduction (maximal energy 300 J), and a 1064-nm wavelength was used to tighten the lower eyelid skin (maximal energy 200 J). From March 2015 to December 2019, a total of 261 patients underwent ultrasound-guided diode laser lower blepharoplasty. The procedure took 17 min on average. Total energy of 49 J-510 J (average = 228.31 J) was delivered in 1470-nm wavelengths or 45-297 J (average = 127.68 J) was delivered in 1064-nm wavelengths. Most patients were very satisfied with their results. Fourteen patients experienced complications, including nine cases of transient hypesthesia (3.45%), and three skin thermal burns (1.15%). However, these complications were not observed after strict control of the energy delivery below 500 J for each lower lid. Improvement in lower eyelid bags can be achieved using a minimally invasive approach in selected patients with ultrasound-guided laser lipolysis. It is a fast and safe procedure that can be performed in the outpatient setting.
对于通过微创下睑成形术选择性去除多余眶周脂肪，可考虑采用激光溶脂术。为了在避免并发症的同时将能量传递精确控制到解剖学上的精确位置，可利用超声引导。在局部麻醉下，经皮将二极管激光探头（Belody，Minslab，韩国）插入下眼睑。通过超声成像仔细控制激光设备的尖端和眶周脂肪体积的变化。使用1470纳米波长减少眶周脂肪（最大能量300焦耳），使用1064纳米波长收紧下睑皮肤（最大能量200焦耳）。2015年3月至2019年12月，共有261例患者接受了超声引导下二极管激光下睑成形术。该手术平均耗时17分钟。在1470纳米波长下传递的总能量为49焦耳至510焦耳（平均 = 228.31焦耳），在1064纳米波长下传递的总能量为45焦耳至297焦耳（平均 = 127.68焦耳）。大多数患者对其结果非常满意。14例患者出现并发症，包括9例短暂性感觉减退（3.45%）和3例皮肤热烧伤（1.15%）。然而，在严格将每个下睑的能量传递控制在500焦耳以下后，未观察到这些并发症。对于选定的患者，采用超声引导激光溶脂的微创方法可实现下睑眼袋的改善。这是一种快速且安全的手术，可在门诊环境中进行。
