Many patients are turning to non-invasive procedures to save them money, and time. Surgical procedures can often take weeks to heal but non-surgical treatments can often take only days. While the results aren't as dramatic, a non-invasive procedure can help keep the surgeon away for a bit longer. Fractional lasers help to rejuvenate the skin and stimulate collagen growth, improving the appearance of fine lines and wrinkles. Recently physicians have been using fractional resurfacing technologies outside of the typical treatment zone and finding great results.
"To tell you exactly how this started, we started using fractional devices," says Dr. Bruce Katz of the Juva Skin Center. "First non-ablative fractional such as Fraxel, then fractional Erbium and then most recently, fractional CO2, and we're working on the face, neck and chest area and we were getting great results. Our female patients were really thrilled and then a few of them started to say to me, 'Dr. Katz, my face looks great but what can you do about my eyes?' And I started thinking, what can we do about their eyes? You know, we haven't been doing the eyelids at all."
Dr. Katz understood that there were safety concerns and first addressed those. "We thought there was some danger perhaps or that you have to be very careful (obviously) around the eyes. Then I started looking into it more carefully and I realized by putting corneal shields, metal shields under the eyelids, over the eyeballs, that the procedure would be perfectly safe. We started a study - we actually ended up publishing a study this past January in one of the medical journals of 100 patients so it was a really large study - we did 12 month follow ups; most studies you see in our literature maybe 3 or 4 month follow-ups. We did a full 12 month follow up to see that not only were we getting the benefits but that they would be long lasting and we found that they were."
The procedure has become known as the Madonna Lift and is able to treat several symptoms of aging eyes. "It actually not only takes away wrinkles and tightens the eyelid's skin, it takes away dark circles and we get an eyebrow elevation as well - an eyebrow lift. So we've been getting really dramatic results. Our patients are really thrilled and the best part about it is that there's minimal down time. Our patients generally do a few sessions and they can go back to work most of the time the next day. They can cover the redness with a little makeup so it's a really easily tolerated procedure particularly in New York, our patients work on wall street or they're really high powered, they can't afford to take off 4, 5 or 6 days with a surgical eyelift or a heavy duty laser resurfacing, so the Madonna Lift really fits that demand for people who are on the go who really have busy life styles but they want the improvement which they can get now with just a few sessions and minimal down time."
Dr. Katz says the Madonna Lift is an appropriate procedure for people of all skin types and hasn't come across any issues. "We find that we haven't had any problems, no side effects at all. The worst side effects is that you get a little red or a little puffy which is easily covered with makeup." Age is also not an issue, "We treat women in their 30's up to 80's. It all depends on how much sun exposure they've had. I'm actually seeing younger and younger patients now because they come in and they grew up in Florida or California and they have been baking in the sun and their developing a squint line or dark circles from too much sun and they just love the results."
Dr. Katz often performs the Madona Lift along with using botulinum toxins such as Dysport or Botox. "We find that we get even faster results because the botulinum toxin will access the muscles so the laser can get in there and even get faster collagen remodeling and skin tightening."
It does take a few sessions with the physician to see improvement. "It usually takes about two or three treatments until you start seeing the results. The interesting thing about it is that the results continue.... People will see an improvement over the next two or three months but collagen remodeling takes months to occur, so a lot of our patients say 'well you know I've had 3 treatments, I have nice results, but 3 or 4 months later I couldn't believe how much better it looked.' So the collagen changes take several months even after the last treatment."
The sessions aren't expensive, especially when compared to cosmetic surgery. "Usually we charge per session and it runs anywhere between $700-$800 in New York, and some people may need 2 or 3 or 4 sessions depending on how deep the wrinkles are and how much downtime the patient wants."
There are several fractional lasers on the market, and Dr. Katz has found that the SmartSkin CO2 works well because of its versatility. "A lot of the other fractional lasers don't allow you to change the shape of the laser beams or fits under the eyebrow and obviously you have to be very careful there."