TL;DR:
- A2 magazine feature where Dr Sly Nedic covers eye area rejuvenation and Derma-DNA testing.
- Covers her credentials: WOSAAM, IHS, A4M, 20+ years experience, Thermage and filler accreditation, DNA testing diploma.
- Explains what a youthful eye area looks like and the anatomical signs of eye ageing (hollowing, drooping brows, crow’s feet, lower eyelid bags).
- Runs through treatment options: Thermage RF, BonTA (Botox), lasers and peels, hyaluronic acid fillers, mesotherapy.
- Concludes that eye rejuvenation needs a combination of techniques and an experienced, artistic practitioner.
A2 magazine – Dr. Nedic explains eye area rejuvenation, Derma- DNA tests for healthier-looking skin and talks about her own anti-aging regime
Our Expert Panel
A2’s professional contributors
Dr Sly Nedic MBChB(Bel) Aesthetic and Anti-Ageing practitioner
Dr Nedic is a founder of the 8th Sense medi-spa in Sandton, where she passionately combines aesthetic makeovers with anti-ageing medicine, bioidentical hormone replacement therapy and preventative DNA testing. This makes the practice unique as it offers treatments for aging on the inside as well as out, for both women and men alike. She is a board-certified doctor of WOSAAM (World Organization Society Of Anti-Ageing Medicine), a member of IHS (International Hormone Society) and A4M (American Academy of Anti-Ageing Medicine). She has more than 20 years of medical experience where she is an accredited expert for the Thermage medical procedure, and an accredited doctor for advanced filler techniques, BonTA and mesotherapy (France), as well as Master courses (Paris). She is also an accredited doctor by Laboratories Reunis-Europe for comprehensive DNA testing (diploma in DNA testing from the Reunis academy). Dr Nedic is an author of many articles and is a lecturer at the international and local anti-aging congresses. Dr Nedic has extensive knowledge in all aesthetic treatments, non-invasive facial rejuvenation and body sculpturing – as well as anti-aging medical treatments through World Congresses and Workshops – which she attends regularly.
Eye of the beholder
In the quest for ageless eyes, the search can be endless when faced with all the new advancements in the aesthetic world. Dr Sly Nedic makes simple the art of eye rejuvenation through an expert eye.
The eye is the mirror of the soul, but nevertheless, beauty and youth are generally measured by the appearance of the eye region (Peri-orbital region). A youthful eye area is a full and open look, with no hollowness around the eyes. The upper eyelid fold is localized approximately 8mm from the edge of the eyelid eyelash, and without excessive skin. The eyebrow is also slightly convex, and the lower eyelid is toned with a good exposure to conjunctiva.
The signs of eye ageing appear differently in different people – and generally occur around the age of 40 – while stabilizing at the age of 60. There are many anatomical structures involved in ageing eyes and peri-orbital area, and even supporting structures can influence the appearance of eye youth (such as cheeks and temples). Peri-orbital ageing is multifaceted and each anatomical structure will require different techniques, often requiring the combination of treatments.
What are the signs of the ageing eye area?
Excess skin of the upper eyelid can be wrinkled and lax, sometimes even interfering with vision. It can also make the application of eye make-up quite tricky. With ageing, the position of the eyebrows is often changed, leading to ptosis (droopiness). This is the second most common complaint of the ageing woman. The eyes are also protected by a layer of fat, and with ageing this fat can atrophy and create the appearance of hollow eyes. They can also protrude, which is a hallmark of ageing eyes… and needless to say, is not aesthetically appealing.
The muscle which closes the eyelid (orbicularis) actually becomes more prominent as the structure above rapidly ages, creating crows feet wrinkles. These wrinkles become very visible when one smiles, and what seems to be pretty at a younger age can become destructive at a more mature age. Laxity of the lower eyelid is a very obvious sign of ageing. Lower eyelids elongate with ageing and can also show bulging fat, creating lower eyelid “bags”. In the lower eyelid the tear troughs deform further, complicating lower eyelid appearance.
The cheek may be flattened with age which creates a sad look. However, the dynamic of the patient’s smile can give the appearance of youth by shortening of the lower lid and mid cheek. In addition, sun damage and age-related pigmentation, vascular lesions and skin texture problems (such as roughness and dullness) further complicate the eye region.
What can we do to rejuvenate the eye area?
When we decide on a treatment, the predominance of the anatomical structure of the most aged area is normally the first one to start with. The complexity of the eye region will need a combination of techniques to activate the most youthful results.
Skin laxity and sagging are best treated with monopolar RF like Thermage®. The new CPT hand will deliver results that are deeper, more effective – and painless – thereby assuring the patients’ comfort. The aim is to stimulate new collagen production over a period of time, creating less sagginess and smoothing wrinkles. This can be achieved in a single treatment without any downtime or surgery.
The dynamic peri-orbital wrinkles or crows feet are treated with a BonTA, carefully delivered in an optimal dose so as to not cause excessive swelling for patients who are prone to this condition. BonTA can also help with brow lifts, completing that younger look. For lower eyelid wrinkles BonTA is sometimes used if there is no excessive laxity when checked by a snap-back test.
For improvement of texture and mitigation of fine lines, gentle methods such as traditional phototherapy, pulse light or fractional lasers are usually used. However in more severe cases, more ablative treatments such as CO2 lasers, LED resurfacing, ER: YAG lasers and even 30-40% TCA peels should be used. These treatments should always be performed with good eye protection and by experienced physicians.
The recent trend in creating the youthful eye look is in mastering filling techniques with hyaluronic acid fillers. Instant youthfulness can be achieved by adding a filler in the malar area, leading to shortening of the lower eyelid, peri-orbital hollowness and tear troughs. Fillers should be done by an experienced injector who avoids over correction and superficial deposits, as this leads to a poor outcome. But if this is done correctly, it will result in a total disappearance of the hollowness, creating a beautiful youthful appearance.
For peri-orbital fat atrophy, fillers can be injected behind the eyes (retro-orbitally), thus creating more of a youthful look. A small amount of filler can be deposited just under the outer eyebrow, creating an eyebrow lift which every woman desires.
Mesotherapy treatments combined with a different concentration of non-cross linked hyaluronic acid can be used for peri-orbital rejuvenation. This can be used for mild cases, or as an addition to combination techniques.
Conclusion
To achieve successful rejuvenation of the eye area, it is necessary to use a combination of techniques. One must have perfect anatomical knowledge of this region, as well as advanced training and an artistic eye.