In our practice, we have some people who come in and want a natural filler with no risk of allergic reaction. Recently people have come in asking for the “vampire facelift” or the “Dracula facelift” where the person’s own blood is used to rejuvenate their appearance in a way like popular fillers such as Restylane. This procedure is not a surgical facelift nor does it create the same effect as a facelift. The procedure helps restore or enhance areas which require volume. Platelet rich plasma (PRP) can be used for the following:
- Improve the glabellar lines (the number 11 sign between the brow)
- Improve the Forehead lines
- Improve the appearance of periorbital lines (crow’s feet)
- Improve Nasolabial folds
- Improve smile lines
- Treat acne scars
- Improve the vertical lip lines (lipstick lines)
- Improve the marionette lines (the ones from the corners of the mouth to the chin)
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Are My Under Eye Circles and Hollows Related to Sinuses/ Deviated Septum? Could Restylane Help?
I’m in my late 20′s and recently moved to a high altitude, dry climate. I’ve had subtle circles for awhile, but in the last year they’ve gotten much worse. They are a purple/blue and also sunken/hollow, particularly around the tear trough. I’ve been having nasal congestion issues during sleep, so I saw an ENT who diagnosed a deviated septum. I’ve been having nasal congestion during sleep, so I saw an ENT who diagnosed a deviated septum. My questions are: could the congestion/ deviated septum be related to the circles/ sunken look? If so, would a septoplasty correct them? Would Restylane be a good option for me?
Thank you for your question!
Essentially, you’re wondering whether the situation where you have a deviated septum and any type of sinus related issue is affecting the under eye area. And of course, being you’re young, we naturally can assume that this is an age-related situation.
Well, from the photos you submitted, it’s clear that you have very light skin and there isn’t a lot of fat on that under eye area. Basically, the area from the eyelid to the cheek, we refer to the eyelid-cheek junction or a transition point of the tear trough area is an area with some variability. And a lot of people are just genetically very very thin in this area. And what we end up seeing is a relatively bluish color to this area because basically looking through skin that’s almost transparent. And so you’re seeing the bluish color of the blood vessels.
So the question about the relationship between the under eye area and the sinuses, there is some relationship but it is usually more of a fluid-type of relationship and what the means essentially is whenever the sinuses get congested or there’s allergies, there’s actually a common pathway where everything drains and it’s behind the eye. So, very often that area can have some fluid. Now in your case, that’s not what we’re talking about. With you, it’s more about the thickness of the tissue and the volume in that area.
So an approach that we offer in our practice, we look at this area in a couple of different ways. One, we look at the cheek area and see if any volume may be added to the cheek. Now when you’re young, we’re not interested in having you do a lot of procedures that are typically more age-related procedures. However, conservative options may be something worth entertaining.
So in our practice, we do procedures such as the use of platelet rich plasma or platelet rich fibrin matrix to help add some collagen and some quality to the skin. This is a very leading edge type of work that we’ve been applying in other areas of our practice including the hair loss division of our practice. But platelet rich plasma is actually your own blood and it is spun down so we have this pure platelet concentration that has growth factors. And a lot of times, these growth factors work very well in improving the skin quality and building the collagen under the skin. In addition to this, we also routinely use hyaluronic acids such as Restylane to add some volume, to help soften that tear trough area.
My advice is to consider how committed you are to doing something in the short term and these procedures can basically last anywhere from 6 months to a year but does vary from individual to individual.
So as far as answering the question about the sinuses, of course manage your sinuses and deviated septum as per your EENT doctor but I wouldn’t expect too much of a dramatic change in the skin quality under the eyes and it should potentially addressed with a variety of different approaches using your natural as well as your injectable filler. So I hope that was helpful and thank you for your question.
Dr. Prasad has been using the process of platelet rich plasma to enhance and restore the skin of the face and neck. Platelet rich plasma (PRP) contains growth factors which stimulate your body to repair and restore tissues using your body’s own natural processes. With his technique, Dr. Prasad is able to rejuvenate your skin by isolating elements from your blood which can then be injected below wrinkles, folds and even acne scars.
Platelet rich plasma(PRP) systems such as Selphyl® technology, produce a platelet rich fibrin matrix (PRFM) from your own blood. This PRFM contains the growth factors your body uses to initiate and control wound healing. Dr. Prasad uses platelet rich plasma (PRP) to improve wrinkles, folds and scars (including acne scars) on your face in combination with or without surgery or lasers. In face Dr. Prasad also uses platelet rich plasma (PRP) to accelerate recovery from and to enhance the results of rhinoplasty, facelift, fat transfer and facial implant surgery.
