**coming soon** FELC Non-Surgical Eye Lifts

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The Felc by Fusion GT creates a non-surgical eye lift procedure which has taken the UK by storm in 2017. It is now becoming more and more popular amongst patients who don’t want more invasive surgeries. 

As people age, parts of their anatomy undergo changes which are often not welcomed. The most common complaint about a patients’ appearance is looking old, tired, and saggy. Often the eyes are a focus of this change in appearance over time and it’s true that the eyes give away your age. In some patients, hooded or tired-looking eyes are an inherited feature which worsens over time. In a society that values looking more youthful, attractive and refreshed, surgery was until recently the only real possibility to effectively rejuvenate the eyelid.  

Subtle anti-ageing procedures are preferred these days. The number of blepharoplasty (or eyelift) surgery procedures has remained more or less static for the last 3 years. In contrast, radical surgery has significantly reduced.  Patients are now more educated about cosmetic procedures than ever. There is a distinct trend away from conspicuous enhancement and toward understated, refreshed-looking results. Today’s trend is to tweak, not tuck and the Felc non-surgical eye lift is a revolutionary progression in the field of medical aesthetics. It is for this reason the world has become excited about the inception of Soft Surgery as it has since been shown as an effective tool in the management of unwanted signs of ageing and skin disorders, most notably by providing surgical-quality eyelid lift results with significant reductions in risks, costs and downtime.  

Most commonly described by patients as “saggy”, “droopy” or “hooded” eyelids, the medical term for a low lying upper eyelid is blepharoptosis or simply ptosis. This can either be congenital, i.e. present at birth, or acquired, becoming progressively worse over the course of time. The speed at which this develops is variable and may progress gradually over the years.  

Ageing is the most common cause of ptosis, with patients noticing more laxity of the upper eyelid past their 4th decade. In severe cases, excess eyelid tissue can cause decreased vision in addition to being a cosmetic problem. 

Ageing eyes can make a person look tired and sad when they don’t mean to. For this reason, a great deal of effort is made to improve their condition. This includes a wide range of makeup, cosmetics, and wrinkle treatment at one end of the spectrum and cosmetic surgery at the other. “Soft Surgery” stops short of the severe nature of conventional surgery, carrying far fewer risks. But it does very well at delivering the results that bridge the gap consumers have been looking for.  

Surgical  

Conventional blepharoplasty surgery results in modification of the upper, lower or both eyelids. This is done by removing the skin and fat tissue that cause functional and aesthetic deficits. The procedure is always carried out under general or local anaesthesia in an operating theatre setting. It involves the removal of unwanted tissue by cutting it with a scalpel and then stitching the cut back up. This procedure is performed by qualified facial plastic surgeons and requires a high degree of skill and knowledge of the eyelid anatomy. Surgery doesn’t come cheap, and carries surgical risks. Serious complications include risks of scarring, infection, bleeding and nerve and vessel damage. Other complications include dry eyes, uneven results and brow or eyelid ptosis (drooping). There is also the serious risks associated with general anaesthesia. The downtime from such a surgery can be considerable. A nice way of summarising is that patients will be “supermarket ready” in a week, “socializing ready” in three weeks, and “photography ready” in three months. Surgical augmentation of the eyelids therefore needs careful consideration. Any prospective patient must also be totally committed to both the procedure and the potential consequences. It can, however, correct severe skin laxity, it is still the gold standard for correcting lax eyelid tissue and results can last more than a decade. 

Non-surgical  

Blepharoplasty inherently describes a surgical procedure, originating from the words “blepharon” (eyelid) and “plasty” (to form). Nevertheless, a non-surgical eyelid lift would appeal to those who shy away from the potential risks of surgical procedures. And also to those concerned about downtime and cost. To date there hasn’t been any advances worth mentioning that provide predictable, noticeable results – until soft surgery came along.  

This is a device which utilises plasma in order to achieve effects on the skin. Plasma might sound a little bit sci-fi, but is a natural phenomenon. Alongside solid, liquid and gas, it is one of the four fundamental states of matter. It’s difficult to create plasma, and it has to be generated as a gaseous mixture of highly negatively and positively charged ions. The Felc device generates a small arc like a tiny lightning bolt that interacts with the tissue, causing sublimation. This is where solid matter is turned into gas. In short, the surface of the treated tissue is instantly vaporised. Developed in Italy, it was first used on patients for the purposes of eyelid lifting by Prof Giorgio Fippi. He is the President of the Italian society for aesthetic medicine and non-ablative surgery. He first came up with the idea of plasma surgery way back in the seventies.   

