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CO2 Laser-Assisted Blepharoplasty: A Comprehensive Guide

Updated: Jun 15, 2023

By Phornrak Sriphon,MD, Ophthalmologist, Glaucoma specialist, Eyelid Surgeon

Introduction and overview

Blepharoplasty, commonly known as eyelid surgery, involves removing excess skin, fat, and muscle from the upper and/or lower eyelids to improve their appearance and restore a more youthful look. In traditional blepharoplasty, a scalpel is typically used to make incisions. However, laser CO2-assisted blepharoplasty offers certain advantages due to the properties of the CO2 laser.

The CO2 laser emits a concentrated beam of light that vaporizes or ablates tissue with high precision. During CO2 laser-assisted blepharoplasty, the laser is used to make precise incisions, thereby minimizing bleeding and trauma to the surrounding tissues. It also allows for more controlled tissue removal, resulting in improved cosmetic outcomes.

The Step-by-Step Process

  1. Consulting with a doctor : before surgery is the most important step. It involves an evaluation and discussion with the physician to talk about goals, desires, possible eyelid shapes, concerns, limitations, and medical history. Additionally, the doctor will assess and measure visual acuity, examine the eyelids, eye layers, front part of the eyes, dry eye condition, muscle function, and other details. All of this information will be used to plan an appropriate surgical technique and explain the potential risks and benefits of the procedure.

  2. Eyelid Marking: In this step, the eyelid design will be drawn on the back surface of the eyelids using a surgical marker prior to administering anesthesia, as planned.

  3. Anesthesia Administration: On the day of the surgery, anesthesia is typically administered, primarily through local anesthesia at the eyelid area. This may include the use of eye drops to numb the eye. This is done to rely on your blink reflex during the procedure to approximate the desired eyelid shape. As a result, you will remain conscious throughout the surgery, but without feeling any pain or discomfort.

  4. Skin incision: The surgeon will use a CO2 laser to create incisions instead of a scalpel, whether excess skin needs to be removed or not. After that, the process of identifying fat in the eyelids, adjusting the eye muscles, and suturing according to the planned technique will begin.

  5. Surgical Technique: The process of removing excess skin, adjusting the outer eye muscles, and removing fat can be performed simultaneously in this step. However, it depends on the planned surgical technique and the individual's specific concerns and needs.

  6. Wound Closure: After the structural adjustments of the eyes have been made, the surgeon will proceed to close the incisions using non-absorbable sutures. These sutures are designed to remain in place and provide proper wound healing without dissolving.

  7. Recovery and Follow-up: After the surgery, immediate cold compress will be applied, and your condition will be monitored for approximately 30 minutes to ensure there are no complications before you are ready to go home. The doctor will provide specific post-operative instructions, such as using cold packs, taking prescribed oral or eye drop medications, and avoiding strenuous activities. Additionally, a follow-up appointment will be scheduled for suture removal 5-7 days after the surgery to monitor the healing progress and check the incision site.

The surgical procedures of each physician may vary in the 7-step process mentioned above, depending on their expertise and the chosen techniques. These steps were specifically outlined for Dr. Porak Sripon's CO2 laser-assisted blepharoplasty.

Is CO2 Laser-Assisted Blepharoplasty Right for You? Assessing


The CO2 Laser-Assisted Blepharoplasty technique can be used on individuals of all genders and ages, including those with a history of easy bleeding, easy bruising, elderly patients, and those desiring smooth, minimally visible scars with a faster overall recovery time.

Understanding the Benefits

1. Minimally Invasive: When compared to conventional surgical methods that involve the use of scalpels, CO2 laser-assisted blepharoplasty is considered a minimally invasive procedure. It allows for quick surgery, minimal tissue damage, and the laser can create smooth incisions, reducing tissue trauma and potentially facilitating faster recovery.

2. Reduced Bleeding and Swelling: CO2 laser has the effect of reducing bleeding during surgery. This means that there is less blood loss throughout the procedure. Consequently, the postoperative effects of bruising and swelling tend to decrease.

3. Recovery and Skin Enhancement: CO2 laser technology can stimulate collagen production in the skin, focusing on the deeper layers. The laser helps tighten the skin, improve its structure and tone, including the area around the eyes. This can contribute to a more youthful and vibrant appearance, potentially allowing for simultaneous skin rejuvenation around the eyes.

4. Smooth Incisions and Minimal Scarring: CO2 laser-assisted blepharoplasty results in smooth incisions and minimal scarring.

Pre-operative and Post-operative Care

Preoperative Guidelines Before Eyelid Surgery:

  1. Avoid medications that can thin the blood, such as aspirin and Plavix, for at least 7-10 days or as directed by your doctor.

  2. Shower, wash your face, and shampoo your hair on the morning of the surgery appointment.

  3. On the day of eyelid surgery, avoid wearing makeup or using cosmetics that are difficult to clean.

  4. Arrange for a caregiver to assist you after the surgery. It is advisable not to drive yourself.

  5. Wear comfortable clothing and choose a shirt that buttons in the front.

  6. Eat easily digestible food before coming in for the surgery.

Postoperative Guidelines After Eyelid Surgery:

  1. Sleep with your head elevated at a 45-degree angle.

  2. Apply cold compresses to the swollen area for the first 2-3 days or until the swelling subsides.

  3. Avoid wearing contact lenses for 2 months (if there was muscle correction involved).

  4. Avoid wearing makeup for 1 week.

  5. Avoid any direct trauma to the surgical incision until the stitches are removed.

  6. Schedule a follow-up appointment for stitch removal within 7 days.

  7. Take prescribed medications as instructed by your doctor.

  8. Do not pick, scratch, or rub the incision.

  9. Maintain a normal diet, but avoid spicy foods.

  10. Expect swelling for 2-4 days, after which the incision will gradually improve until it is completely healed.

Common Concerns and What to Expect

  1. Pain : After CO2 laser surgery, there is generally less pain compared to conventional surgical methods, as the laser can stop bleeding without cuatery, reducing the amount of discomfort caused by cuatery.

  2. Swelling and bruising: After CO2 laser surgery, swelling and bruising may occur, especially in the first 2-3 days. However, they will gradually reduce and disappear within 7 days. Cold compresses can help expedite the healing process.

  3. Recovery time: The recovery time after CO2 laser surgery can vary depending on the individual and the extent of the procedure. In the early stages after surgery, there will be visible incisions. The doctor will provide guidance on wound care and appropriate recovery time. However, in general, recovery from CO2 laser surgery tends to be relatively quick and does not require a long duration.

  4. Results: The results of CO2 laser surgery will become evident within 1 week to 6 months after the procedure. You will notice clear changes in the shape of your nose and the area around your eyes. However, in some cases, it may take longer to see the full results. Your doctor will provide guidance on the necessary waiting time to fully appreciate the results.

  5. Continued Care: After CO2 laser surgery, it is important to schedule follow-up appointments with your doctor to monitor the results and provide additional care. Your doctor will give you guidance on appropriate ongoing care to ensure optimal healing and maintenance.

Before and After

The results of CO2 laser surgery can vary from person to person.



The information provided in this content is intended for general informational purposes only and should not be considered medical advice. It does not establish a doctor-patient relationship and should not be used for medical decision-making. Users should seek medical consultation from a qualified healthcare professional for specific medical conditions and should not disregard or delay seeking medical advice based on this information. The author and publisher of this content are not liable for any errors or consequences arising from the use of the provided information. Users use this content at their own risk and discretion.

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