Laser blepharoplasty and laser resurfacing of the periorbital area.

Although blepharoplasty has long been the traditional method of improving the aesthetic appearance of the eyelid area, it yields little improvement in several of the major signs of periorbital aging including (1) wrinkling of the infrabrow and lower lid skin, (2) crow's foot wrinkles, (3) malar bags and wrinkles, (4) crepey changes in the periorbital skin texture, (5) pigment spots and other actinic damage, (6) elongation of the apparent vertical height of the lower lid, and (7) loss of the gentle, indistinct transition between the lower lid and cheek skin. All of these indications can be improved by the combination of laser blepharoplasty and laser resurfacing of the periorbital region. In addition to resurfacing, the author prefers to use the laser for the incisional aspects of the blepharoplasty, as it is quick, causes less sensory nerve stimulation, is less likely to damage the inferior oblique muscle, and has essentially no bleeding--and therefore, less ecchymosis--postoperatively. This technique is described and illustrated photographically. Its outcomes include a high-quality result that maintains itself well over time, improvement in the signs of periorbital aging not treated by traditional blepharoplasty, a low rate of complication, and high patient satisfaction.