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Improvement of Dermatochalasis and Periorbital Rhytides With a High‐Energy Pulsed CO2 Laser: A Retrospective Study

BACKGROUND Upper eyelid dermatochalasis is typically treated with excisional blepharoplasty. The role of the CO2 laser previously had been confined to that of a vaporizing, incisional, or hemostatic tool. Over the past several years, however, ablative CO2 laser skin resurfacing has been popularized as an adjunctive treatment to blepharoplasty to minimize periorbital rhytides through its vaporizing as well as skin-tightening action. OBJECTIVE To evaluate the safety and efficacy of a high-energy pulsed CO2 laser as a stand-alone treatment for dermatochalasis and periorbital rhytides. METHODS Sixty-seven patients (skin phototypes I–IV) with mild-to-severe upper eyelid dermatochalasis and periorbital rhytides received periocular CO2 laser skin treatment. Global assessment scores of dermatochalasis and rhytides were determined by a side-by-side comparison of periocular photographs preoperatively and 1, 3, and 6 months postoperatively. In addition, caliper measurements of upper eyelids before and 1, 3, and 6 months after treatment were obtained. RESULTS Both dermatochalasis and periorbital rhytides were significantly improved after periocular CO2 laser skin resurfacing. Patients with more severe dermatochalasis and rhytides showed greater improvement after CO2 laser treatment than did those with mild or moderate involvement. Side effects were limited to erythema and transient hyperpigmentation. No scarring, hypopigmentation, or ectropion were observed. CONCLUSIONS Periocular skin resurfacing with a CO2 laser can safely and effectively improve upper eyelid dermatochalasis and periorbital rhytides.