Why Lasers Cannot Replace Surgical Lifting

Can lasers lift and tighten skin? Advertising messages from device
manufacturers and individual medical practices have implied or outright made
claims that facelifts can be done non surgically using lasers and other
heating devices like high-frequency ultrasound heat generating what thermal
energy devices do have a role in cosmetic medicine it’s important to
understand the limitations of these technologies and understand where they
stand in comparison to any other types of procedures it’s also important to
recognize the potential detrimental effects of excessive heat on the skin
I’m Dr. Amiya Prasad I’m a Board-certified cosmetic surgeon and
Fellowship-trained oculofacial plastic and reconstructive surgeon I’ve been in
practice in Manhattan and Long Island for over 20 years I performed a full
range of surgical facelifts from many lifts and deep plane facelift I also own
several lasers and thermal energy delivery devices including fractional
CO2 laser long pulsed 1064 YAG laser erbium lasers W-switch laser and Pelleve
radiofrequency I also perform other non-surgical facial rejuvenation
treatments like the use of PRP or platelet-rich plasma to improve skin
quality as well as fillers and implants to improve facial volume in areas such
as the lips chin cheeks and jaw line associated with genetics and facial
aging starting off with what lasers and other thermal energy devices can do they
can tighten and improve the skin several ways the heat of thermal devices can
make the skin contract so they can help improve issues like wrinkles thermal
devices work on a controlled injury model where heating the skin to specific
temperatures will induce the body to produce
halogen as a repair response to injury collagen is the protein that gives skin
its strength and its foundation and contributes to the appearance of a
youthful smooth looking skin with partial ablation also known as
fractionated laser treatment the top layers of skin can be partially removed
to allow for new fresh layer of epidermis to come in lasers such as a
q-switch laser can tone the skin and stimulate collagen without any ablation
or downtime in our practice we use a long pulsed 1064 YAG laser which can
elevate the skin temperature to tighten the skin as well as to induce fat
reduction on the face and body as effective as these devices can
potentially be they cannot lift the skin like a facelift the aggressive marketing
using celebrities to promote non-surgical so-called facelift using
devices as their beauty secret in my opinion is deceptive and potentially
harmful people come in for laser or thermal treatments wanting the same
appearance as a celebrity endorser or the results of a facelift without
undergoing surgery just because a celebrity claims to use a particular
device it doesn’t mean their appearance that the result of only using the
promoted device it’s more likely the celebrity also had facelift as well as
eyelid surgery and cosmetic fillers and a whole other bunch of stuff when people
want results from a thermal device that a celebrity endorser actually got from
multiple unrelated procedures including surgical lifting there is a significant
potential risk to the skins health if a patient receives more aggressive
treatment to lift their skin they may be literally cooking the fat layers beneath
the skin which is very important for a glow of youthful volume misleading
consumers to think a non-surgical lifting as possible can put doctors in a
compromising position to do more aggressive
treatments and potentially compromise safety or do less aggressive treatments
and their patients will end up being dissatisfied having achieved more
realistic outcomes another reason why lifting with thermal devices is not
effective is that sagging goes on beyond just the skin and affects the muscle and
soft tissue layers below the skin the skin throughout most of the body is only
two millimeters in thickness but muscle and soft tissue also sags with aging
various thermal devices only focus on the outer layer and even if they can
contract and tighten the skin they cannot do that for the muscle and soft
tissue in a way that is done in surgery so visible sagging will persist even
minimally invasive procedure such as thread lifts can only lift the skin and
not the underlying muscle or soft tissue layers surgical lifting can tighten and
lift the muscle and soft tissue layers which leads to obviously visible and
superior results in appearing more youthful and ensures a longer-lasting
effect than just treating this top skin layer facelifts don’t address every
aging issue and additional treatments can be needed from volume augmentation
and maintaining skin quality while surgical face lifting and laser
treatment alternatives are often considered as the first treatment for
facial aging a significant aspect of facial aging is often not factored in
the facial foundation is bone bone loss has the most significant effect on
facial appearance this volumetric loss throughout the face notably in the
cheeks causes the facial structure to shrink and the face to look deflated
with less facial volume to support the skin the skin appears like it’s sagging
facial volume loss can be treated without surgery using a technique
called Structural Volumizing by placing thicker longer-lasting fillers deeper
than traditional filler placement at the foundational bone level we can restore
volume and give the face more definition since volume is placed at the bone level
and held in place by the muscle layer the filler doesn’t migrate like it tends
to do when placed just below the skin which is typical I would say that for
the majority of people who are trying to tighten and lift their skin without
surgery that structural volumizing will have a much more substantial benefit to
their appearance than heating the skin to try to shrink wrap their way to a
more attractive appearance a youthful face has volume and definition with a
soft and radiant glow to the skin by defining the problem you define the
solution lasers and other thermal treatments are perfectly suited for skin
resurfacing tightening collagen stimulation however if you’re looking to
lift what appears to be sagging skin a proper evaluation to determine the
degree of volume loss relative to the degree of skin and underlying tissue
sagging provides the key information needed for you to make an informed
decision when facial aging is approached from the inside outward volume provides
structure and the skin can be treated with lower energy non ablative lasers
PRP and gentle treatments to the epidermis patients come in asking for
the latest over hybrid heating device after educating them about bone loss I
provide more impressive results in 15 minutes with structural volumizing using
long lasting hyaluronic acid fillers then any shrink-wrapping heat technology
could ever produce I hope you found this information helpful thank you for your

