Periorbital Lasers

  • Jason N. PoznerEmail author
  • Megan C. Jack


Nonsurgical periorbital rejuvenation has become quite popular in recent years as techniques and equipment have improved and as patients are seeking less invasive options. Laser resurfacing has morphed into treatments with a variety of devices all with the intent of shrinking skin and avoiding incisions. The devices used are full-field lasers, fractional lasers, radiofrequency, and ultrasound technology. This chapter discusses laser treatment options available to physicians, expected results, combination treatment with surgery, and complications.


Fractional Laser Laser Safety Laser Resurface Periorbital Area Variable Pulse Width 
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Supplementary material

Video 4.1

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  1. 1.
    Baker TM. Dermabrasion: as a complement to aesthetic surgery. Clin Plast Surg. 1998;25(1):81–8.PubMedGoogle Scholar
  2. 2.
    Deprez P. Textbook of chemical peels: superficial, medium, and deep peels in cosmetic practice. Oxfordshire: Taylor & Francis; 2007.CrossRefGoogle Scholar
  3. 3.
    Baker TJ, editor. Skin resurfacing. Clin Plast Surg. 1998;25(1):1–53Google Scholar
  4. 4.
    Fulton Jr JE, Barnes T. Collagen shrinkage (selective dermaplasty) with the high-energy pulsed carbon dioxide laser. Dermatol Surg. 1998;24(1):37–41.CrossRefPubMedGoogle Scholar
  5. 5.
    Felder DS. CO2 laser skin resurfacing in oculoplastic surgery. Curr Opin Opthalmol. 1996;7(5):32–7.CrossRefGoogle Scholar
  6. 6.
    Kang DH, Choi JH, Koo SH, Park SH. Laser blepharoplasty in Asians. Ann Plast Surg. 2002;48(3): 246–51.CrossRefPubMedGoogle Scholar
  7. 7.
    Gladstone GJ, Black EH, Rose Jr JG, Sierra CA, Myint S, Brazzo BG, et al. Oculoplastic surgery atlas: eyelid disorders. New York: Springer; 2002.CrossRefGoogle Scholar
  8. 8.
    Ismail AR, Anthony T, Mordant DJ, MacLean H. Regional nerve clock of the upper eyelid in oculoplastic surgery. Eur J Ophthalmol. 2006;16(4):509–13.PubMedGoogle Scholar
  9. 9.
    American Society for Laser Medicine and Surgery: Wausau, WI.
  10. 10.
    American National Standard for Safe Use of Lasers, 2011; ANSI Z136.3. Laser Institute of America. and
  11. 11.
    Bentkover SH. Plasma skin resurfacing: personal experience and long-term results. Facial Plast Surg Clin North Am. 2012;20(2):145–62.CrossRefPubMedGoogle Scholar
  12. 12.
    Weber SM, Downs BW, Ferraz MB, Wang TD, Cook TA. Facial resurfacing with coblation technology. Medscape J Med. 2007;10(7):155.Google Scholar
  13. 13.
    Kilmer S, Semchyshyn N, Shah G, Fitzpatrick R. A pilot study on the use of a plasma skin regeneration device (Portrait PSR3) in full facial rejuvenation procedures. Lasers Med Sci. 2007;22(2):101–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med. 2004; 34(5):426–38.CrossRefPubMedGoogle Scholar
  15. 15.
    Tierney PE, Hanke CW, Watkins L. Treatment of lower eyelid rhytids and laxity with ablative fractionated carbon-dioxide laser resurfacing: Case series and review of the literature. J Am Acad Dermatol. 2011;64(4):730–40.CrossRefPubMedGoogle Scholar
  16. 16.
    Sukal SA, Chapas AM, Bernstein LJ, Hale EK, Kim KH, Geronemus RG. Eyelid tightening and improved eyelid aperture through nonablative fractional resurfacing. Dermatol Surg. 2008;34(11):1454–8.PubMedGoogle Scholar
  17. 17.
    Foster KW, Kouba DJ, Fincher EE, Glicksman ZS, Hayes J, Valerie F, et al. Early improvement in rhytids and skin laxity following treatment with a combination fractional laser emitting two wavelengths sequentially. J Drugs Dermatol. 2008;7(2):108–11.PubMedGoogle Scholar
  18. 18.
