Plasma Jet Treatment
Plasma Jet Eyelid (Non-Surgical Blepharoplasty)
A comprehensive scientific and clinical guide to eyelid lift with fractional plasma technology; from the sublimation mechanism and differences from surgery to safety protocols, care, and treatment results.
What is Plasma Jet and how does it work in eyelid rejuvenation?
Plasma Jet, or non-surgical dynamic blepharoplasty, is one of the most advanced minimally invasive methods in cosmetic dermatology for the treatment of laxity, mild to moderate drooping eyelid skin, and crow's feet wrinkles around the eyes. This system works by utilizing the fourth state of matter, plasma (ionized gas) .
When the tip of the device's probe is placed within a micron (less than 1 mm) of the epidermis, the electrical potential difference between the device's needle and the skin causes the ionization of gases in the surrounding air (mainly nitrogen and oxygen). This process produces a miniature plasma arc. The concentrated thermal energy from this discharge causes a biophysical phenomenon called sublimation , in which superficial keratinocytes are converted directly from a solid to a gas without melting or uncontrolled burning.
Immediate Retraction
The sublimation of dead cells at micrometer-scale points with specific intervals creates immediate tension in the cellular matrix and immediately leads to the shrinkage of the drooping eyelid tissue.
Neocollagenesis and deep remodeling (Neocollagenesis)
Controlled subepidermal heat penetrates the dermis layer and stimulates fibroblasts to produce new type I collagen and elastin without damaging adipose tissue.
Why doesn't the plasma jet damage the deeper layers?
The safety of this technique lies in the phenomenon of no thermal diffusion to the basal lamina . When using standard medical equipment, the depth of penetration of thermal energy into the papillary layer of the dermis is limited and the electrical current does not pass through the patient's body; therefore, the sensitive structures within the eye socket, lacrimal glands, and sensory nerves around the eye remain completely safe.
Ideal candidates and preoperative clinical evaluation
Correctly determining the therapeutic indication is the most important step in achieving clinical satisfaction. Plasma jet is not a complete and total replacement for surgery for everyone, but it brings the highest efficiency for a specific group of applicants:
- Mild to moderate upper eyelid drooping (mild dermatochalasis): People whose eyelid skin has lost some of its elasticity but whose peripheral vision is not yet impaired.
- Excess skin without fat herniation: Clients who do not have prominent fat behind the eyelid (pseudoherniation of orbital fat) and only complain of superficial elastotic wrinkles.
- People with a fear of anesthesia and the surgical blade: Applicants who are reluctant to undergo invasive surgical procedures due to personal reasons, advanced age, or underlying diseases.
- Minor asymmetry after blepharoplasty surgery: People who have had a history of blepharoplasty and need subtle unilateral correction or retouching of excess skin.
- Fine lines and crow's feet of the lower eyelid: Patients who have very mild baggy skin under the eyes and desire to tighten the skin scaffold.
⚠️ Who are unsuitable candidates?
Patients with true ptosis due to weakness of the levator palpebrae superioris muscle, massive fat herniation in the eye socket, very severe drooping that overhangs the eyelashes, or very dark skin with a strong tendency to keloids and hyperpigmentation will not receive a good therapeutic response from plasma jet and are considered candidates for open blepharoplasty surgery.
