Nariaki Miyata: Improvement of Lower Eyelid Shape by Transconjunctival Er:YAG Laser Irradiation
There are two types of aging-related changes in the lower eye lid: atrophy and laxity. We can improve atrophy by using various kinds of fillers, however, improvement of laxity requires a tightening effect. Some energy-based devices can contract the skin surface, but it is difficult to contract the orbital fat. Therefore, transconjunctival lower lid blepharoplasty is commonly performed in Japan. It’s available to remove orbital fat directly. On the other hand, for less invasive procedure, transconjunctival Er:YAG laser irradiation has been used in recent years. Unfortunately, there are opinions that it is sometimes ineffective.
Considering the mechanism of action for the transvaginal or transurethral mucosal irradiation laser treatments, it is necessary to generate a photo-thermal effect firmly in the deep layer to contract the orbital fat tissue. Therefore, I think that the best results can be obtained by considering all of the three following conditions; the wavelength characteristics of Er:YAG, the pulse duration, and the water content adjustment. For a few months, I have been trying transconjunctival Er:YAG irradiation under these new conditions. I shall report these short-term results and discuss the advantage of this method.