So, some of you may have seen a certain doctor and her office manager about town looking like they got into a poorly considered bar brawl. Was there a late night disagreement over who was making the next pot of coffee? Actually, no. It’s always safe to say that if all the staff in a cosmetic practice are jumping on having something done, it’s because it works. Hence the puffy rings around our eyes here at Tahoe Medical Spa.
So what is this popular new procedure? The Madonna Eye Lift, developed by Dr. Bruce Katz in New York. This non-surgical alternative to blepharoplasty uses the one of the latest innovations in laser techonology: fractional laser resurfacing.
This shift in treatment ignores older thought paradigms that the only way to reach the dermis, or deeper layer of skin, is to remove the entire upper layer, or epidermis. This allowed the dermis to be tightened, reducing laxity and deeper wrinkles, but removal of the entire epidermis results in a long and painful healing process, often with weeks under ointment and months of redness as the skin settles back down. (click here for more on fractional treatments)
Newer treatments are based on the realization that a laser beam can be split, or fractionated into many tiny columns which can penetrate through the epidermis into the dermis, while leaving the majority of the surface intact. This allows healing to happen in days, rather than weeks or months. It also allows powerful resurfacing treatment results to be achieved with less pain and sometimes divided between several minor treatment sessions which can easily be fit into busy lives that have no space for extended downtime.
The Madonna Eye Lift takes advantage of these fractional benefits and uses laser wavelengths which are able to both ablate and heat tissue to gain immediate tightening, followed by further improvement over the next few months as collagen production is stimulated. Ablative or resurfacing lasers react with water in the skin, creating great heat and tightening. However, until fractional treatment options were developed, it was limited in that it was often too powerful to use off facial skin, resulting in sharp demarcation at the jawline where the neck was untreated. This is especially a problem for people with darker skin where there is a noticeable difference between the lighter untreated skin, and that which was not able to be treated.
Fractional treatments allow a gentler use of lasers around the eye area, while still accomplishing the impressive skin tightening that makes this laser so very useful at reducing wrinkles and laxity. For those who would prefer to obtain results in a single session, or are willing to tolerate a bit longer downtime (usually 6-9 days of redness and peeling), even more dramatic results can still be obtained with a single full-field resurfacing treatment which covers 100% of the surface area.
When these techniques are employed around the eyes, a marked improvement can be seen in hooding, loose or crepey skin, and these treatments can even lighten dark circles and help lift the eyebrows back to a more youthful position. The only thing it can’t fully correct is bulging, or herniated fat pads beneath the eyes, although even these often improve in appearance when the overlying skin is tightened.
Although Dr. Katz’s website suggests that this is a virtually painless, no-downtime procedure, having personally undergone the treatment we prepare patients for something a bit more significant, although the results are well worth it. In addition to a potent anesthetic cream which we have patients apply to the skin in two coats, first one hour, and then again 20 minutes before the procedure, we also offer patients a mild oral pain medication and sedative to minimize discomfort.
Once patients are relaxed, anesthetic and lubricant drops are placed in the eyes and protective metal eye shields, which are much like opaque contact lenses, are inserted. The laser treatment usually lasts only 5-10 minutes, but we do prepare people for some brief, but sharp and hot discomfort during the actual treatment.
Although Dr. Katz allows patients to wear makeup immediately after treatment, we have found patients heal better if the skin is kept clean, only covered with protective moisturizer. It is normal for the area around the eyes to be somewhat reddened and puffy, particularly in the first day, but to a lesser extent for a total of 3-5 days, depending on the intensity of the treatment. If you look closely at the treated skin, as you can see in the picture below (at the point of maximal redness and swelling) you can see the pattern of fine dots where skin was treated.
A typical treatment ablates 11-33%% of the skin, removing old or damaged collagen which contributes to laxity. The heat generated in the tissue also helps the surrounding skin tighten and stimulates further collagen remodeling. For most people with moderate wrinkles or hooding, 4-5 treatments will effect an optimal result. For those with very early crepeyness and fine lines, 2-3 sessions can help as a maintenance treatment to forestall signs of aging. Due to the stimulation of collagen in the deeper dermis, most patients notice ongoing improvement in the area even several months after treatment. For those with more significant signs of aging who have the time and prefer to complete their treatment in a single session, full-field, rather than fractional ablative resurfacing can effect dramatic changes in a one treatment with just a bit longer downtime - on average 6-8 days until one is able to return to wearing makeup.