After a restful night’s sleep, looking into
the mirror, when you see a tired, old looking reflection, there is a problem. The
problem which is giving this tired appearance are your under eye circles, and
under eye puffiness. The causes of dark under-eye circles and puffiness are
varied and multifactorial. Some of these include factors that can be controlled
with change of lifestyle to avoid situations such as dehydration, stress, sleep
deprivation, allergies, smoking, alcohol, unhealthy foods and lack of exercise.
There are other factors which are treatable by medical, non-surgical or
surgical methods. These include treatment of hereditary hyperpigmentation,
treatment of stasis of blood, treatment of age related descent of cheek with
hollowing and thinning of skin, and treatment for fat bulges in the lower
eyelid.
At MedSpa, the aesthetic team under the
guidance of the US Board Certified Plastic Surgeon, Dr. Ajaya Kashyap, believes
in a stepwise approach, known as the KAS Approach. Initially, prevention of bad
lifestyle habits is targeted. This is then followed by treatment of any systemic
medical problems, through surgical or non-surgical therapies.
The stages
increase from minimalistic to invasive – from simple lifestyle changes to
non-surgical to surgical treatments. At the start, an in depth analysis is performed
to assess if the problem of under eye circles is chronic or transient. After this is carried out, a Targeted
Aesthetic Therapy is formulated and administered. The following are the 5
stages, from minimal to invasive, and the various treatment and therapy options
in each stage.
·
Stage 1: Prevention Avoiding 4
S’s –Stress, Spirits(alcohol), Sleeplessness and Smoking
·
Stage 2: Treat - Allergies,
nasal congestion, dehydration and dietary deficiencies
·
Stage 3: Medical Aesthetic Treatments for Hyperpigmentation
and Stasis:
a)
Topical Creams – Gentle
Retinoids and Vitamin C serum along with Hydroquinone are applied keeping away
from the eye
b)
Chemical peels – like mild
Glycolic and Kojic acid away from the eye can help. The lower eyelid skin is
extremely thin and sensitive and strong chemicals should never be applied.
c)
IPL and Lasers- 4-6 sessions of
IPL or Lasers can be quite helpful. Again we always shield the eyes.
d)
Carboxytherapy - This is the
mainstay of our treatment for stasis or pooling of blood which is a major cause
of undereye dark circles. A small amount
of sterile Carbon Dioxide is injected into the eyelid skin with the help of a
very fine needle. This causes temporary puffiness of eyelids for a few minutes
after which the body washes away the Carbon Dioxide along with the products of venous
stasis.
·
Stage 4: Medical Injectable Treatments
a)
Hyaluronic Acid Fillers like
Restylane or Juviderm – these are injected deep and very carefully to fill-up
the hollow areas
b)
Autologous fat can be injected
in place of fillers and lasts much longer
c)
PRP from the individual’s own
blood is a recent addition to our approach to this common problem.
·
Stage 5: Surgical Treatment
a)
Blepharoplasty- this procedure
removes and replaces the fat in the lower eyelid as well as removal of excess
skin is done. We always combine this with lower eyelid lift or tightening which
gives long lasting improvement.
b)
Mid-cheek lift- This procedure
lifts the cheek and the descended cheek pad of fat and also eliminates the
hollow or the “tear-trough” resulting in the lasting rejuvenation of the
lid-cheek junction.
The stage 1 and stage 2 include lifestyle
changes and medical medicinal treatments. Stage 3 and 4 are topical and
minimally invasive treatments. Stage 5 includes invasive procedures. Each of
these treatments, stages 3 to 5 are outpatients treatments with treatment times
varying from 30 minutes to 90 minutes. Finally, at Medspa we believe that we should
always do the least invasive and most effective treatments possible.
Predictability, safety and longevity are always kept in mind when choosing a
treatment. So, stop looking tired, and have your assessment performed with the
KAS Approach to formulate the right treatment plan for
you.
About Dr. Ajaya Kashyap,
Dr. Ajaya Kashyap,the Senior Cosmetic Surgeon at Apollo Hospital,
New Delhi, who is a Double American Board Certified Surgeon - Diplomate American
Board of Plastic Surgery and Diplomate American Board of General Surgery. He
recently (May 2005) moved to New Delhi after 16 years of practicing medicine in
the U.S.A., spending the last ten years in the Greater Boston area in Massachusetts.
He had a very successful private plastic surgery practice with staff privileges
at Metrowest Medical Centre, U-Mass-Memorial Marlborough Hospital,
Leonard-Morse Hospital and Nashoba Valley Medical Center. His wide spectrum of
patients came from various parts of the US and abroad. He had an academic
appointment as Assistant Professor at University of Massachusetts Medical
School. Dr. Kashyap has been the medical director of Aesthetic Centre at Metro
west since 2001 and was the attending plastic surgeon at The Wound Clinic in
Framingham, Massachusetts. He is a Fellow of American College of Surgeons
(FACS), an active member of the American Society of Plastic Surgery (ASPS), and
an ex-member of Massachusetts Medical Society and American Medical Association.
