Laser eyelid surgery is my specialty. The laser arcus marginalis release to remove dark circles is the most exciting development in plastic surgery in the past 3 years. Patients come to my practice in
Dark Circles under the Eyes affect a much younger age group than the typical eyelid rejuvenation or blepharoplasty patient. While dark circles do occur with eyelid aging, many people complain that they have had dark circles since childhood.
Most people who come to see me for correction of dark circles under the eyes are in their 20’s and 30’s and they complain that the dark circles under their eyes:
- Make them look tired
- Create a hollow eye appearance
- Make them look older
- Are impossible to cover with make up
- Make them look ill
Most people decide to do something about the dark circles under their eyes because they are tired of people asking if they are tired or sick.
The Arcus Marginalis Release with Fat Repositioning
Dark Circles under the Eyes are caused by the attachment of a structure called the Arcus Marginalis which tethers the lower eyelid skin to the bone of the eye socket just below the lower eyelid. This attachment holds the dark circle tight to the bone and the loose lower eyelid skin above the dark circle falls over the dark circle and deepens the shadow of the dark circle.
I use the laser to make a small transconjunctival incision on the inside of the lower eyelid and release the Arcus Marginalis and then I place fat beneath the dark circle to plump the dark circle. This is called a transconjunctival arcus marginalis release with fat repositioning.
Transconjunctival refers to the fact that the incision is on the inside of the eyelid through the conjunctiva, the pink skin on the inside. The benefits of the transconjunctival approach are:
- No visible scar on the eyelid
- No change in the shape of the eyelid
- Better access to the Arcus marginalis
The importance of the transconjunctival approach, making the incision on the inside of the eyelid, cannot be overstated. The older scalpel method of making an incision on the outside of the eyelid damages the support of the lower eyelid and can result in a sad eyed look or hound dog eyes.
I only use the transconjunctival approach so that your beautiful lower eyelid shape will be preserved.
The benefits of using the laser are:
- Less Bleeding
- Less bruising
- Less swelling
- Faster recovery
- A more accurate result
- Faster surgery-about 1/3 of the operative time required with scalpel blepharoplasty in my hands
When we meet I will talk with you and ask you to explain to me the specific goals you hope to achieve. I will examine you and tell you my findings and describe the areas where I think improvement can be made. I will demonstrate on your eyes the appearance that I believe the arcus marginalis release will create on your eyes and face.
I will then recommend the procedure I feel is best for you. I will discuss the procedure, your recovery, your expectations and answer your questions. Photos of your face and eyes will be taken. You will be given an estimate or quote of the cost of the procedure. Financing is available.
The pre operative visit, usually 2-3 weeks before surgery, is the time when we will sit down and clearly define your goals. We will discuss what you hope to achieve and what I believe I can achieve with an Arcus Marginalis Release.
You will also undergo a history and physical exam to make certain that you are healthy and have no medication allergies or contraindications to surgery. An EKG (electrocardiogram) may be done if you have a history of heart problems or have reached a certain age. You will also be given prescriptions for post operative medications.
You also will be asked to read and sign surgical consent forms which outline the risks, potential complications, limitations and expectations of eyelid surgery.
The Arcus Marginalis Release and fat repositioning takes about 45 minutes to an hour. If an upper blepharoplasty is also done to remove upper eyelid hooding, the procedure can take up to 90 minutes.
The surgery can be done under local anesthesia, but most of my patients choose to go to sleep for the procedure. This provides for your comfort and also reduces the time of the operation.
Protective laser impermeable shields are placed over your eyes to prevent injury to your eye during surgery. Very special laser safety precautions are taken in the operating room.
Very experienced superb anesthesiologists will be taking care of you. Safety is our first concern. We use modern, very safe anesthesiology techniques, and take precautions to avoid nausea after surgery.
The Arcus Release is almost always done as an outpatient or day surgery. Ice packs are placed over your eyes immediately after surgery to help minimize bruising and swelling.
After you wake up you will be taken to the recovery room where a nurse will be taking care of you. The nurse monitors you, makes certain you are comfortable and checks your vision. You will spend 2-3 hours in recovery. After that, as soon as you are comfortable, able to drink and eat a bland food such as crackers or cookies, and able to go to the bathroom, you will be discharged. The nurse will escort you by wheel chair to your car.
We require that someone bring you to the surgery center and take you home, and that you have someone staying with you the night after your surgery.
Post op- What to expect
My patients do not usually complain of pain following the Arcus Release. Initially you will feel your vision is obscured because I place protective ointment on the eye. For two weeks after surgery you will use this ointment at night when you go to bed. You will also be using soothing eye drops during the day for a few weeks after surgery.
I can tell you a great deal more about the correction of dark circles under the eyes and how it would work for you if I see you in person. Call me to set up a consultation or contact me by email. If you would like to email me your photos I can email you my thoughts about how I think an Arcus marginalis Release would work for you. For more information on eyelid rejuvenation visit my blogs on eyelid surgery. For an informative website on the topic of dark circles under the eyes visit My Dark Circles.com.
I look forward to meeting you.