Throughout Los Angeles and Beverly Hills there is a buzz about a “new and innovative” procedure that promises eyelid surgery without scarring. The promise of no scars following surgery sounds appealing; who doesn’t want to walk away from surgery with all the benefits of a refreshed look without the evidence of surgery? But as the old adage goes, “if it sounds too good to be true, it probably is.”
How does invisible eyelid surgery work?
According to the doctor who “invented” this procedure, invisible eyelid surgery involves both “subconjunctival blepharoplasty” (usually called transconjunctival blepharoplasty) and a simultaneous “advanced” laser treatment performed by a dermatologist. Using a micro-fractional CO2 resurfacing laser to treat lower eyelid skin by “tightening” the area following removal of fat through an incision made on the inside of the lower lid (transconjunctival incision), this procedure touts a younger and refreshed appearance of both the upper and lower lids without cutting surgery. And all this has a recovery period of about a week and no one will be able to see any evidence that you’ve had surgery! Now that sounds too good to be true.
Why the skepticism?
When you break down the idea of “invisible eyelid surgery” into its basic parts, all you’re really left with is lower eyelid blepharoplasty and CO2 resurfacing; two procedures that have been offered by cosmetic and oculoplastic surgeons for years. Invisible eyelid surgery isn’t a new idea as the advertising physician would have you believe. It’s simply two existing procedures packaged together and given a brand new name! No surprise this is often how “new” things are invented in Beverly Hills all the time.
The risks of transconjunctival blepharoplasty
The idea behind the transconjunctival blepharoplasty is to remove the lower eyelid fat pads to eliminate puffiness around the lower lid that makes you look tired and aged. But transconjunctival blepharoplasty is not without some serious risks that, if performed without skill or experience can result in permanent damage. This approach of permanently removing eyelid fat is an old approach to lower eyelid surgery. It can be effective for a small number of people. The more current approach is preservation of this fat using a procedure called an arcus marginalis release. Simply throwing away the fat can cause a hollow lower eyelid.
The risks of CO2 laser resurfacing
Deep CO2 laser resurfacing has fallen out of fashion because of the negative experience many have had healing from these treatments. There is a very real risk that your skin will suffer from permanent depigmentation, and that the scarring caused by such treatments will likely affect the texture of your face. This is because the treatment depth needed to improve deep facial lines makes post laser resurfacing scars, particularly skin texture changes, relatively common. In fact these types of skin texture changes and skin depigmentation are so common that many surgeons think that this is the expected outcome of the service!
Micro fractional C02 laser is an effort to reduce this damage. These treatments do provide freshening of the skin but generally are not powerful enough to reduce lower eyelid lines. Chemcial peels, although they require much more training than a laser treatment are still the preferred methods. In some cases, the chemical peel was all that was needed for the lower eyelid contour to be much smoother even without lower eyelid surgery!
What kind of eyelid surgery will work for me?
Dr. Steinsapir says this a lot, so it should come as no surprise: the best lower eyelid surgery is customized for the individual and designed to meet his or her particular features, goals, and medical needs. This means that the lower eyelid surgery ideal for one person may be a specialized type of blepharoplasty while for another it may be a midface lift designed to correct tissue descent and return it to its proper anatomical location in the lower eye area. Once you and your oculoplastic surgeon determine the best procedure, together, you and your surgeon must customize it even further to fit your features and obtain natural results. Dr. Steinsapir observes: “people don’t do well with a one size fits all, cookie cutter approach.”
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
