Laserassistierte Blepharoplastik

Abstract

Blepharoplasty is one of the most frequently performed plastic cosmetic interventions. For this purpose the CO laser is an instrument that can be used as a laser scalpel to cut as well as in its ablative function to remove skin irregularities, such as scars and tumors and also to treat changes of the skin due to aging. Fractionated laser irradiation reduces the duration of skin redness and the postoperative rehabilitation time after a resurfacing. The advantages of the CO laser are a gentle intraoperative preparation and less postoperative swelling due to an additional cauterization of blood vessels. Disadvantages are an increased occurrence of wound dehiscence and the high cost of instrumentation. Before performing a blepharoplasty an exact analysis of changes of the eyelid and also the wishes of the patients are necessary to establish the most suitable surgical procedure and the correct dosage. In addition to skin and fat resection, depending on the original situation it is possible to tighten slack skin with a resurfacing, to shift the fat compartments, to change the position of the eyebrows, to correct a ptosis and also to modulate the tension of the lid. The frequency of complications can be reduced by good planning of the surgical intervention. In the case of occurrence of complications, suitable treatment strategies should be available.

Severe Corneal Damage After Minor Eyelid Surgery: A Case Series

“…Benefits of using the CO 2 laser are reduced operative time, less bleeding, superior intraoperative visibility, less bruising and swelling, no pain, and a shorter recuperation period. [19][20][21] It is also possible that the laser can have a more potent effect on corneal tissue than scalpels. The heat generated by the cautery and the ablative effects of the CO 2 laser may account for the stromal tissue loss and slow closure of the epithelial defects seen in these cases that would not have been seen with a scalpel.…”

Laser‐assisted blepharoplasty: An innovative safe and effective technique

“…Some authors, however, underlined the disadvantages of using the CO 2 laser compared with the steel scalpel attributing it to its cost in terms of purchasing and maintaining the laser equipment, the need for additional and extensive laser training for surgeons and assistants, and the need for two assistants rather than the one needed for scalpel surgery. 45 However, the CO 2 laser leads to a number of advantages in comparison to theses surgical approaches, already discussed above, such as gentle intraoperative preparation and less postoperative swelling due to an additional cauterization of blood vessels 46 and the possibility to perform precise incision and hemostasis with the same device 47 Moreover, the possibility of using fractionated CO 2 and 1540-nm laser in the lower periorbital area allows us to achieve a greater shrinkage effect than using fractionated CO 2 alone. 20 Collagen production and remodeling continues for several months after blepharoplasty CO 2 laser treatment as reported in literature 48 In addition, a study using cytotoxicity and proliferation analysis and confocal analysis showed that the 1540-nm laser leads to cell proliferation and a significant increase in type III collagen compared to a nonirradiated control sample and therefore guarantees skin rejuvenation of the lower periorbital area.…”