THE VIRGINIAN-PILOT  
              Copyright (c) 1994, Landmark Communications, Inc.

DATE: Sunday, October 2, 1994                TAG: 9409300045
SECTION: HAMPTON ROADS WOMAN      PAGE: 02   EDITION: FINAL 
TYPE: Letter 
                                             LENGTH: Short :   44 lines

IN FACE LIFTS, SCALPEL IS AS EFFECTIVE AS A LASER

Dear HRW:

I was pleased to see ``Under the Knife'' in HRW (Aug. 28). It brought out the physical and emotional benefits the patient received from plastic surgery. Aesthetic plastic surgery can be most helpful in giving patients greater satisfaction and comfort with their self-image.

However, I have serious concern about the featured role of the laser for lower eyelid surgery. It is misleading because the laser is not proven to be better for making routine skin incisions in face lifts and eyelid surgery.

Quoting from the article, ``there is no bleeding, there is no bruising.'' Later in the article, the patient is quoted as saying she had bruising under her lower eyelids for weeks! In conventional eyelid surgery, bruising is, of course, temporary and varies from none to moderate, so this is not an important difference. I am concerned that the article gives patients the impression that the laser is advantageous for this surgery, when there is not only no proven advantage but the added danger of possible harm to the eye itself. Even with a shield on the cornea, the globe can still be possibly damaged by the laser.

The point I wish to emphasize is that cosmetic eyelid surgery must first be safe for the patient's vision. Whether there is no bleeding or two or three microdrops is not significant to the patient's healing. It is significant that the surgery performed with a scalpel by a trained plastic surgeon has been proven totally safe.

Lasers are excellent when used for the right indications, such as improving the appearance of birth marks, tattoos and a large variety of skin lesions. Innovations bring advances, but it is important to be cautious when using new tools. Cosmetic surgery should be done with the patient's safety foremost in mind.

RICHARD A. MLADICK, M.D., F.A.C.S

Director

The Mladick Center for Cosmetic Plastic Surgery by CNB