What is the cost of ptosis surgery?

What is the cost of ptosis surgery?
Cost of any surgery is based on factors such as: surgeon’s fee, anesthesia, facility
cost and aftercare.
Surgical procedures are not commodities like electronic goods.
The results of your procedures are something you will live with for a long time.
Understanding the cost of delivering high level of care usually give my patients an
understanding of how we arrive at our fees.

After the operation, will my eyelid look the same as before?

After the operation, will my eyelid look the same as it did before?
The answer to this question is based on the objective of the eyelid surgery.
If you are having ptosis surgery, then elevating the height of the eyelid should improve the
appearance of your eyes.
If you have unilateral ptosis or ptosis affecting only one eye, I aim to maximize the symmetry
and shape with the other eye so your eyes look the same before you did before you developed

Once I had ptosis surgery, will I need any other treatment?

Once I’ve had ptosis surgery, will I need another treatment?
There are several factors that can impact if and when you need another surgery.
These factors include: the type of ptosis you have, the age when you had the procedure,
changes related to aging and your own tissue’s elasticity.
For example for someone who has congenital ptosis or ptosis you are born with has surgery
before the age of 6 and as they get old may need to get another surgery in their teen
years or young adulthood.
The more common type of ptosis called acquired ptosis occurs in later life and is caused
by the thinning or detachment of the tendon of the levator muscle which is the muscle
responsible for lifting the eyelid.
A common term for this type of ptosis is referred to as aponeurotic ptosis or levator muscle
The procedure to approach this type of ptosis in my experience can last for years without
needing any additional surgery.
Ptosis surgery may require enhancement during the first several months or years if there
is any issue related to the height, symmetry or contour.

How does the recovery for eyelid ptosis compare to that of blepharoplasty?

How does the recovery for eyelid ptosis compare to that of blepharoplasty?
In my experience, correction of the most common type of eyelid ptosis related to the thinning
of the muscle tendon called levator aponeurosis doesn’t make a significant difference in
the recovery period when compared to upper eyelid blepharoplasty.
In some situations, swelling can last longer depending on the specific issue during or
related to the surgery.

What is recovery like after ptosis surgery?

