Dr Brad's Non-Surgical Blepharoplasty And Peri-Orbital Rejuvenation Treatments.

(Treatment withdrawn, in favour of SmartXide laser skin tightening).

Dr Bradley Tomkins is fully trained and insured able to offer you the “non-surgical blepharoplasty” procedure. This might be more technically described as a “superficial, fractionated, minimally ablative epidermal sublimation treatment delivered by a plasma energy device”.

Over time, the skin of the upper eyelids can become loose and droopy, creating the appearance of “hooded eyelids”. The medical term for this condition is dermatochalasis. Previously, the only treatment for this was surgery, in the form of a “blepharoplasty” which involves the eyelid skin being cut away and for many people is too daunting a prospect.

Fortunately, Dr Brad is able to offer this safe, effective, “non-surgical” treatment using a plasma energy device to contract the loose skin. There is no cutting so no scalpels are used and you do not need a general anaesthetic. The non-surgical blepharoplasty using plasma energy is performed to drastically reduce laxity, improve the eye lids and your overall appearance.

The treatment is effective in the improvement of appearance of the skin of both

• the tarsal eyelid (the skin covering the eyeball) and
• the orbital eyelid (the skin covering the rest of your orbit/eye socket), including the often stubborn and problematic under-eye area.

What is Plasma?

Plasma is the “fourth state of matter”, different to the usual liquid, solid or gas materials we are familiar with. Plasma is essentially an ionised gas and in this case it is ionised air! Scientists estimate the more than 90% of matter in the universe is plasma but it is unusual for it to occur under normal conditions on the Earth’s surface. The most common familiar example of plasma is “fork lightning”, as the electrical charge in the clouds is conducted to the ground by an enormous arc of ionised air (AKA “plasma”).

In a medical device, the electrical energy levels used to generate a plasma energy arc are obviously far lower than that of a fork lightning strike!

When a medically generated plasma arc contacts the skin it acts by “electro-fulguration” to cause superficial carbonization of the skin. The carbonisation is crucial to the dissipation of the energy, limiting the effect to a superficial level. The presence of carbonised tissue also insulates the deeper skin cells against repeated application of plasm arc energy, which is good for safety. The carbonisation of the superficial skin occurs by the rapid process of sublimation, which means the conversion of solid matter to gas without the more common process of transitioning through the liquid phase first. Therefore, every time the plasma arc contacts the skin, a dark “carbonised” crust results and a smoke plume is generated. To the untrained eye, this looks like your skin is receiving a “burn” but it is not strictly a “thermal burn” of the kind we are all familiar with ie caused by fire, boiling water, hot radiators etc.

The Procedure.

After a consultation to determine your suitability for the procedure you will be given the opportunity to review a sign the consent form. Pre-treatment photographs will be taken. A numbing cream will be applied to the skin and left for 15-30 minutes to take effect. The skin will then be prepared with antiseptic solution.

You will be positioned on an insulated couch.

Dr Brad painstakingly delivers the plasma energy to the eyelid skin in a “fractionated” pattern. This means the plasma is applied to a “fraction” of the skin i.e. not all of it, and this results in a speckled pattern of carbon crusts on the surface of the skin. This is sufficient to cause a clinically useful contraction of tissue whilst the presence of normal, untreated skin cells surrounding each treatment point results in a safer treatment with more rapid healing. Due to the anaesthetic effects of the numbing cream, the procedure is very tolerable.

Dr Brad will position a special plastic tube next to the treatment area, which is connected to a smoke evacuator. This is important for the safety of the patent and the operator because smoke plume has been proven to contain harmful particles and vapours.

Sometimes, Dr Brad might recommend that the area surrounding the problem area also be treated, in order to get superior results.

One treatment may be sufficient for some people but multiple treatment sessions (depending on patient preference) can be delivered 6 weeks apart, with the expectation of further improvement with each treatment. The average number of treatments required for best results is 3.

Afterwards a soothing balm will be applied to promote healing, followed by some high SPF sunscreen to protect the area from UV rays.

Limitations

This procedure is most suitable and effective for patients with eyelid skin laxity who do not want to undergo a general anaesthetic and traditional surgery. Non-surgical blepharoplasty may not be as effective as surgery for large “hoods” of the upper eyelid. Nor may it be as effective as surgery for “bags” or bulges of the lower lids that are attributable to the herniation of fat. Dr Brad can advise you about your personal suitability for this procedure during your consultation.

Aftercare Considerations

An immediate improvement in skin laxity and hooding can often be appreciated. You can expect there to be some redness (erythema) of the treated area and swelling (oedema) may develop. The extent of this varies between patients and can be managed with cool packs and ibuprofen (for those without contraindications to NSAID medicines). You will see the speckled pattern of dark carbon crusts (approx. 1-2mm diameter) on the treated skin and these will typically resolve within 10-14 days (although often sooner than that).

The regular application of a cold pack (not an ice pack), 5 minutes on, 5 minutes off, can be useful to control redness, swelling and or discomfort. The healing tissue may ooze a thin watery fluid and this may be dabbed away using clean gauze.

For the first few days, you are advised to use lukewarm water and a gentle cleanser to clean the area using a dabbing motion. You must not rub the area or manually remove the crusts (they will come away on their own). Manually removing the crusts before they are ready may increase the risk of scarring and a poor aesthetic outcome.

A soothing balm may be applied as often as required to keep the area moisturised and this will also help with any itching or irritation. You should be careful to apply a high SPF 50 sunscreen to the treatment area daily for a minimum of 6 months in order to reduce the risk of UV ray induce post-inflammatory dyspigmentation (“sunshine related skin colour changes”) . Other common sun avoidance measures should also be implemented ie use of a hat etc.

You might like to use some Oxygenetix foundation, colour matched to your skin, to camouflage your treated area (can be purchased from a variety of online stores).

Dr Brad is one of the few medically qualified practitioners of this procedure who can also supply you with specially formulated creams or serum containing real recombinant human skin cell growth factors to apply to the treatment area to promote healing and reduce inflammation for better outcomes.

Due to the potentially inflamed nature of the treatment area in the first few days after treatment you might like to schedule some “downtime” at home, although attitudes to this will vary between patients.

Prices.

Dr Brad wants more people to be able to access this revolutionary treatment so is excited to offer very competitive prices (Withdrawn).