Best under eye rejuvenation treatments! Get younger looking eyes
Summary
TLDRThis 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
😀 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.
🌟 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.
🔥 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.
💉 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.
🚫 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.
⚠️ 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.
Mindmap
Keywords
💡Cosmetic Dermatology
💡Under-eye Rejuvenation
💡Lasers
💡Thermage
💡Injectables
💡Botox
💡Dermal Fillers
💡V-beam Laser
💡PRP and PRF
💡Microneedling
💡Thread Lifts
💡Skin Pinch
💡Eye Serums
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
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