What is recovery like after Ptosis Surgery?
At one level, the recovery after ptosis surgery is related to the type of ptosis surgery as
well as the medical status of the person who’s recovering from the surgery. At another level,
a person’s recovery can be affected by their experience in the operating room as well as
the recovery area. It has been my assertion that the person’s experience during and
immediately after surgery has an impact on the short term recovery as well as the long
term recovery period. The factors which I have been successful in helping my patients
recovery after surgery include: the anesthesia method, the surgical team, the surgical technique
and the post operative recovery process.
In our practice, we help our patients recover faster by performing the surgery under local
anesthesia with LITE™ IV sedation. We rarely use general anesthesia which is usually associated
with longer recovery and in my experience, is also associated with more bruising and
swelling. In addition, we avoid any sedation which can cause nausea and grogginess afterwards.
In fact, we have developed our own customized approach to sedation which can consistently
results in our patients waking up fresh and comfortable allowing them to go home soon
after surgery.
I’ve performed surgery at numerous hospitals and surgery centers and had variable levels
of assistance in those institutions. When assistants and other medical personnel work
with many different surgeons, it’s difficult to perform any procedure smoothly and efficiently.
Longer surgery times can have an impact on recovery. Recognizing this as a challenge
for my patients, I perform my procedures in my own operating facilities which are accredited
by The Joint Commission. The Joint Commission is the same organization that oversees hospitals
and ambulatory surgery centers. I can state without any reservation that working with
my own team in my own facilities has resulted in our patients having a much better recovery
In my opinion, for optimal cosmetic and reconstructive surgery, the surgeon should have: an intrinsically
artistic eye, technical proficiency and a lot of experience. During my consultations,
I discuss that how I feel as a surgeon over 20 years of experience, I am able to handle
many different situations in a way an experienced pilot can handle different situations when
flying a plane. Generally, a well executed surgical procedure will typically result in
a better recovery experience.
Before I designed my own surgical facility, I performed surgeries in hospitals and surgery
centers where I was frustrated by my patient’s experience in the recovery area. Unfortunately,
I found that there was always a mismatch between the number of patients in the recovery room
and the number of people available to take care of them. This resulted in delay in proper
care for procedures such as eyelid surgery where ice and cold compresses need to be applied
as soon as possible. In addition, the patients did not receive the one to one attentive care
that I feel is appropriate for optimal recovery. In my facilities, we have systems and people
to attend to our patients immediately upon the completion of surgery which has helped
my patients recover faster.
As far as the home recovery processes are concerned, it is typical to have some swelling
and some bruising particularly in the first 24-48 hours. We see this improve daily such
that our patients are able to return to work in 5 to 7 days after surgery. Some application
of cover-up make-up and wearing tinted eyewear can be helpful at that time. A significant
part of the healing process occurs during the first few months. Healing can go on for
approximately one year after any type of surgery.

What happens during ptosis surgery?

What happens during ptosis surgery?
Ptosis surgery in adults such as levator muscle advancement and levator muscle resection is
typically performed in our practice under local anesthesia with conscious IV or intravenous
The goal of the surgery is to elevate the eyelids or both eyelids as well as to maximize
the symmetry and the cosmetic appearance.
In order to accomplish this, I typically have my patient open and close their eyes in both
the laying and upright position to confirm the appearance and to make adjustments.
Of course, the patient is comfortable and is not feeling anything when I’m doing this.
When I and my team are happy with the results, we lay the patient back and I complete the
We place cold compresses afterwards and our patients go home without any bandages.

Will my eyesight change after ptosis surgery?

Will my eyesight change after ptosis surgery?
Most people after ptosis surgery appreciate an improvement in their vision through the
improvement of the eye position relative to the pupil.
My patients report that the world feels brighter and they don’t feel the strain of keeping
their eyes open anymore.
In terms of wearing glasses and contact lenses, I advise my patients that they can wear their
glasses if needed after surgery.
But as far as contact lenses are concerned, I usually recommend waiting about a week since
during that time antibiotic ophthalmic ointment is being applied to the eyelid and it can
get on the contact lenses and affect their quality of the vision.
When resuming contact lens wear, I advise liberal use of lubricating eye drops because
it’s expected that the eyes are going to be more dry in the post-operative period and
with the eyes being more open, the tear film may need supplementation.
In terms of your eyeglass or contact lens prescription, it’s possible, you may need
to adjust your prescription.
When the eyelid is drooping, it can affect the curvature of the cornea causing a very
mild astigmatism.
I generally recommend waiting several months before having the patients go to their ophthalmologist
to check if their prescription’s changed.

Can I fix ptosis without surgery?

Can I fix ptosis without surgery?
Ptosis is typically caused by a physical condition affecting the levator muscle.
The levator muscle is which lifts the eyelid.
Since this condition is an anatomical issue, surgery is the most effective treatment for
In some people, an eyedrop can be used to temporarily contract an accessory muscle of
the eye called Mueller’s muscle which can lift the eyelid 1-2 mm for purpose for posing
such as for photography.

What are the alternative to ptosis surgery?

What are the alternatives to ptosis surgery?
If your ptosis is significant enough to be cosmetically concerning or is affecting your
vision, there are really no practical alternative to ptosis surgery to get an optimal result.
Ptosis surgery can be performed safely with minimal risk.
Meet with an experienced oculofacial plastic surgeon and learn what type of procedure is
right for you.