Best under eye rejuvenation treatments! Get younger looking eyes

Summary

This video script by a board-certified cosmetic dermatologist delves into under-eye rejuvenation, a popular cosmetic concern. The dermatologist discusses various treatments, emphasizing the importance of skin's unique structure in this area. She highlights the benefits of lasers and energy-based devices for stimulating collagen and elastin production, while also addressing the use of injectables like Botox and fillers, and their potential risks. The script also touches on less effective treatments like PRP, microneedling, and thread lifts, advocating for a balanced approach combining professional treatments with daily skincare.

Takeaways

• 🎓 The speaker is a board-certified cosmetic dermatologist specializing in non-surgical rejuvenation treatments for the under-eye area.
• 📍 The under-eye area is the first to show signs of aging due to its thinner skin and different histology compared to other facial areas.
• 🔍 As we age, the under-eye area can develop fine lines, wrinkles, laxity, bags, and dark circles due to the loss of collagen and elastin.
• 💡 The speaker advocates for treatments that stimulate the skin's own regenerative processes to produce collagen and elastin for long-term results.
• 👨‍⚕️ The importance of finding a specialist who understands and is trained in using lasers and energy-based devices for rejuvenation treatments is emphasized.
• 🌟 Lasers and energy-based devices like Thermage are recommended for their ability to stimulate collagen and elastin production, leading to a smoother and tighter under-eye area.
• ⚠️ The speaker advises against using Botox under the eyes due to the risk of altering eye shape and causing issues like sclera show.
• 🈲️ The use of PRP and PRF for under-eye rejuvenation is cautioned due to their temporary effects and potential for frequent re-treatments.
• 🚫 Microneedling under the eyes is discouraged due to the risk of post-inflammatory hyperpigmentation and permanent discoloration.
• 🌱 Injectable fillers, particularly tear trough fillers, should be used by expert injectors and are best for addressing volume loss rather than fine lines and wrinkles.
• 🛠️ Surgical options like skin pinch are mentioned for severe cases but should be performed by skilled oculoplastic surgeons to avoid complications.

Q & A

What is the primary focus of the video?

The primary focus of the video is on under eye rejuvenation, discussing various treatments and approaches to address aging in the under eye area.

Why is the under eye area the first to show signs of aging according to the dermatologist?

The under eye area shows signs of aging first due to its thinner epidermis and dermis, as well as a different glandular composition compared to other areas of the face.

What are some of the noticeable changes that occur under the eyes as we age?

Some noticeable changes include fine lines, wrinkles, under eye laxity, bags or puffiness, and dark circles due to the thinning of the skin and loss of collagen and elastin.

What is the dermatologist's view on using fillers for under eye rejuvenation?

The dermatologist is not a huge proponent of using fillers for under eye rejuvenation, preferring instead to stimulate the skin's own regenerative processes to produce collagen and elastin for a more natural and long-term effect.

What types of lasers are mentioned in the video for under eye rejuvenation?

The video mentions ablative lasers, non-ablative lasers, and hybrid non-ablatable ablative lasers like the Halo for under eye rejuvenation.

Why is it important to find a laser specialist for laser treatments?

It is important to find a laser specialist because operating lasers requires extensive training and expertise to perform them safely and correctly, ensuring the best results.

What is the role of Thermage in under eye rejuvenation?

Thermage uses heat in the form of radiofrequency, micro-focused ultrasound, or ultrasound to stimulate fibroblasts, the collagen-producing cells, which helps tighten the under eye area and improve its appearance.

What is the dermatologist's opinion on using Botox for the under eye area?

The dermatologist has a no-fly zone for Botox injections under the eyes due to the risk of changing eye shape and causing a condition called sclera show, where too much white is visible under the iris.

What are the potential issues with using PRP and PRF for under eye rejuvenation?

PRP and PRF are safe but have a temporary effect as they are pulled into the vasculature and carried away from the treatment area, requiring frequent re-treatments that may not be as effective as other treatments.

Why does the dermatologist advise against microneedling under the eyes?

Microneedling under the eyes can cause post-inflammatory hyperpigmentation and may not provide effective results, leading to potential discoloration and the need for further treatments to correct the issue.

What is the alternative to surgery for severe under eye laxity or wrinkles?

For severe under eye laxity or wrinkles, the dermatologist may refer to oculoplastic surgeons who can perform a procedure called a skin pinch, which involves the excision and removal of excess under eye skin.

What is the importance of using an under eye serum according to the dermatologist?

The dermatologist emphasizes the importance of using an under eye serum with specific active ingredients tailored for the under eye area, comparing it to eating clean and taking supplements after a workout for skin health.