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Question No. 5- November 13
When I Smile or Squint, The Thin Skin Under My Eyes Puffs Up into Wrinkly Bags. What Are my Options?
Thank you for your question. You’re asking what to do about wrinkly skin that becomes very wrinkly and puffy when you smile. Now this is a very common issue in my practice, especially people with lighter skin. You know, the eyelid skin is the thinnest skin in the body and that means that the skin being half millimeter in thickness is easily affected by a lot of factors including sun exposure, being one of the biggest ones, smoking, even hydration can really affect the delicate skin under the eyes. So based on the photos you submitted, what I notice to you was that even if your skin is relaxed, when your face is relaxed, there are lines that are there. Now those lines in our field, we refer to those as static lines. And then, when you smile, those wrinkles and lines become more accentuated, and those are referred to as dynamic lines.
One of the biggest mistakes people has made, and as a specialist in the eye area, I have seen so many people who went to a doctor to have the skin removed with the misperception that there was excess skin. And so when they removed the skin, because when they smiled it bunched up so much, if their face was relaxed, their eyelid pulled down and it’s a problem called lower eyelid retraction. So I’m not going to advise you to have cosmetic eyelid surgery necessarily. Essentially, the approach that I would consider is to treat the skin so that it improves in skin quality.
Now how do we do that? This is a half millimeter thick skin so there’s only so much you can do. But in my practice, I routinely use lasers, such as my fractional CO2 laser and I combine it with the use of platelet- rich plasma. Now this is a very leading edge procedure where we actually draw your own blood and we spin it and concentrate the factors that are responsible for healing. And what that does is, it stimulates the body’s own collagen and it basically improves the skin texture as well as stimulating blood supply, and so the skin becomes healthier. So, if you were to have platelet- rich plasma and the laser, that’s one aspect of this.
Now, years ago, I actually made a point to recommend combining these treatments where we try to smooth out the skin with Botox or Dysport. And the reason is we want to reduce the activity of muscles that will cost the wrinkling to occur during that time when the skin is healing. So, I think that combining something like Botox or Dysport to reduce the activity of the muscle and then using a procedure or a combination of procedures to smooth out the skin, I think will help. I don’t think that it will completely eliminate it because as long as you’re moving and smiling, you’re going to have some of that bunching. But I think this will be a good way to help prevent things from getting worse and improve the current situation. I hope that was helpful and thank you for your question.
A small amount of your blood is drawn (like having routine blood tests in your doctor’s office), and Dr. Prasad uses platelet rich plasma (PRP) with Selphyl® technology (an FDA cleared device to separate the elements of your blood in a specific way) to generate a platelet rich fibrin matrix (PRFM).
This Selphyl® PRFM primarily contains fibrin, a natural blood protein, and platelets, the part of your blood chiefly responsible for stopping bleeding. However, in addition to this function, platelets also contain growth factors, proteins which signal cells in your body to perform tasks such as producing or reorganizing collagen, developing blood vessels, etc. The platelets in the Selphyl®PRFM, as opposed to other platelet systems, release these growth factors in a concentrated but natural way.
It is believed that these growth factors stimulate the cells in the tissue treated, such as those below wrinkles, folds, laugh lines and acne scars, to rejuvenate the skin over the next few weeks.
After determining that platelet rich plasma (PRP) or Selphyl® platelet rich fibrin matrix (PRFM) is right for you, a small amount of your blood will be drawn, similar to having basic blood tests at your doctor’s office. This will then used to prepare the Selphyl® PRFM in a 6 minute process. During that time, the areas of the face to be treated will be cleansed and numbed, either with a topical cream or spray or with a small injection.
Once this is done, the platelet rich plasma (PRP) or Selphyl®PRFM is injected into the skin to be treated. Cool compresses are then applied to these areas. The entire process typically takes no more than 15-20 minutes.
What to Expect Afterwards
Immediately after treatment with platelet rich plasma (PRP) or Selphyl® platelet rich fibrin matrix (PRFM), the treated area is slightly red; this typically fades in a few hours. There is usually very little bruising, which is generally limited to a few “points” and can easily be covered with make-up. There is some mild swelling, which in most patients fades in a few days.
Beyond this, there is usually some “settling” of effect over the first 1-2 weeks, after which the improvements noted are long-lasting. Selphyl® PRFM can provide a natural-looking improvement using your body’s own capacity for repair and regeneration.
Before and After Examples
Shown here are before (left) and after (right) views of actual patients. It’s important to remember that every patient responds differently to surgery, and no one can be certain that he or she will get the results shown. However, these photos will illustrate the changes that are possible with these procedures.