Dear Dr. Seckel, I am 52 years old and I had a consultation with a Cosmetic Plastic Surgeon to have a facelift, along with Erbium peel done on my lower eyelids and botox. Since the procedures are very expensive, I was wondering if you would recommend having the lower eyelids down with the laser and the botox and waiting to have the facelift, or go ahead and wait to have it all done at once, which is what he wants to do? From what I have read, the downtime may be high for the laser treatment, compared to the facelift. Thank you, Jenny, Salem, OR.
Dear Jenny,
I always recommend to my patients that they take their time in deciding to have a major facial rejuvenation procedure. I also tell my patients frequently to do smaller non-surgical facial rejuvenation options and save their money for expensive surgery later on. I don’t think people should spend money they can’t afford on cosmetic surgery.
If your main concerns are wrinkles and aging changes in your eyelids then the laser skin rejuvenation procedure called the microlaserpeel, or the activefx laser skin peel may help. The laser eyelid peel can remove eyelid wrinkles. If you have large eyelid bags, dark circles under the eyes or puffy eyelids and loose eyelid skin, then a laser eyelid peel wont help, you would need a blepharoplasty.
If you have crow’s feet which bother you, then Botox® can help a lot. IMPORTANT- if you have a laser eyelid peel or laser skin rejuvenation on the eyelids wait 6 weeks before having Botox®. If you have Botox® first and then a laser peel the inflammation caused by the laser will cause the Botox® to wear off in a few weeks-so it is a waste of Botox®. Wait until you have healed from the laser peel.
Recovery time for a face lift is 2-3 weeks. Recovery time for a laser eyelid peel is 2-3 weeks so I don’t think there is much difference. Yes, the eyelids will remain pink after a laser eyelid peel for a few additional weeks but that is easily covered by make up.
I agree with waiting until you are really ready. However if your eyelids really bother you there is nothing wrong with doing eyelid rejuvenation first.
Just be certain that you understand all of the various options for eyelid rejuvenation. Visit drseckel.com to see results of facial rejuvenation procedures like blepharoplasty, eyelid rejuvenation, dark circles under the eyes and eyelid bags.
If you have eyelid bags and dark circles and hooding of the upper eyelids you will need an upper and lower blepharoplasty. I do these with the laser and I do the lower eyelids through an incision on the inside of the lower eyelid called a transconjunctival blepharoplasty-this avoids a visible scar and preserves the natural shape of the eyelid. If you have dark circles under the eyes, usually a procedure called arcus marginalis release and fat repositioning is needed as well.
If you only want to remove eyelid wrinkles and crow’s feet then an eyelid laser peel and botox will suffice.
There are also different degrees of laser eyelid peel. I frequently do what is called a Microlaserpeel® which is a superficial laser peel (40 microns) and only requires 4-5 days of recovery. This laser peel can be repeated 2-3 times over 6-9 months and can produce a very satisfactory eyelid wrinkle removal result.
The deeper erbium laser peel (100 or more microns), also called laser resurfacing, which requires 2-3 weeks down time, only needs to be done once. However this deeper peel is more risky and can cause complications. Deeper laser peel should never be done on the lower eyelid if the eyelid is lax or loose, because the tightening of the eyelid by the laser can pull the eyelid down causing a sad eyed look or “hound dog eye” appearance called an ectropion. If the eyelid is lax then it must first be tightened by a procedure called a canthopexy before a deep laser peel is done. You can check your eyelid by gently pulling down on the lower eyelid and letting go. The eyelid should snap back quickly against the eyeball-if it does not then you probably would need a canthopexy before having a deep laser peel on the lower eyelid.
The time to have a face lift is when you really feel you need a face lift. Generally a face lift is most helpful when you notice sagging skin below your chin, “jowls” along the jaw line, and sagging cheeks and brow. This is a very personal decision.
I hope my answer has been helpful. Since I have not examined you and not seen your face, I can only provide general guidelines.
I wouldn’t worry about recovery time from a Microlasaerpeel® on the lower eyelids, as long as your eyelids are not loose or lax.
Thank you. For further information on face lift, eyelid wrinkle removal and eyelid rejuvenation read Save Your Face or contact me.
Boston, Massachusetts