Outlines

00:00

😀 Introduction to Under Eye Rejuvenation

The speaker, a cosmetic dermatologist, introduces the topic of under eye rejuvenation, highlighting its popularity among patients. They emphasize the unique characteristics of the under eye area, such as thinner skin and different glandular composition, which make it more susceptible to showing signs of aging. The dermatologist outlines the common issues like fine lines, wrinkles, laxity, bags, and dark circles, and stresses the importance of stimulating the skin's own regenerative processes for long-term benefits over using temporary fillers.

05:01

🌟 The Role of Lasers in Rejuvenation

This paragraph discusses the use of lasers for under eye rejuvenation, explaining that they stimulate collagen and elastin production, which can help maintain a smooth and tight under eye area. The speaker differentiates between ablative, non-ablative, and hybrid lasers, mentioning the Halo as an example. They stress the importance of finding a laser specialist for safe and effective treatments and mention that lasers are not commonly found everywhere due to their operator-dependence and the need for extensive training.

10:03

🔥 Thermage and Energy-Based Devices

The speaker introduces Thermage and other energy-based devices as effective treatments for under eye rejuvenation. They explain how these devices use heat to stimulate fibroblasts and collagen production, leading to tightening of the under eye area. The paragraph details the process of Thermage treatment, including the use of an intraocular eye shield for safety, and mentions the longevity of its results, typically lasting about five years. The speaker also shares personal experience with Thermage and recommends finding a qualified provider.

15:03

💉 Cautions with Botox and Fillers

In this paragraph, the speaker addresses the use of Botox and fillers for under eye rejuvenation with caution. They mention the 'no-fly zone' for Botox injections to avoid altering eye shape and causing complications like scleral show. The speaker advises using Botox judiciously in areas like crow's feet and bunny lines. They also discuss the role of fillers, particularly tear trough fillers, for addressing hollows and volume loss but warn against overuse, which can lead to distortion and the need for frequent touch-ups.

20:05

🚫 Debunking Common Misconceptions

The speaker dispels misconceptions about certain treatments for under eye rejuvenation. They discuss the use of V-beam laser for addressing dark circles caused by underlying vasculature and differentiate it from pigmentation issues that may require different lasers. They also critique PRP and PRF treatments, explaining their temporary nature and potential for frequent re-treatments. The speaker advises against microneedling under the eyes due to the risk of hyperpigmentation and recommends seeking expert injectors for thread lifts to avoid visible threads and complications.

25:06

⚠️ The Risks of Untrained Injectors

This paragraph serves as a warning about the influx of untrained cosmetic injectors during the COVID-19 pandemic. The speaker expresses concern over the lack of proper training and education among these practitioners, which can lead to ineffective treatments and complications for patients. They emphasize the importance of seeking qualified professionals for aesthetic treatments and share personal experiences of correcting issues caused by untrained injectors.

👁️ Surgical Options and Skincare

The final paragraph touches on surgical options for severe under eye issues, such as skin pinch surgery, and the importance of consulting with skilled oculoplastic surgeons. The speaker also advocates for the use of eye serums with specific active ingredients for daily under eye care, comparing in-office procedures to gym workouts and daily skincare to a healthy diet and post-workout supplements.

Keywords

💡Cosmetic Dermatology

Cosmetic Dermatology is a specialized field of medicine that focuses on aesthetic enhancement of the skin, hair, and nails. In the video's context, the speaker is a board-certified cosmetic dermatologist who discusses various treatments for under-eye rejuvenation, emphasizing the importance of this area in showing signs of aging and the different cosmetic procedures available to address it.

💡Under-eye Rejuvenation

Under-eye rejuvenation refers to a set of cosmetic procedures aimed at reducing the signs of aging around the eyes, such as fine lines, wrinkles, dark circles, and puffiness. The video's theme revolves around this concept, with the speaker providing insights into the most requested treatments for this area and the latest techniques available.

💡Lasers

Lasers are devices that emit a concentrated beam of light used in cosmetic dermatology for various skin treatments, including under-eye rejuvenation. The script discusses different types of lasers, such as ablative, non-ablative, and hybrid lasers, and their role in stimulating collagen and elastin production to improve skin texture and reduce signs of aging.

💡Thermage

Thermage is an energy-based device that uses radiofrequency to heat the deep layers of the skin, promoting collagen production and skin tightening. The speaker mentions Thermage as a preferred method for under-eye rejuvenation, highlighting its effectiveness in providing long-lasting results.

💡Injectables

Injectables refer to substances that are injected into the skin for cosmetic purposes, such as Botox and dermal fillers. The video discusses the use of Botox for crow's feet and the cautious use of dermal fillers in the under-eye area to avoid complications like nootropion.

