Dr. Silbert has been performing Laser eyelid surgery with a CO2 laser for over 20 years. CO2 Laser eyelid surgery can be performed on the upper or lower eyelids and can be combined with full-face or peri-ocular CO2 Laser resurfacing to tighten the skin of the face and/or the skin around the eyes. Dr. Silbert performs the surgery at Physician’s Surgery Center LGH with light sedation to enhance patient comfort.
Instead of using a blade, a laser is used on cutting mode to remove the skin and the fat during the procedure. The laser serves to both cut and cauterize the skin and fat and is able to close blood vessels while it cuts, minimizing bleeding. The laser is also able to make a very precise incision that heals with minimal scarring. Using the laser Dr. Silbert is able to minimize bleeding and bruising, which can help patients heal more rapidly.
The procedure is used to remove excess skin from the upper eyelids and to remove fatty bags of the upper lids and below the eyes. Although results of eyelid surgery can be very good using a blade to make the incisions, Dr. Silbert believes that the laser provides for a more exacting surgery with less black and blue, and quicker healing.
Ptosis or droopy eyelid, also known as Blepharoptosis, is when your eyelid margin sits lower than normal. In general, this means your upper lid covers 1-2 mm of the cornea. In Ptosis, the lid often rests over the top part of the pupil and obstructs vision.
Most cases of acquired ptosis (ptosis which is developed over time, not ptosis you are born with) result from stretching or disinsertion of the attachment of the levator muscle. Patients often note that the eye seems small and complain of a limited field of vision, difficulty reading, fatigue, and headache. Acquired Ptosis can occur at any age, but it is more commonly seen in older adults.
To determine if Ptosis repair is a medically covered procedure, measurements are taken, as well as photographs, are taken demonstrating how droopy the eyelid is. A special test called a ptosis visual field is performed to demonstrate a loss in the patient’s superior visual field. Once all the testing and visual complaints are obtained, the surgery can be scheduled as an outpatient, same-day procedure. Most cases scheduled with our office will also go through a pre-authorization or pre-determination process with your medical insurance.
Dermatochalasis is defined as loose and extra eyelid skin. It is often found in combination with orbital fat herniation. This extra skin can droop down and may cause hooding of the upper lids, where skin overhangs the eyelids without the presence of ptosis. This can give similar visual complaints as mentioned for ptosis above.
On some occasions, dermatochalasis is medically significant and, if found to be interfering with the vision, it can be considered reconstructive in nature, and surgery may be covered by insurance. In other cases, it is purely cosmetic and will not be covered by insurance. A cosmetic Blepharoplasty can be performed in the office under local anesthetic (completely awake) or in the surgery center under sedation or under General Anesthesia on its own.