To meet the rising demand by patients for aesthetic treatments, it has become increasingly popular for physicians of many different disciplines to add these non-invasive treatments to their practices. Ophthalmologists are among the growing number of physicians to perform these procedures. This makes sense since the advent of some of the most popular aesthetic treatments, botulinum toxins, Latisse and lasers, historically relate to the practice of ophthalmology. Dr. Allen Scott, an ophthalmologist, first used botulinum toxins for the treatment of strabismus and blepharospasm. Laser technology is well known in the ophthalmology world because of our multiple uses in the eye. And Latisse was discovered from a side effect of a popular glaucoma medication.
To encourage integration of aesthetics into the ophthalmology practice, we incorporated a symposium dedicated to this topic into Hawaiian Eye.
On Saturday January 14, 2012 at the Grand Wailea on Maui, the first annual Oculoplastic Symposium: Aesthetic Treatments of the Face was held the day before Hawaiian Eye began. I invited Dr. Femida Kherani, from Canada, to speak with me and cover a variety of aesthetic topics geared toward the general ophthalmologist.
The symposium began at 2pm with an hour of didactic information. A discussion of the aging process and ideals of beauty, followed by anatomy for facial aesthetic procedures started the session. An update on botulinum toxins was then given by myself. I stressed the importance of knowing facial anatomy applicable to these injections as well as the differences and similarities of the 3 FDA approved botulinum toxins: Botox, Dysport and Xeomin. Dr. Kherani then discussed the various commercially available dermal fillers and injection techniques and uses for each. She discussed the most popular filler, hyaluronic acids, and use in the nasolabial folds. She also mentioned others including Radiesse, made of calcium hydroxyapatite, and Sculptra, which is made of poly-L-lactic acid. Proper injection techniques include being familiar first with the anatomy of the treatment area, then knowing the depth and angle of injection and how to avoid potential complications. The more robust products such as Perlane, Radiesse and Juvederm Ultra Plus, should be injected into the deep dermis or even subdermal, whereas Restylane and Juvederm Ultra should be injected into the mid dermis. It is ideal to fill to full correction with most fillers. With this technique, touch ups are likely to require only about half the volume.
The last talk focused on aesthetic upper eyelid blepharoplasty. A review of patient evaluation, preparation, surgical technique, post operative management and potential complications was given.
After the didactic session, 2 hours were spent demonstrating live patient injections using botulinum toxins and dermal fillers. Various techniques were shown using the full spectrum of available and FDA approved products. Patients were brought on stage and the injections were projected onto large video screens for the entire audience to see. I demonstrated full face contouring and rejuvenation on the first patient using both botulinum toxins and dermal fillers. Botulinum toxin was injected into the forehead, glabella and crows feet area. Fillers were injected into the nasolabial folds, marionette lines and oral commissures. The next patient received perioral rejuvenation through injections into the orbicularis oris with Botox, and lip injections with Restylane and Perlane to her oral commissures. To demonstrate a male face we used Radiesse in the nasolabial folds with use of a cannula as well as Xeomin to the upper face in the frontalis and glabella. Another patient received a combination of Dysport and Juvederm for full-face rejuvenation, including Botox to the glabella and frontalis and filler to the nasolabial folds. At the end we had a raffle for free botulinum toxin treatments. The lucky winners were able to come up on stage and get their injections immediately. The audience had ample opportunity to observe and ask their questions related to the multitude of aesthetic treatments.
We were so pleased with the outcome of this symposium. We had close to 100 attendees. There were no additional fees for those registered to attend Hawaiian Eye 2012.
In 2013 we plan to continue the tradition, but take it a step further. We hope to plan a full day of oculoplastic talks and demonstrations, including topics on functional oculoplastics, as well as aesthetics. Some potential topics are: innovative treatments for dry eye, oculoplastic complications of anterior segment surgery and disease, trauma, eyelid procedures for anterior segment problems, common eyelid malpositions, and blepharoplasty to name a few. We have already recruited several more speakers who are eager to attend and educate. Again we will have an aesthetic portion geared toward the general ophthalmologist and best of all, we will invite attendees and their families to volunteer for free aesthetic treatments! We hope you will join us next year….aloha.