Laser Fat Destruction & Eyelid Burns

Although many cosmetic surgeons now recognize that lower eyelid bags are more commonly due to tissue loss rather than true fat protrusion, there are many who are still excising lower eyelid fat. Apparently a very small subset of these is attempting to remove this fat by making a small incision in the lateral lower lids, inserting a fiber from the "LaserTight" device and attempting to melt the fat and tighten the skin. This is a procedure that is new to me, and on the surface appears fraught with hazard. There are muscles near the fat that, if injured, could make it difficult for both eyes to move in a coordinated fashion. Furthermore, bleeding from eyelid surgery can rarely result in loss of vision, and this procedure is performed without direct visualization.

In the November 2009 journal "Lasers in Surgery and Medicine" there is a report of a 54 year old woman who was treated with "EyeTight", a trademarked procedure. The procedure was performed by a plastic surgeon who described it as a nonsurgical blepharoplasty. The treatment was performed in an office setting under local anesthesia and took about 40 minutes.  Immediately after the surgery the patient noted linear crusting of both lower eyelids, as well as marked discomfort and swelling. When the patient was seen by the reporting physicians, 23 days later, she had full thickness eyelid skin burns due to the laser injury.

The skin on the eyelid is the thinnest skin in the body. All lasers work by adding energy to the area treated. Burns have been reported with similar lasers used in other locations, but using a laser on very thin skin increases the risk. Lasers have successfully used on the external surface of the eyelid skin to tighten the skin, but not in an attempt to reduce bags. Lasers can be very precise instruments, but must be used in a well controlled fashion

.How can you avoid being involved in such a situation? The physician was a plastic surgeon and presumably appropriately trained. We know nothing about his/her reputation in the community, but this would be important. However, if you search the internet for physicians performing this procedure, you will come up with very few names. That should be a warning flag. You should never hurry out to have the latest procedure. Lots of procedures that have been touted on TV have been found to be worthless, or worse. If you're an early adopter of new procedures, you should be aware that you're part of an experiment.

Gerald N. Bock MD

California Skin & Laser Center

Stockton & Lodi, CA

Comments

[laser vision surgery]

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