    Karsai S, Czarnecka A, Ju``nger M, Raulin C. Ablative fractional lasers (CO(2) and Er:YAG): a randomized controlled double-blind split-face trial of the treatment of peri-orbital rhytids. Lasers Surg Med. 2010; 42(2):160–7.CrossRefPubMedGoogle Scholar
  19. 19.
    Kotlus BS. Dual-depth fractional carbon dioxide laser resurfacing for periocular rhytidosis. Dermatol Surg. 2010;36(5):623–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Mezzana P, Scarinci F, Costantino A, Marabottini N, Valeriani M. Lower eyelid ablative fractional resurfacing: a new technique to treat skin laxity and photoaging. Acta Chir Plast. 2010;52(2–4):35–8.PubMedGoogle Scholar
  21. 21.
    Fitzpatrick RE, Rostan EF, Marchell N. Collagen tightening induced by carbon dioxide laser versus erbium: YAG laser. Lasers Surg Med. 2000;27(5):395–403.CrossRefPubMedGoogle Scholar
  22. 22.
    Ruiz-Esparza J. Noninvasive lower eyelid blepharoplasty: a new technique using nonablative radiofrequency on periorbital skin. Dermatol Surg. 2004;30(2 pt 1):125–9.PubMedGoogle Scholar
  23. 23.
    Goldstein SM. Ocular surface temperature changes associated with Pellevé radiofrequency treatment. American Society of Ophthalmic Plastic and Reconstructive Surgery Annual Fall Scientific Symposium Presentation, Oct 2011.
  24. 24.
    Stampar M. The Pelleve procedure: an effective method for facial wrinkle reduction and skin tightening. Facial Plast Surg Clin North Am. 2011;19(2): 335–45.CrossRefPubMedGoogle Scholar
  25. 25.
    Javate RM, Cruz RT. Use of an imaging device after nonablative radiofrequency (Pellevé) treatment of periorbital rhytids. American Society of Ophthalmic Plastic and Reconstructive Surgery Annual Fall Scientific Symposium Presentation, Oct 2011.
  26. 26.
    Taub AF, Tucker RD, Palange A. Facial tightening with an advanced 4-MHz monopolar radiofrequency device. J Drugs Dermatol. 2012;11(11):1288–94.PubMedGoogle Scholar
  27. 27.
    Gliklich RE, White WM, Slayton MH, Barthe PG, Makin IR. Clinical pilot study of intense ultrasound therapy to deep dermal facial skin and subcutaneous tissues. Arch Facial Plast Surg. 2007;9(2):88–95.CrossRefPubMedGoogle Scholar
  28. 28.
    Swanson E. Objective assessment of change in apparent age after facial rejuvenation. J Plast Reconstr Aesthet Surg. 2011;64(9):1124–31.CrossRefPubMedGoogle Scholar
  29. 29.
    Alster TS, Bellew SG. Improvement of dermatochalasis and periorbital rhytids with a high-energy pulsed CO2 laser: a retrospective study. Dermatol Surg. 2004;30(4 Pt 1):483–7.PubMedGoogle Scholar
  30. 30.
    Lieb WE, Klink T, Mu``nnich S. CO2 and erbium YAG laser in eyelid surgery. A comparison. Ophthalmologe. 2000;97(12):835–41. German.CrossRefPubMedGoogle Scholar
  31. 31.
    Millman AL, Mannor GE. Histologic and clinical evaluation of combined eyelid erbium: YAG and CO2 laser resurfacing. Am J Ophthalmol. 1999;127(5): 614–6.CrossRefPubMedGoogle Scholar
  32. 32.
    Hidalgo DA. An integrated approach to lower blepharoplasty. Plast Reconstr Surg. 2011;127(1):386–95.CrossRefPubMedGoogle Scholar
  33. 33.
    Kim EM, Bucky LP. Power of the pinch: pinch lower lid blepharoplasty. Ann Plast Surg. 2008;60(5):532–7.CrossRefPubMedGoogle Scholar
  34. 34.
    Punthakee X, Keller GS, Vose JG, Stout W. New technologies in aesthetic blepharoplasty and brow-lift surgery. Facial Plast Surg. 2010;26(3):260–5.CrossRefPubMedGoogle Scholar
  35. 35.
    Perkins SW, Batniji RK. Rejuvenation of the lower eyelid complex. Facial Plast Surg. 2005;21(4): 279–85.CrossRefPubMedGoogle Scholar
  36. 36.
    Carter SR, Seiff SR, Choo PH, Vallabhanath P. Lower eyelid CO(2) laser rejuvenation: a randomized, prospective clinical study. Ophthalmology. 2001;108(3): 437–41.CrossRefPubMedGoogle Scholar
  37. 37.