Unlike conventional surgical intervention, skin is not removed. Also the fat pads around the eyes are not altered in the treatment. Instead, it achieves its outcome by skin tightening this means the results are dependent on how much excess skin there is to correct, and is the limiting factor in how much of a result can be achieved. 

Treatment of the surface of the skin does not result in heat conduction to the dermis, so there’s no damage to underlying structures. So is safe for use on the eyelid tissue with a significant reduction in risk compared to normal surgical measures. There is also minimal risk of scarring compared with conventional surgical eye lifts, which will always leave a scar, no matter how small and well hidden.   

The treatment creates a series of small burn-like marks on the skin surface. This, in turn, creates a wound healing response which results in the formation of new collagen in the dermis, thickening it and giving a rejuvenated appearance. Results are seen immediately after treatment and continue to improve in the first two weeks whilst the skin heals. Thereafter, there is further improvement with gradual regeneration of the skin.  

Patients should expect to be in clinic for around an hour or so. After the consent discussion, local anaesthetic is applied to the skin. The numbness ensures that the procedure is comfortable and the treatment aims can be achieved. The device is then used to treat the target areas and eliminate the folds of skin, causing contraction. This usually takes around 20-30 minutes, during which time the patient may feel some heat and discomfort. There will be small brown spots present after treatment, called carbon crusts. For best results up to three treatments are usually required to achieve near surgery-quality results. The timing of follow up treatments depends on the response of the skin on the eyelids, but this is usually between 6 and 8 weeks. 

Soft surgery is effective at correcting a whole host of age-related changes affecting the appearance of the tissues. These include; • 

• Droopy eyelids and skin folds • 
• Wrinkles underneath the eyes • 
• Crows feet •
• Aged skin around the eyes • 
• Xanthelasma (fat deposits under the upper eyelid skin) • 
• Improvement of results previously obtained by blepharoplasty surgery • 
• Skin tags, warts and dermal naevi (skin coloured moles) on the upper and lower eyelids • 
• Certain types of pigmented patches such as seborrhoetic keratosis (age spots) and solar lentiges (sun spots) and sun-induced lesions   

The key to great results is realistic expectations. Also it’s important we only treat patients who are suitable for the procedure. As a patient it is important to be clear what is to be treated and what the likely outcome is. Likewise for the practitioner, it is important to remind the patient this is a non-surgical eyelid lift. As such the results will likely not be as dramatic as a surgical procedure with only one treatment.  

Patients suitable for a non-surgical eyelid lift should have mild to moderate skin laxity. Those with severe laxity and those with laxity that extends to compromise their visual field may be better suited to surgical intervention. Likewise, patients who complain of eye bags caused by the prolapse of fat pads under or above the eyes will see little improvement.   

Patients who are taking certain types of medication may not be suitable for treatment. You will need to be prepared to take time off work. Also patients who have very hectic social commitments and want to rush treatments may not be suitable. 

The changes to the skin that are obtained are long-lasting and will last in line with the patient’s ageing, this means the results will last several years  

It can feel a little hot and painful whilst the procedure is ongoing, which stops when the treatment is over. After the treatment, the area can feel tight and tender for a few days when the swelling is present and as the tissue is healing. In this time it is advisable to take painkillers and anti-inflammatories if required.  

Simply because it is non-surgical does not render it downtime-free. Patients should, however, be back to relative normality after around a week. The treatment itself leaves a series of tiny brown dots on the eyelid, which look a little like a burn.  For the first 2-3 days following your eye lift, swelling will be profuse. The eye is a delicate area and this is to be expected. Some patients develop more swelling than others. In this time it’s advisable to take time off work and the eyelids may be tender. In the initial period, keeping the area clean and dry is a must. Some patients find applying cold compresses and taking anti-inflammatories reduces the swelling. Avoiding exercise in this initial time is beneficial. It is not a good idea to decorate the house, clean the oven or go on holiday. It’s also not recommended to go on sunbeds or go swimming. Keeping the area clean and protected from sunlight is the most important part of the aftercare. The crusts will shed after approximately 5-7 days, after which time the skin can appear scaly and pink. The redness can take around a month to reduce, but this is dependent on skin type. It is also dependent on wound healing response. The skin that results at this time is soft fragile, sometimes called “baby skin”, and will take some time to settle and adapt to the surrounding, untreated skin. 

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