💡Botox

Botox is a neurotoxin derived from the bacterium Clostridium botulinum, used in cosmetic procedures to relax muscles and reduce the appearance of wrinkles. The speaker mentions Botox as a treatment for crow's feet but advises against its use directly under the eyes due to the risk of altering eye shape and causing nootropion.

💡Dermal Fillers

Dermal fillers are substances like hyaluronic acid that are injected into the skin to add volume, smooth out wrinkles, or enhance facial features. The video discusses the use of dermal fillers for under-eye hollows and volume loss, but also warns against overuse, which can lead to distortion.

💡V-beam Laser

The V-beam Laser is a specific type of laser treatment that targets vascular issues, such as dark circles under the eyes. The speaker describes its use in brightening the under-eye area by targeting the underlying vasculature that can cause a dark appearance when the skin is thin.

💡PRP and PRF

PRP (Platelet-Rich Plasma) and PRF (Platelet-Rich Fibrin) are treatments that involve injecting a concentrated form of the patient's own blood, rich in growth factors, into the skin to stimulate healing and collagen production. The speaker discusses the limitations of PRP and PRF for under-eye rejuvenation, noting their temporary effects and potential for frequent re-treatment.

💡Microneedling

Microneedling is a procedure that involves creating tiny punctures in the skin with fine needles to stimulate collagen production and skin regeneration. The speaker advises against microneedling under the eyes due to the risk of post-inflammatory hyperpigmentation and lack of significant benefit.

💡Thread Lifts

Thread lifts are a cosmetic procedure that uses threads or sutures inserted under the skin to lift and tighten sagging areas. The speaker mentions thread lifts as an option for under-eye rejuvenation but expresses a preference for other treatments like lasers, citing the potential visibility of threads and the difficulty of removal if misplaced.

💡Skin Pinch

A skin pinch is a surgical procedure where excess skin under the eyes is removed to address severe laxity or sagging. The speaker mentions this as a last resort for patients with significant under-eye skin laxity, emphasizing the importance of seeking a skilled oculoplastic surgeon for such procedures.

💡Eye Serums

Eye serums are topical treatments specifically formulated for the delicate skin around the eyes. The speaker recommends investing in a good eye serum as part of a daily skincare routine to complement in-office procedures, comparing it to the importance of proper nutrition in addition to exercise.

Highlights

Under eye area is the most requested area for rejuvenation treatments.

Specialization in lasers and energy-based devices for cosmetic dermatology.

Eyelid skin is distinct in histology, thinner, and shows age first.

Aging starts from the 20s with loss of collagen and elastin leading to wrinkles and laxity.

Under eye bags are due to fat pad movement and thinner skin.

Glandular functional units become noticeable as the skin thins with age.

Dark circles under the eyes are caused by underlying vasculature visibility.

Enhancing skin's regenerative processes is more effective than passive filler treatments.

Lasers stimulate collagen and elastin production for under eye area rejuvenation.

Finding a laser specialist is crucial for safe and effective laser treatments.

Thermage is a favored energy-based device for long-term skin tightening.

Injectable fillers should be used cautiously in the under eye area to avoid complications.

Botox usage in the under eye area can cause changes in eye shape and appearance.

PRP and PRF are temporary treatments for under eye hollows with limited long-term effects.

Microneedling under the eyes can cause hyperpigmentation and is not recommended.

Thread lifts for under eyes can be seen through the skin if not placed correctly.

Surgical options like skin pinch are for severe cases with significant skin laxity.

Daily use of an eye serum is essential for maintaining under eye health.

