EyeTight (LaserTight LLC; Philadelphia, Pa.), a new device and procedure for nonsurgical lower lid laser blepharoplasty, may be one of those rare and elusive treatments. But it's a new approach, a new concept — and the treatment's broad-scale availability depends on getting the word out — and education on its use and applications.
BLEPH MAKEOVER "Many doctors, when they first hear about this, are confused," says Mark Solomon, M.D., F.A.C.S., of Bala Cynwyd, Pa. Dr. Solomon, who is clinical associate professor of surgery, Drexel University College of Medicine, Philadelphia, and medical director for LaserTight, explains that the procedure takes a different approach to lower lid blepharoplasty."Unlike Fraxel or CO2, both of which are surface treatments, for instance, the EyeTight procedure is under the surface," he tells Cosmetic Surgery Times . "We use local anesthesia, it's performed in the office in about 15 minutes, and the patient is on his or her way with minimal downtime."
What, exactly, is the procedure? Using an EyeTight endoprobe, a puncture is made, the probe is inserted, and the fat bags under the skin are vaporized. The probe, about the size of a typical catheter, is removed, and the procedure is done. "The skin then shrinks, because the fat underlying it is gone — so the skin shrinks secondarily," Dr. Solomon explains.
According to the LaserTight Web site, EyeTight requires 980 nm laser energy delivered through a 20-gauge endoprobe to vaporize fat cells while simultaneously promoting tightening of the skin. The nonsurgical procedure, performed under local anesthesia, can be completed within 15 minutes. Tightening of the skin continues for six to eight weeks post procedure.
PATIENT SELECTION Who are good candidates, and who aren't? Basically, anyone who is a good candidate for a transconjunctival blepharoplasty is a candidate for the EyeTight procedure. "People who are not candidates are those with diminished lid tone or those prone to ectropion. But a person with good skin tone, who has lid support, and who has fat bags — that is a good candidate." While EyeTight can be very useful for lower lid blepharoplasty, the upper lids may not be as amenable to this approach. "With the upper lid, it is usually an issue of too much skin," Dr. Solomon says. "So I'm going to be making an incision anyway, and the fat presents itself that way."
EyeTight is FDA cleared for use in lower lid blepharoplasty. Dr. Solomon has been using and fine-tuning the technique for about a year, and he says that, so far, the lasting effects seem to be comparable to conventional transconjunctival blepharoplasty.
LEARNING CURVE Regardless of how promising or innovative a procedure might be, patients and physicians should proceed with care, in the opinion of Donn R. Chatham, M.D., president elect, American Academy of Facial Plastic and Reconstructive Surgery, and practitioner, Chatham Facial Plastic Surgery, Louisville, Ky. "When new technology is introduced, there is always the hope of a better way of treating patients."
As Dr. Chatham sees it, "This device uses laser energy and minimal incisions, and appears well suited for its purposes of helping reduce unwanted subcutaneous fat." Be that as it may, he advises, history will be the judge of EyeTight — and any new procedure or product. "Not all new devices brought to market ultimately survive the test of time. All procedures require a learning curve, sometimes additional treatments are required, and results are better in the hands of some surgeons than in others," he notes. "Complications can occur with any device or procedure."