    Alster TS. Comparison of two high-energy, pulsed carbon dioxide lasers in the treatment of periorbital rhytids. Dermatol Surg. 1996;22(6):541–5.CrossRefPubMedGoogle Scholar
  38. 38.
    Harris DM, Fried D, Reinisch L, Bell T, Schachter D, From L, et al. Eyelid resurfacing. Lasers Surg Med. 1999;25(2):107–22.CrossRefPubMedGoogle Scholar
  39. 39.
    Rosenburg GJ. Temporary tarsorrhaphy suture to prevent or treat scleral show and ectropion secondary to laser resurfacing or laser blepharoplasty. Plast Reconstr Surg. 2000;106(3):726–7.CrossRefGoogle Scholar
  40. 40.
    Weinstein C. Postoperative laser care. Clin Plast Surg. 2000;27(2):251–62.PubMedGoogle Scholar
  41. 41.
    Weinstein C, Ramirez OM, Pozner JN. Postoperative care following CO2 laser resurfacing: avoiding pitfalls. Plast Reconstr Surg. 1997;100(7):1855–66.CrossRefPubMedGoogle Scholar
  42. 42.
    Mannor GE, Phelps RG, Friedman AH, Meltzer M. Eyelid healing after carbon dioxide laser skin resurfacing: histological analysis. Arch Ophthalmol. 1999;117(7):913–6.CrossRefPubMedGoogle Scholar
  43. 43.
    Weinstein C, Pozner JN, Ramirez OM. Complications of carbon dioxide laser resurfacing and their prevention. Aesthet Surg J. 1997;17(4):216–25.CrossRefPubMedGoogle Scholar
  44. 44.
    Richert SM, Bridenstine J. Transepidermal elimination of elastic fibers after carbon dioxide laser resurfacing. A report of two cases. Dermatol Surg. 1998;24(2):275–8.CrossRefPubMedGoogle Scholar
  45. 45.
    Sheinbein DS, Loeb RG. Laser surgery and fire hazards in ear, nose, and throat surgeries. Anesthesiol Clin. 2010;28(3):485–96.CrossRefPubMedGoogle Scholar
  46. 46.
    Ho SGY, Chan HHL. Laser treatment of ethnic skin. In: Hruza G, Avram M, editors. Lasers and lights. 3rd ed. London: Elsevier Saunders; 2013.Google Scholar
  47. 47.
    Mack WP. Complications in periocular rejuvenation. Facial Plast Surg Clin North Am. 2010;18(3): 435–56.CrossRefPubMedGoogle Scholar
  48. 48.
    Fife DJ, Fitzpatrick RE, Zachary CB. Complications of fractional CO2 laser resurfacing: four cases. Lasers Surg Med. 2009;41(3):179–84.CrossRefPubMedGoogle Scholar
  49. 49.
    Mieziak AI, Gottsch JD, Iliff NT. Exposure keratopathy after cosmetic CO2 laser skin resurfacing. Cornea. 2000;19(6):846–8.CrossRefGoogle Scholar
  50. 50.
    Trelles MA, Brychta P, Stanex J, Allones I, Alvarez J, Koegler G, et al. Laser techniques associated with facial aesthetic and reparative surgery. Facial Plast Surg. 2005;21(2):83–98.CrossRefPubMedGoogle Scholar
  51. 51.
    Roberts 3rd TL. The emerging role of laser resurfacing in combination with traditional aesthetic facial plastic surgery. Aesthetic Plast Surg. 1998;22(2): 75–80.CrossRefPubMedGoogle Scholar
  52. 52.
    Roberts 3rd TL. Laser blepharoplasty and laser resurfacing of the periorbital area. Clin Plast Surg. 1998; 25(1):95–108.PubMedGoogle Scholar
  53. 53.
    Pozner JN, DiBernardo BE, Bass LS. Laser resurfacing. In: Hruza G, Avram M, editors. Lasers and lights. 3rd ed. London: Elsevier Saunders; 2013.Google Scholar
  54. 54.
    Goldberg DJ. Lasers for facial rejuvenation. Am J Clin Dermatol. 2003;4(4):225–34.CrossRefPubMedGoogle Scholar
  55. 55.
    Papadavid E, Katsambas A. Lasers for facial rejuvenation: a review. Int J Dermatol. 2003;42(6):480–7.CrossRefPubMedGoogle Scholar
  56. 56.
    Bernstein EF, Andersen D, Zelickson BD. Laser resurfacing for dermal photoaging. Clin Plast Surg. 2000;27(2):221–40.PubMedGoogle Scholar
  57. 57.
    Manaloto RM, Alster TS. Periorbital rejuvenation: a review of dermatologic treatments. Dermatol Surg. 1999;25(1):1–9.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Sanctuary Medical Aesthetic CenterBoca RatonUSA

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