The steel blade has traditionally been the instrument of choice for eyelid plastic surgery. The elegant contour of a #15 surgical blade is familiar to many. Alternatively, you may be acquainted with the blade-free technology employed to create skin incisions and perform operations. So, it reasons that the question to answer is, are these new technologies better? What are their advantages? Are there any drawbacks?
Laser technology in eyelid plastic surgery
Laser is an excellent example of technology that allows oculoplastic surgeons to perform plastic and reconstructive eyelid surgery. Many types of lasers can be employed for this purpose; however, the CO2 laser is by far the most popular.
The CO2 laser makes surgical incisions in the skin, resects tissue, and dissects through tissue planes. It also has the advantage of cauterizing blood vessels as it cuts through tissues. This feature translates to less bleeding during operations, making surgeries more efficient and creating less postoperative bruising. One of the drawbacks of this technology is that laser energy can easily damage the delicate tissues of the eyelids. Also, an inherent risk associated with the CO2 laser is that it may penetrate through the eyelid tissues to cause permanent and severe damage to the eye, especially the cornea. For this reason, all surgeons who use the CO2 laser should protect the eye with metal corneal shields.
The CO2 laser can also treat wrinkles under the eyes. In these cases, the laser is used to create a carefully “controlled” skin burn. The laser energy will promote collagen turnover and the formation of new elastin fibers. The result is smoother, younger-looking eyelid skin. Although this treatment boasts good results, it is not for everyone. Darker skin tones may incur irreversible damage that will manifest itself in skin pigmentation.
Electrosurgery: indispensable technology for eyelid surgeons
Electrosurgery is a term used to describe a surgical modality that uses electricity, i.e., heat, to cause tissue disintegration. Different modalities may be employed for various purposes. For example, electrocautery uses heat from an electric source to control bleeding or destruct abnormal tissue during surgery.
Eyelid surgeons frequently use a monopolar electrosurgery device to make incisions on the skin and dissect through tissue planes instead of using more traditional instruments such as blades or scissors. Therefore, most eyelid surgeons rely on electrosurgery technology to perform the vast majority of their operations safely and efficiently.
Additional technologies currently utilized to achieve excellent results in eyelid plastic surgery that do not require the prototypical blade include plasma, radiofrequency, and IPL. We will discuss these in greater detail in upcoming blogs. Stay tuned!
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