Specialized comparison of plasma jet eyelid surgery with surgical blepharoplasty
The choice between plasma jet and traditional blepharoplasty is based on physiological differences, clinical need, and patient preference. The following table outlines the fundamental differences between the two procedures:
| Comparison parameter | Plasma Jet Eyelid (Plexer/Plasma) | Classic blepharoplasty (surgery) |
|---|---|---|
| Type of intervention | Non-invasive to minimally invasive (no incisions and no stitches) | Invasive (surgical incision with a blade or electrocautery) |
| Type of anesthesia | Local anesthesia with lidocaine/prilocaine cream | Local injection anesthesia with sedation or general anesthesia |
| Orbital fat removal | Infeasible (focused solely on skin tightening) | Possible (removal or rearrangement of excess fat pads) |
| Scars and scars | No surgical incision line (complete improvement of crusted spots) | A fine linear scar in the natural crease of the eyelid |
| Recovery time | Short (5 to 7 days of crusting, 2 to 3 days of swelling) | Long (2-3 weeks of bruising and stitches) |
| Number of sessions | 1 to 3 sessions (6 to 8 weeks apart) | Single session |
| Clinical durability | 2 to 3 years (depending on biological aging process) | 7 to 10 years or more |
| Risk of bleeding and infection | Very slight (due to superficial carbonization of the vessels) | Risk of hematoma, retrobulbar hemorrhage, and suture infection |
Step-by-step steps for performing the eyelid plasma jet technique
Implementing the clinical protocol for eyelid plasma jet requires careful adherence to the sterilization chain and the operator's skill in controlling distances and power of the device:
1. Preparation and local anesthesia
The eye area is thoroughly sterilized and cleansed with alcohol-free solutions to remove any remaining oil, cream, or makeup. A 1 mm thick layer of high-strength anesthetic cream (a combination of 2.5% lidocaine and 2.5% prilocaine) is then applied to the eyelid and covered with a nylon dressing (occlusion) for 30 to 45 minutes to minimize pain.
2. Anatomical marking and tissue stretching
The doctor uses a sterile surgical pencil to mark the natural creases of the eyelid and the area of excess skin. During the procedure, the skin is pulled outward with the non-dominant hand to completely smooth out the creases and angle the needle perpendicular to the surface.
3. Implementing the Spot Technique / Grid Pattern
The plasma spots are applied using a grid-like technique. Each plasma shot lasts less than a tenth of a second and creates a diameter of about 0.5 mm. The distance between two adjacent spots should be maintained at about 1 to 2 mm to maintain healthy tissue bridges between them; these healthy bridges are the source of accelerated skin re-epithelialization.
4. Intraoperative dynamic contraction test
One of the biggest advantages of plasma jet is that the patient is awake; the doctor asks the patient to open and close their eyes during the procedure to assess and adjust the amount of eyelid lift, bilateral symmetry, and the angle of opening of the palpebral fissure.
Recovery period, crust formation, and pre- and post-operative care
The final result of plasma jet is as much dependent on the patient's commitment to follow the recovery protocols as the skill of the physician. In the first few days, the physiological inflammatory response is part of the cellular renewal process.
Essential care before treatment
- Avoid tanning, sunburn, and solarium for at least 4 weeks before the treatment session.
- Discontinue use of topical irritants such as tretinoin, retinol, and exfoliating acids (AHA/BHA) one week in advance.
- Discontinue anticoagulant medications such as aspirin and ibuprofen under a doctor's supervision to reduce edema and petechiae.
Post-treatment clinical care
- Swelling management for the first 48 hours: Use indirect cold compresses (ice packs wrapped in dry sterile gauze) at 10-minute intervals to control severe eyelid edema.
- Keep the crusts dry: The treated area should not be washed for 48 hours. After that, gently cleanse and dry with only physiological saline or a very mild foaming cleanser.
- Strictly do not touch scabs: The carbon grains (crusts) fall off on their own within 5 to 7 days. Picking or rubbing them can cause permanent scarring and dark spots.
- Physical protection against ultraviolet radiation: Mandatory use of standard UV400 sunglasses with full side coverage and mineral sunscreens (containing zinc oxide or titanium dioxide) without fragrance after the scabs have completely fallen off for at least 2 to 3 months.
- Avoid cosmetics: Avoid any eyeliner, mascara, powder, and eyeshadow until the epidermis is completely closed (at least 7 to 10 days).
Possible complications, prevention and clinical management
Although plasma jet is a safe and minimally invasive procedure, failure to observe sterile principles or incorrect implementation of the technique by non-physicians can lead to unpleasant clinical consequences:
Post-inflammatory hyperpigmentation (PIH)
The most common complication, especially in skin types 3 and 4, occurs due to premature exposure to sunlight or premature picking of scabs.
Management: Anti-blemish creams containing azelaic acid, hydroquinone, or kojic acid under medical supervision.