Transcripts

foreign

I'm a board certified Fellowship trained

cosmetic dermatologist in Newport Beach

California and today I wanted to do a

video on under eye Rejuvenation and the

reason why I wanted to do this video is

it's probably the most requested area

that I get for my patients so we just

finished Clinic just now and my practice

is in Newport Beach and it's 100

Cosmetics I specialize in lasers and

energy-based devices and all things

cosmetic Dermatology and I feel that

this is probably the most sought after

area to receive rejuvenating treatments

whether it be lasers or tightening

devices or injectables so I wanted to

dedicate a video to you guys just to

kind of update you and keep you updated

with the latest and greatest in

non-surgical Rejuvenation of the under

eye area so before I move on ask you to

like subscribe and share this Channel

with anyone who wants non-sponsored

content from a board certified

dermatologist and I'll keep you guys in

the know with the latest and greatest so

the under eye area is the first to show

our age and the reason why this happens

is that skin is different than other

areas of the face the histology meaning

when you look under the microscope of

the eyelid skin is totally different

than that of the face and I just know

this because I spent years looking under

the microscope when I was doing most

micrographic surgery where you excited

skin cancers and you look at skin day in

and day out under the microscope that

skin is very very different than other

areas of the face and it's also the

first to show our age because of that

and the epidermis is thinner the dermis

is thinner and the glandular component

composition of that tissue is different

so what happens as we get older and this

even starts in our 20s you know you

start aging the day that you're born

right but it's just understanding these

changes and why they happen and why

you're seeing things under the eye that

you didn't see before you can see fine

lines and wrinkles because that skin is

thinner and as it's losing collagen and

elastin it doesn't have that structural

support that it once had to keep that

skin nice and firm and tight so you may

start to notice under eye wrinkles under

eye laxity you can notice under eye bags

or kind of like a puffiness under the

eye and that usually happens from a

movement of the fat pad that's

underneath the face and the skin being

thinner so that's more visible than it

was before sometimes a lot of my

patients will complain of little almost

like these little white tiny little

millimeter like pop papules under the

eyes those are glandular functional

units that are functional in the skin

but these glands weren't as noticeably

and they weren't as noticeable as they

were before because the skin was thicker

and had more collagen it kind of

camouflaged it a little bit more

sometimes you can start to notice dark

Hues under the eyes like a purple or

dark blue discoloration that wasn't

there before making you look like tired

or making you look sickly or older and

the reason why you get that dark

discoloration is because of the

underlying vasculature that may have

been camouflaged before by having

thicker skin with more collagen and

extracellular Matrix proteins in it so

what happens is as we age and as we get

older as we gain wisdom and half

birthdays you lose the collagen and

elastin and under eye skin and that can

cause a myriad of of problems dark

circles of underlying fat pads teardrops

Fine Lines wrinkles Lexi all those

things so by enhancing your Skin's own

regenerative processes to make collagen

and to make elastin and to make all

those extra cyber Matrix proteins that

we once had to get it back to where it

was before in my opinion is a lot more

efficacious and a lot better long term

for longevity for skin health and just

Aesthetics in general than just

passively doing a bunch of filler or

passively doing you know prf or PRP

which lasts like a few weeks maybe so I

always am a big proponent of lasers

energy-based devices things are going to

stimulate your Skin's regenerative

processes because not only does it look

more natural but the long-term sequela

the long-term look of it looks a lot

better than having a disfigured face

with a bunch of tear drop filler don't

get me wrong tear traveler has its main

role and it does play a role and has its

place but I feel that all too often and

people will just jump to that instead of

fixing the problem and stimulating the

body to make the collagen and elastin

that has been lost to kind of reverse

aging process so talking about lasers

first so lasers are one of the best

things you can do to stimulate collagen

and elastin to help keep the under eye

area nice and smooth and tight and

there's different lasers you have

ablative lasers you have non-ablative

glaciers and then you have kind of

hybrid non-ablatable ablative lasers

like the Halo so it doesn't really

matter which laser it is because when

you're talking about an ablative laser

that could be a CO2 it could be an

erbium or you talk about a non-ablative

laser that could be a fraxel or you know

a pixel or a pixel or there's so many

different kinds of lasers so I don't

want you guys to get kind of hung up on

the laser but it's really important to

find a laser specialist who understands

lasers and you may not find lasers that

often because you know there's so many

Medi spots nowadays there's there's not

very many medical spas that have true

lasers because lasers like this one

behind me the picot you really have to

have extensive training and have a laser

surgeon who understands how to operate

these lasers to perform them safely and

correctly so usually what lower tiered

non medical practices will do is they'll

have you know an IPL or a bvl or micro

needling or these kind of lower tiered

um treatments that may not work as well

but they're safer and they're easy to

operate you use a drop down menu you

kind of do the same thing on everyone

but when you really use a powerful laser

that's very elegant in and the results

are just next level and doing this over

a lifetime is really beneficial I have a

