The eyes have it!!!!

As the most commonly complained about area on the entire face, there are so many aspects to ageing around the eyes both in cause and treatment. Patients so often complain of the “tired look”. Because of numerous treatments available, I thought I would address this essential cosmetic unit of the face in my blog. First off, sun causes many of the problems in this area. The skin is generally thinner and more sensitive than any area of the face and thus very susceptible to radiation damage from the sun in the form of hyperpigmentation and fine lines. Also, there is a strong  genetic factor in ‘circles around the eye” . Many teenagers even suffer with purple rings around the eyes that sleep does not resolve.  Although it is not completely clear, it appears that this discoloration is similar to a bruise from leaky blood vessels around the eyes. In addition, as we age, the soft tissue or fat redistributes. Some get bags, some get hollow rings, some both. All of these things contribute to the changes in skin looseness and wrinkles.  So with all these factors …what fixes it all? Fortunately, a combination of several small things make a huge difference without having to do major surgery in those with mild to moderate problems..Unfortunately, those that have let the problem get severe over the years have limited options other than surgery.

To start, using a good eye cream with antioxidants, bleaching agents and sunscreen will certainly help. Retin-A like compounds, if tolerated, may help if used over the very long term, as well. Using fillers around the eyes, either Juvederm or Restylane can help reorganize the soft tissue so the hollows are filled and the appearance of  bags are reduced. This is truly a great treatment that people love in this area. Although very effective, it must be performed by someone who really knows what they are doing with fillers as it can easily not look right.  And lastly, there are several lasers and radiofrequency devices that can significantly tighten skin and treat fine lines around the eyes. Although is has a bit of downtime (5 days of bad sunburn like effect) , the Fraxel Repair , fractionated CO2 laser does wonders to tighten skin and smooth out wrinkles in only one treatment in this area.

So there you have it….there is hope for the eyes. Technology has come along way in this realm.  Do your research, see someone who has a lot of experience in this area, and remember it is easier to clean up a room when it is not too dirty. So do something about it when it starts to bother you not when it is really bad.

Ah yes, another filler battle ensues…… People want to know “which is better”. The short answer , to me, is Radiesse. Many well respected dermatologists and plastic surgeons would disagree. Which is fine….this is my blog …they can start their own. The long answer goes like this.  Radiesse and Sculptra are both FDA approved fillers that work best for overall volume enhancements….cheeks , chins, temples, hands, etc.  Both put “air back in the balloon”, so to speak. Both can be used to achieve excellent cosmetic results that depend more on the injector than the substance itself. So aren’t they just interchangeable?…..not so much.   I like Radiesse for several reasons. First, it is a natural substance already found in the body. To date I have seen zero reactions. Sculptra is made of a substance that is foreign and more reactive (many sutures are made of similar material).  I have seen many reactions or unsavory aesthetic results pass through my office, fortunately from other injectors. Sculptra does last longer than Radiesse but I have found it much less predictable – meaning in some patients it disappears too quickly  and doesn’t cause enough of an clinical effect or the filler develops too much and lasts way to long. Much of this lies in the fact that Sculptra must be performed in several treatment sessions with the effect “building’ over time. Radiesse, I inject whatever I need in one treatment session and the results are in general, immediate and predictable.  And finally, Radiesse, I have found, to be much more cost effective for the patients and the physician. In my practice, 1 1.5 cc syringe of Radiesse has been equivalent to one bottle of Sculptra in patient effect. The substance itself is cheaper than Sculptra and the ability to perform all  necessary filling in one treatment session allow the physician to discount the additional syringes used. So there you have it. Being the only juror in this discussion, I am certainly biased. My opinion may change but Radiesse works for me and my patients. Obviously they both exist because there are many that like Sculptra. Only time will tell if one is superior.