Erythema and prolonged redness (Erythema)
The skin under the scabs is pink and thin and usually returns to its normal color within 2 to 4 weeks. If erythema persists for more than 6 weeks, it is a sign of tissue irritation.
Management: Repairing ointments rich in sodium hyaluronate and zinc oxide.
Severe eyelid edema (Periorbital Edema)
The body's natural inflammatory response to thermal energy, which usually peaks on the second day after surgery.
Management: Keep the head elevated while sleeping (use two pillows) and, in severe cases, prescribe a short course of oral corticosteroids.
Atrophic or hypertrophic scars
Indentation or protrusion due to high power of the device, too close firing points or incorrect overlap of plasma discharge.
Management: Restorative silicone gels and non-destructive fractional lasers.
Duration and number of treatment sessions required
Plasma Jet has a functional structural effect compared to methods such as Botox, as excess skin is sublimated and new fibroblastic structures are formed. However, due to the ongoing physiological process of skin aging, the results are not permanent.
- Typical number of sessions: Depending on the degree of sagging and the physiological age of the skin, 1 to 3 sessions are usually required for optimal results. The interval between sessions should be at least 6 to 8 weeks to allow for complete dermis regeneration.
- Duration of Results: On average, treatment results last between 2 and 3 years . Maintaining a healthy lifestyle, protecting yourself from UV rays, and avoiding smoking will maximize the longevity of results.
Absolute and relative contraindications
Assessing the patient's medical history is crucial to prevent systemic risks or irreversible tissue damage:
🚫 Absolute Contraindications
- Presence of a pacemaker or implantable cardiac Holter monitor (due to interference from the device's frequency waves).
- Pregnancy and lactation (lack of sufficient experimental evidence on the stability of skin factors).
- The presence of metal implants in the head and face, eye socket, or skull in the path of the current field.
- A definite history of keloid formation, excess flesh, or hypertrophic scars.
- Active herpes infection (ocular herpes), styes, blepharitis, acute dermatitis, or open wounds at the treatment site.
- Uncontrolled active systemic autoimmune diseases such as lupus erythematosus or psoriasis in the active phase.
Relative contraindications (under the supervision of a doctor)
Very dark skin phototypes (Fitzpatrick types 5 and 6) due to the high likelihood of post-inflammatory dark spots, diabetic patients with delayed wound healing, people who have taken oral isotretinoin (Roaccutane) within the past 6 months, and patients with severe dry eye syndrome.
Frequently Asked Questions from Patients
- Is Plasma Jet eyelid surgery painful?
- By using local anesthetic creams with the appropriate dosage and sufficient waiting time (at least 40 minutes), the patient experiences only a mild tingling sensation or mild spot heat, and the procedure is completely tolerable.
- When do the brown scabs or crusts fall off?
- These carbon spots usually fall off naturally between the fifth and seventh days. During this time, they should not be applied with thick ointments or picked off with nails, as keeping them naturally dry ensures a clean, stain-free fall.
- Does plasma jet affect vision?
- No; the electrical discharge and plasma beam have a depth of less than 0.2 mm and are concentrated solely in the epidermis tissue up to the beginning of the papillary dermis, and do not penetrate the structures of the eyeball, sclera, retina, and optic nerve.
- When will the real results of the treatment be visible?
- Although tissue shrinkage is seen immediately after the shot, the real result becomes apparent after the initial swelling subsides, the crusts completely fall off, and new collagen fibers are synthesized, i.e., in the fourth to eighth weeks after the treatment session.
Clinical summary and conclusion
Plasma Jet Eyelid is one of the achievements of minimally invasive dermatology technology, which, if selected carefully by the patient, is an excellent option for removing loose skin and initial eyelid drooping. The lack of anesthesia, the absence of longitudinal incisions, and the short recovery time have made this method a popular solution. At the same time, it should be noted that this method is not a substitute for blepharoplasty surgery for deep orbital fat hernias or severe skin drooping. Performing this procedure under the supervision of a specialist physician and using approved standard devices will guarantee safe, stain-free, and refreshing results for the face.
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