lot of patients who will come in for

full face laser resurfacing maybe once a

year and then maybe you know once a

quarter or maybe twice a year they'll

come and we'll just do just the under

eye area just to keep that area

rejuvenated and what lasers do is they

stimulate collagen and elastin synthesis

and over time that will help keep that

under eye area nice and smooth and tight

and will help diminish the appearance of

fine lines and wrinkles and again the

reason why you don't find lasers

everywhere is because they're a little

bit more operator dependent harder to

use and you really what part it requires

a higher level of expertise but when you

find a laser specialist and the right

laser there's nothing that compares to

it we're just few and far between it's

definitely worth looking at looking it

up and trying to find a provider in your

area or someone close in the vicinity of

where you live to have these treatments

done because long term there's nothing

that comes close so in addition to

lasers another device that we can use to

help stimulate collagen and rejuvenate

the under eye area is thermometer

energy-based devices now when you talk

about energy-based devices there's soft

waves there is All Therapy I love

Thermage because I've had all those

different devices and you know when I

did my laser Fellowship we were in a

large building with hundreds of lasers

and I saw which lasers gave the happiest

patients the most consistent outcomes

and and the most reproducible Next Level

outcomes and those are the devices that

I happen to have in my practice when I

opened my own private practice three

years ago so although software of old

therapy therapy there's a lot of

different tightening devices out there

Thermage happens to be my favorite now

and I'll talk about all of the energy

based devices kind of like under an

umbrella term of energy-based devices

and it pertains to all of them but what

they do is they put heat in the form I'm

sorry they put heat in the form of

either radar frequency Micro Focus

ultrasound or ultrasound in the um in

the case of ulthera and it stimulates

your fibroblasts which is the collagen

producing cells to make collagen and

that helps tighten that area now when we

do Thermage there's a special handpiece

that goes on for the eyelid um that or

the under eye area you don't use the

same hand piece that you use on the face

or for a neck on the eyelid it has a

special eyelid handpiece and so if you

go to a provider and they're not using

that handpiece you know then they're not

doing it correctly and you have to put

into your ocular Eye shield into the eye

in order to do Thermage even you can do

it above the eye and below the eye but

because this video we're talking about

under our Rejuvenation I'm going to be

specific for the under eye but you put

an intraocular Eye shield in the eye and

then you do the Thermage underneath the

eye and it usually takes about two to

three months to start to see tightening

and Improvement in that area and those

results continue for up to a year and

results typically last about five years

or so so even for myself I did it when I

was 30 when I was 35 when I was 40 when

I was 45 and it's one of the best things

that I've done long term to keep that

under eye area chock full of collagen

and to help keep it nice and smooth and

firm and tight and the intraocular Eye

shield sometimes can spook some people

out like especially if people are

squeamish with their eyes being touched

and things like that people who wear

contact lenses are usually a lot a

little bit you know it's a little bit

easier to you know insert the

interoperative Eye shield in but it's

actually very comfortable procedure we

usually I use a little bit of numbing

drops your eyeball is numb it's kind of

when you go and you get your eyes down

by an ophthalmologist and you have an

eye exam but the memory drops in but the

intraocular Eye shield in and you can't

really feel it once it's in there and

then we only have it in the AI for about

15 to 20 minutes per side while we do

the thermos treatment then we take it

out and you're done so important things

to know is that you do need the Eye

shield it's not painful or scary and you

have to go to a provider who knows how

to put one of those eye shields in

because I actually learned on a

pediatric ophthalmology rotation how to

put intraocular eye shields in and we

learn about pediatric patients who are

very squirmy and probably the hardest

patients to actually put an Eye shield

in and if I can put it in those little

guys I can you know it makes it very

easy for me to put it into adult

patients but I got gained a lot of

experience um there when I did my

pediatric rotation what we were doing

um lasers for things like port wine

stains and different birthmarks that

were part of laser treatments we'd have

to put intraocular Eye shield into those

little guys so if I can do it in that

facial Revelation it's made it very easy

so don't let that turn you off from

having Thermage done under eyes because

at the under eyeings it's one of the

best treatments available

so next moving on to injectable so let's

start with botox first so BOTOX for

under the I have a no-fly zone for botox

injection and the only reason why is

because it can change the way your eye

shape looks when you smile and it can

cause a nootropion where you know your

eyelid margin is you have like sclero

show which is just a an optimogic term

for you you see too much white under

your iris of your eye between the live

margin and the iris that there's too

much white showing there it just is

called Square show and it looks kind of

funny and that can happen as a side

effect of Botox so Botox can be used but

very diligently and very precisely so we

often do Botox for the crow's feet area

and sometimes when people have a lot of

laxing under the eye doing crow's feet

Botox can actually accentuate that so

you have to have an injector who's

highly skilled and can kind of think

outside the box and knows his or her

Anatomy well because the way you can

kind of fake it out and cheap is that

