Nonresective shrinkage of the septum and fat compartments of the upper and lower eyelids: a comparative study with carbon dioxide laser and Colorado needle.
BACKGROUND
The purpose of this article is to describe an alternative nonresective treatment of the fat-septum component of the eyelids during blepharoplasty, using shrinkage desiccation with two low-energy modalities: a carbon dioxide laser and a low-range grid of electrocautery with a Colorado microdissection needle.


METHODS
Thirty-six patients underwent a four-lid blepharoplasty. During surgery, after exposure (not opening) of the septum and assessment of the amount of bulging by gentle globe compression, a grid spray of electrocautery (right eye) and carbon dioxide laser (left eye) was applied over the entire septum until shrinkage and correction of the bulging was achieved. Preoperative, postoperative day 15, and 1-year follow-up photographs were evaluated using an objective grading system by blinded surgeons. For statistical analysis, the Wilcoxon matched-pairs signed-ranks test was used, with p < 0.05 indicating statistical significance.


RESULTS
All the patients completed the 15-day evaluation, but only 32 completed the 1-year follow-up. No major eye or eyelids complications were observed. There were no statistical differences in surgical time and postoperative pain on either side. In this study, laser fat-septum shrinkage achieved substandard results compared with electrocautery when analyzed as a continuous variable, but it did not influence the categorical Strasser scale final result in the short- and long-term follow-up.


CONCLUSIONS
The method described is simple and safe, and provides a subtle but long-lasting, adequate result. No statistical clinical differences were observed between the electrocautery and laser fat-septum shrinkage techniques.
Prado
Arturo
A
Division of Plastic Surgery, School of Medicine, Clinical Hospital J. J. Aguirre, University of Chile, Santiago, Chile. pradoplast@yahoo.com
Andrades
Patricio
P
Danilla
Stefan
S
Castillo
Paulo
P
Benitez
Susana
S
D000273:Adipose Tissue / Q000473:pathology*; D000328:Adult; D019882:Blepharoplasty / Q000295:instrumentation* / Q000379:methods; D002245:Carbon Dioxide; D004564:Electrocoagulation / Q000295:instrumentation*; D004954:Esthetics; D005143:Eyelids / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D009339:Needles; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D016037:Single-Blind Method; D016896:Treatment Outcome
D002245:Carbon Dioxide