Non-surgical Blepharoplasty Using Plasma Technology, an Australian Experience

This week, we have our guest contributor, Dr Maysa AbuLaban from Perth, Australia to share with us her post course experience. After attending multiple courses led by IFAAS, she implemented knowledge learned and started to introduce plasma technology in her clinic, Al Nour Clinic in Perth, Australia . Let's hear her personal experience with non-surgical blepharoplasty using Plasma for tightening and lifting of the periorbital region.

Overview

The eyes have always been a centre of attention for aesthetic work. On one hand, they are the prime means of nonverbal communication, and the first to attract attention on anyone’s face. On the other hand, they are the first to show signs of aging, from periorbital wrinkles to infraorbital bags, droopy eyelids and heavy eyebrows. The use of plasma energy in skin tightening is not new.

A publication in dermatologic surgery magazine in 2008 documented the use of a device called Portrait that utilised high levels of plasma energy for resurfacing over large areas of skin such face and neck, hands and forearms with excellent results. However, down time and complications profile were comparable to Co2 resurfacing which negatively impacted on its popularity. Unlike the older devices, plasma pens utilise low levels of plasma energy to tighten thin skinned areas which makes them very suited for eyelids. In the last year, there has been a noticeable increase in the popularity of plasma pen use for upper eyelid tightening in Australia.

Our Experience

We introduced plasma technology to our clinic located in Perth WA in March 2018. Up to date, we performed upper eye lid tightening using the (Ultra V Plasma Pen) on 157 patients.Patients were predominately females, with ages ranging between 17 to 73 years and skin types 1-4. Most had age related moderate to severe upper eyelid hooding, tow patients had unilateral congenital ptosis. Most patients had no previous surgical or non surgical intervention, others had past history of surgical blepheroplasty.

Procedure

Patients who have regular Botox treatments for upper face were not to have the treatment for 3 months prior to treatment and non till after the follow up. This will allow accurate assessment for results.Topical anaesthesia was applied to upper eyelid skin for one hour. Eyes are then irrigated with normal saline, and skin is also cleaned with normal saline.

Plasma pen was then applied starting from lower eyelid crease up to 2-3 mm inferior to eyebrows at level 2. Immediately after treatment, small ice packs were applied to the area treated for 10-15 minutes after which a cooling gel was applied. Patients were provided with a 1% hydrocortisone ointment and instructed to apply twice daily for 3 days. Patient was assessed at t one month and 3 months post treatment.

Observations

After analysing before and after treatment photos, the following observations were made:

Most patients achieved significant tightening of upper eyelid skin manifested in 2-4 mm elevation of lower eyelid crease after one treatment.
Improvement was observed as early as 3 weeks post treatment and continued to improve for at least 8 weeks after.
Improvement was observed in patients who did not have any prior treatment, and those who had surgical blepheroplasty or other forms of non surgical eyelid tightening. Significant improvement was also noticed in 2 patients with unilateral congenital ptosis.
Side effects included moderate eyelid swelling, scabbing, itchiness, mild temporary hyper pigmentation and eye irritation due to the topical anaesthetic.
Most patients were able to return to work and resume normal social life on day 4.

Before and After Illustrations

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