you do a nathalis Botox which we call

the bunny lines when you scrunch your

nose up and you get wrinkles there I'm

doing a little bit of Botox there and

along the um the crow's feet can help

soften this area also now I have to be

careful because this is by no means an

injection course I'm by no means giving

out any medical information this is just

a YouTube video just kind of educating

you guys and telling you about what

treatment options are out there and what

things to look out for because being a

physician with a medical license you

know it gets kind of scary on YouTube we

have different um credentials than other

people on social media and you know it

has to be really we have to be very um

diligent with saying this is not an

injection course and I'm not teaching

you guys how to do Botox by any means

take a course if you need to learn how

um but when we do um under eye Botox we

don't usually go directly under the eye

now you can do something called jelly

roll Botox which is like one unit right

underneath what we call the jelly roll

area which can help with um softening

those lines also but unless you're an

expert injector I don't recommend doing

it I think doing the safer areas like

the crow's feet the nasalas and maybe a

couple droplets under the eye if you're

comfortable with it as an injector and

if you as a patient are going to

somebody who's highly highly skilled and

highly trained otherwise don't

jeopardize it don't risk it it's not

worth it it's your face and you don't

want to have to walk around for three to

six months with irregular looking eyes

Okay so next thing we want to talk about

for under eye Rejuvenation is pure trop

filler now I'm not a huge filler

proponent I'm a laser girl I'm an expert

in lasers and Laser medicine but I do do

a lot of injectables in my office as

well as a matter of fact I served on The

Advisory board when tier truck filler

got FDA approved when a fabella got tear

drop approval by the FDA and I'm a

trainer for alargan where I teach people

how to do tear drop filler I happen to

use the cannula but you have to go to

someone who again is an expert injector

because it is your face in the teardrop

area it can be a very high risk area I

prefer to use a cannula because this is

safer delivery mechanism and it causes

less bruising less swelling and it's a

much better experience for the patient

in my experience and

um it's also important to know that tear

popular has its role it's not that again

I'm a big proponent of lasers and

tightening devices I'd rather tighten up

that skin and make everything look

better than possibly putting a bunch of

filler that's going to stretch out the

skin to smooth out the wrinkles and then

a year goes by and then you're going to

need more filler and then more filler

and then more and then you start getting

Fuller and Fuller floor under the eyes

and it starts looking distorted so I

think that it's an important um teaching

point to know that yes tear truffler has

its role it's great for under eye

Hollows it's great for under eye volume

loss and it's a great treatment to help

smooth out the topography like there's a

Hill Valley Hill or like a teardrop area

where there's a little sunken volume

loss it helps smooth the eyelid cheek

Junction by adding in that little bit of

volume but the problem that I think some

people get into especially with

everybody trying to be an aesthetic

injector these days without having the

appropriate training and going through

years and years of education at school

trying to educate themselves they just

will passively use tear trough filler to

help smooth fine lines and wrinkles yes

tear top filler will temporarily smooth

out fine lines and wrinkles because

you're stretching out the skin it's like

taking a balloon that's you know that

doesn't have any air in it blowing it up

it's going to stretch out the skin to

make the fine lines and wrinkles look

better but guess what a year later when

those fine lines and wrinkles come back

and you still have tear truffler there

and you added more and more that's when

you get into trouble and people start to

look start to look distorted and

disfigured and their eyes get small and

just it's just not a good look so

understanding who is a candidate for

tear trustler and when to traveler would

be an option for you is really important

but if you're doing it for fine lines

and wrinkles under the eyes that's not

the treatment and not the recommended

treatment of choice

Next Step which I want to address is the

under eye discoloration or dark circles

under the eye so when people have dark

circles under the eye it's usually

because that skin is thinner and you're

seeing the underlying vasculature Under

The Eye and v-beam Laser V just stands

for vascular v-beam is a 595 nanometer

wavelength laser that can really help

brighten the under eye area usually I do

two passes I'm not going to give away my

settings on YouTube but there's specific

settings that you have to use and you

have to make sure that you're going to a

laser specialist because a lot of times

people misuse BB when they can cause

bruising that lasts for a very long time

when they use the wrong settings or

preferred dosing I won't even get into

the science behind that or like get you

technical with that but just make sure

you're going to somebody who you trust

who's very well versed in lasers

hopefully laser Fellowship trained and

they can help brighten the under eye

area due to dark circles usually it

requires about three treatments space

one month apart and the downtime is not

bad at all it's a little bit of swelling

which is kind of cool what it looks like

filler

um and then a little bit of redness

that's easily concealable with a little

bit of eye concealer or like the three

in one total I buy color science or some

type of tinted sunscreen it is

definitely worth it and it's just

something that you can do three sessions

of to help fade the under eye dark

circles that happen from the underlying

vasculature that shows through when the

skin thins over time now that's

different than melanin if you actually

