Erbium Laser Skin Resurfacing Pigment Changes

Patient

Q: I have moderate wrinkles and creases on my lower eyelid. I was interested in getting laser resurfacing done. I'm Filipino with medium brown skin. The plastic surgeon I saw told me I was a bad candidate for laser resurfacing with his Erbium laser because of my skin tone; he said there was too high of a risk of getting hypo or hyper pigmentation. Then I saw a cosmetic dermatologist who told me that I wouldn't get hypo or hyper pigmentation with his Erbium laser because he said he knows how to do it right. My question is, is it possible to not get hypo or hyper pigmentation with an Erbium laser if it is done correctly? Please let me know, thank you.

Doctor

A:   Thank you for your question.

I would be very hesitant to have laser resurfacing of your lower eyelids. In my opinion, there is always a risk of hypo/hyperpigmentation in patients with your skin tone. Furthermore, there is a risk of developing an ectropion (turned out lower eyelid) with laser therapy to the lower eyelid. If the wrinkles of the lower eyelid bother you, a lower blepharoplasty (eyelid surgery) may be right for you. The procedure involves making an incision just below the lashes to remove the excess fat, and tighten the skin to remove the redundancy and smooth the wrinkles. You will go home the same day and experience a week of bruising and 2 weeks of swelling. After about 2 weeks you can go out in public without sunglasses but will continue to heal for about another 2 weeks.

Lower blepharoplasty is a procedure that should only be done by board certified plastic surgeons who are trained in aesthetic facial surgery. Please check the credentials of the surgeon you choose to perform your operation.

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