Adorning the eyelashes to draw attention to our most telling area of expression – the eyes – dates back to antiquity. The ancient Egyptians mixed their saliva with antimony, burnt almond, copper, or coal to enhance the lashes. MaybellineTM mascara was created in 1913 by the chemist T.L. Williams who mixed Vaseline with coal for his sister Mabel. Today, a Google search for the term eyelash lift retrieves 61 million results.
Upward tilting of the lashes is desirable because it makes the eyes look larger and youthful. The original eyelash curler was patented in 1931, and today there are hundreds of versions on the market. While eyelash curlers are readily available and inexpensive, they can inadvertently pull out lashes prematurely.
In addition, eyelash perms have been gaining popularity. Eyelash perms (although usually successful) carry a relative risk of damage by chemicals to both the cuticles of the follicles as well as the eyes.
Other eyelash enhancers include topical prostaglandins that increase the length, width, and pigmentation of the lashes and brows. They work very well but carry small risks of complications reviewed in a recent review article by Steinsapir.
My Woodward Laser Lash Lift (WLLL) provides a new alternative with potentially long-lasting results by utilizing an established device: the CO2 laser.
To begin, this technique involves first protecting the globe with a steel jaeger plate. The eyelid needs to be infiltrated with lidocaine. Next, the laser is set on 6W in continuous wave with a focused delivery system using the incisional handpiece with a 200-micron diameter. Approximately 25 focused spots are placed in a “zig-zag” fashion no closer than 2.5 to 3 mm from the lash follicles. Dwell time is controlled by the surgeon with the foot pedal to be about 500 to 750 ms. Since the dwell times are much longer than the computer pattern generator (CPG) provides, it is difficult to standardize. This makes proper protection of the globe with the jaeger plate of utmost importance.
Some degree of the initial upward tilt of the lashes is due to dehydration. When patients are healing, there will be edema that may tilt the lashes downwards again; however, when the edema subsides, the lashes will remain in the improved position.
Post-operative care involves gently cleaning the affected areas with a gauze soaked in diluted vinegar (1 cup distilled water:1 tea-spoon distilled white vinegar) four times per day with the eyes closed. The laser spots will be visible at first, but they will fill in and become invisible after a couple of weeks. After each soak, the areas can be protected with a very small amount of a mild emollient until day ten which is the first day that a patient can wear makeup. The lid margins will remain pink for eight to ten weeks.
This technique was originally developed for patients with functional reasons for their eyelash ptosis, such as floppy lid syndrome associated with sleep apnea or cicatricial entropion after eyelid reconstruction for cancer or trauma patients. It gradually evolved into use for the enhancement of the results of upper blepharoplasty.
A study published in 2019 in Ophthalmic Plastic and Reconstructive Surgery showed that patients that underwent the lash lift procedure along with concurrent upper blepharoplasty had statistically significant improvement of upward tilt of their lashes compared to blepharoplasty alone. There were no reports of lash loss, vision loss, or scars.2 The study evaluating lash lift alone is still underway and is showing even more promising results.
Regardless of the technique used to enhance the lashes, providers should be aware that the eyelashes provide important functions of deflecting debris and preventing water evaporation. Eyelashes that are too long or too short can pose problems with eye protection.
In summary, people have been enhancing their eyelashes with a myriad of techniques for thousands of years. The Woodward Laser Lash Lift adds a new long-lasting alternative to the variety of procedures available today.
About the Author
Julie Ann Woodward, MD; Dr. Woodward is the chief of oculofacial and reconstructive surgery services at Duke University Medical Center. She is a professor of ophthalmology and an associate professor of dermatology. She is currently a fellow of the American Academy of Ophthalmology (AAO), American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), American Academy of Cosmetic Surgery (AACS), Women’s Dermatologic Society (WDS), and Women in Ophthalmology (WIO). She has delivered keynote presentations for conferences around the world. She has also been quoted in a variety of fashion magazines, including Vogue, Self, Fitness, Allure, and Cosmopolitan. She enjoys teaching and performing live demonstrations. She is an editorial board member for three aesthetic journals, and her special interests are in periocular rejuvenation with lasers and injectable neurotoxins and fillers.
References:
1. Steinsapir KD, Steinsapir SMG.Revisiting the Safety of Prostaglandin Analog Eyelash Growth Products. Dermatologic Surgery. 01 May 2021, 47(5): 658-665. DOI: 10.1097/dss.0000000000002928. PMID:33625141
2. Langelier NA, Liss J, Leyngold I, Weller CL, Stinnett S, Woodward JA. CO2 Laser Lash Tilt Technique for the Treatment of Mild to Moderate Lash Ptosis and Augmentation of Upper Eyelid Blepharoplasty Results.Ophthalmic Plastic and Reconstructive Surgery. July/August 2019.Vol 35(4):399-402. DOI: 10.1097/IOP.0000000000001362