have pigment under the under the eyes or

like kind of like where the skin gathers

it can appear a little bit darker

melanin is a different chromophore than

hemoglobin which is what the vascular of

a major kind of targets melanin when you

have

um you know if you're a darker skin tone

or you have like a genetic

predisposition to have dark circles

under the eyes sometimes we can use

brightening agents or sometimes we can

use other lasers that are targeted for

melanin specifically but I don't want to

get into that I'll do a whole laser

video on another

um on another video where I get into the

nitty-gritty and specifics of lasers too

but there's a different laser that we

can use when the um under eye dark

circles are a result of

hyperpigmentation

and another treatment option and I have

a couple patients asking me about this

every once in a while is prf and PRP so

this is the deal of prf and PRP for

those of you who don't know PRS is

platelet-rich vibrin and PRP is

platelet-rich plasma and so what you do

is you go to an office they take a blood

supply or take a blood sample and they

spin it down to centrifuge and they take

out the supernatin which basically has

rather a bunch of growth factors

platelets all good things and you you

suck it up into a syringe and you inject

it into the tear trough now this is the

I'm going to give you you guys know I'm

honest I'm non-sponsored I can say what

I want about any company or any

treatment and it's the truth and it

comes from years of experience but the

thing with PRP and prf is it's safe

because it's a plasma it's made to be

inside the blood vessels it's made to be

intravascular so when people are scared

or hesitant and aren't comfortable

injecting the tear troughs because they

don't they're not trained to do it and

it's scary to them which it should be

because you shouldn't be injecting tear

tops as an injector unless you're

investor are solid and you're highly

trained to do so so instead of doing to

your top filler they'll do PRP or prf

because it's safer because if it gets

into the blood vessel oh well you know

you don't get an arterial occlusion

because it's meant to be in the vascular

drone that just gets circulated away the

problem is is that it has an affinity

for the blood vessels so in PRP and prf

are injected into the skin it doesn't

stay in the tear trough area meaning

you're not going to have the long-term

effects of tear drop filler that you do

with like a hyaluronic acid-based filler

like vobella or like Restylane or you

know rha2 it's going to be circulated

pulled into the vasculature and it's

carried away from the treatment area so

it's a very temporary treatment and in

fact when it first became

um in order to be a possible treatment

for under eye Hollows and under eye

Rejuvenation I participated in clinical

trials of PRP and PRS and we were all

you know excited about it and then just

super let down and disappointed when we

saw that the results did last and the

patients were always unhappy and they'd

have to come in like every month or

every a couple months for you know a new

injection and nobody wants to go through

that so although it's safer it's better

to do a tear trial filler that may be

higher risk but safer when in the hands

of a skilled injector and just earlier

this week I had a patient came in and

she's a beautiful girl she was actually

very young and had um anatomical tear

drops you know she was like in her late

20s and she had anatomical tear trust

and she was told by a provider that she

was a candidate for tear trough filler

but the situation was she was a

candidate for teardrop filler here she

probably didn't feel comfortable doing

that so she tried to talk her into doing

PR or PRP which she did like four or

five times and had to keep going back to

this Mighty spot back over and over

again and then she finally ended up in

my office with his doctor I need to draw

filler like the prf PRP is an option for

me but my other provider said I wasn't a

candidate and it is true that sometimes

people aren't candidates but this was

not the case with her and I just think

that I see that a lot as a provider

um you know you have patients coming in

being turned away from certain Services

because their providers aren't

comfortable performing that service so

they try to talk you into something that

may be more expensive more time

consuming and then doesn't work and then

you keep doing it over and over again

because you're wrapped into some package

or membership or something like that so

just be smarter you guys I know if

you're following me and you're you're

into this channel you're you've already

like done your research and you're

you're smarter than that so I just want

to be able to educate you guys and let

you know that's the 4-1-1 on that's

that's the information about PRP and prf

because

um in theory it would be a great

treatment but in reality it doesn't

compare to some of the other treatments

that we have they're a little bit more

advanced

some may say that there's some growth

factor benefit to the peer prf but if

that's what you're looking for then use

a growth factor serum on the under eye

area or do a laser which is going to

give you a lot more collagen stimulation

than a growth factor or an objective PRP

so that's my um that's my take on it

okay and since we're talking about

medi's boss and not to cap on many Spas

you guys but it's just during covid and

2020 there's just a huge influx of

um cosmetic injectors and people in this

industry that did not take 15 years of

education to get here so they're lacking

in a lot of training and they're doing

things that are not working and hurting

people and again they end up in my

office to reverse these complications

when they happen so this is my trying to

do good in the world and trying to

educate you guys so these things don't

happen to you so on the on that note

micro needling under the eyes is not

something that I would recommend you

guys you're going to find microneedling

on every street corner especially in

this town there's like 50 Medi spas on

my whole way home from Newport Beach to

Laguna when I take PCH that we pass by

all these different medicine spots with

all these micro needling you know

Groupons and like all of these deals and

things like that so the problem with

micro needling under the eyes is it can

cause post-inflammatory

hyperpigmentation a I don't even think

it works that well and B when you get

post-inflammatory hyperpigmentation the

hemosiderin deposition and the pigment

the melanin deposition that can result

from microneedling can permanently

discolor the eyes and so I have a

handful of patients that I have had this

done to them and we've had to work for

months and months using different lasers

and brightening agents to kind of

brighten up the hyperpigmentation left

after microneedling and then the

microneedling didn't really give them

results anyway so they went from having

you know Perfect Skin young patients

with Perfect Skin trying to be proactive

in trying to stimulate collagen in an

under eye area and their you know skin

pipe you know three four five and they

have this horrible hyperpigmentation

that's now a bigger problem so I'm not a

huge proponent of microneedling for

under eye Rejuvenation and that's why

okay last but not least one that comes

up every once in a while are threads for

under eye so thread lifts work really

well and I perform threadless in my

office and I've been doing them for

years and there's a certain type of

thread called the smooth thread or

collagen stimulating threads that you

can inject or into start under under the

eye area to help stimulate collagen kind

of like a filler would just you know

stimulating collagen stimulating elastic

synthesis by the um by the presence of a

thread under the eye I've used them

before and they're okay but I feel like

there's much better treatment options

including lasers I'd much rather do a

laser procedure on a patient and have

them have a much better result for the

same price as doing some smooth spreads

under the eyes sometimes also when

they're not placed correctly if you're

having it done by someone who's maybe

not that well trained you can see them

through and so you can see these like

little lines or like linear structures

under the eye which is never a good look

and once those threads are in there

they're hard to remove and hard to get

out I actually had a patient who has in

place to buy within a different station

in a place by an esthetician and they

were placed incorrectly and so she could

see them through so the esthetician

actually used a scalpel and went in

there and surgically removed it and this

is whole hot mess now I have to fraxle

heart and fax all the scars so that

they're not a parent so again I see the

bad things you guys so you know I'm a

little jaded but I also want to educate

you guys so this doesn't happen to you

so on the topic of threads it can help

stimulate collagen but again it doesn't

work I think it's okay but I think that

there's much better and more elegant

options um out there to help smooth and

tighten the under eye area like the ones

that we already talked about

okay and then the last thing I wanted to

talk about is surgery so I don't perform

lower lip blepharoplasty which is under

eye surgery I do perform upper

lipoplasty in my office um the patients

are awake and that juice requires some

local anesthetics before the under eye

where we're moving around fat and we're

moving around of tissue

um I defer to my oculoplastics uh

colleagues for those procedures but

there's a um there's a surgical

procedure called The Skin pitch where

they can take some excess if it's really

severe and when my patients have a lot

of laxity or a lot of loose skin or um

you know really severe righted under eye

wrinkles then I deferred ocular Plastics

and they'll do a procedure called The

Skin pinch now it's really important to

go to a very you know skilled of course

arthroplastic surgeon and I always refer

to Dr Ray tafon who's in La he's amazing

and also I'm an Orange County Dr Jeffrey

Joseph is incredible but um what they do

is they do a little excision and removal

of that under eye skin the problem is is

that you in order to qualify to be a

attended it for this surgery you need a

lot of laxity like you need to be able

to pinch it and let it go and have it

like stay so that was called that

tenting you have to have a left relaxing

to be a candidate for that and if you're

not if you don't have that much laxity

and you do have a skin pinch surgery you

can have like the opposite problem true

where you're like too tight and you open

your mouth and your eyes you know your

your your you have a bad octopion like

your eyelid margin doesn't even touch

the globe of your eye anymore so the

good thing is is that you have a lot of

you know laxity there then you'd

probably be a surgical candidate but you

have to have it be pretty severe in

order to qualify for that surgery so for

I would say 95 of my patients it's more

all about lasers tightening devices

things to assimilate collagen and

rejuvenate the under eyes through that

mechanism of action so I hope that

answers your questions with under eye

Rejuvenation and how to smooth and

tighten the under eye area of course

also using eye serums helps a lot of

people out there will say the eye under

eye area does not need different active

ingredients that other areas of the face

and I completely disagree and unless

they spent years looking under the

microscope and really understanding skin

histology they may not have that

appreciation but the under eye area

requires specific active ingredient

ingredients and it's a really good idea

to invest in a good under eye serum that

you can use on a day-to-day basis

because I always say in office

procedures like lasers tightening

devices you know injectables are like

going to the gym and what you do at home

every day with your actives and your

skincare is like eating clean and

drinking your protein after a workout so

I hope this helps you guys let me know

what else you guys want me to talk about

drop a comment in the comment section

and I love you guys thanks so much for

watching

[Music]

thank you