Endolift®: the “lunch-time” laser lifting for the lower eyelids

Lasers and others energy-based devices have reached very high levels of results. Although the area of the lower eyelids is one of the most difficult to treat without surgery, Endolift® represents one of the safest and effective techniques that we can offer. Endolift® procedure was performed with a 200 microns second-generation bare fiber connected to an Italian 1470nm semiconductor laser to treat the lower eyelids of a 43-year-old patient with wrinkles and skin laxity. No anesthesia was required. The fiber was easily inserted through the skin, without any incisions, directly between the orbicularis oculi muscle and the septum. The total laser energy delivered was 80 J for each side. Post-procedure the patient immediately resumed her daily activities. Snap Back test was performed before (T0) and 6 months (T1) after the procedure; Fitzpatrick “wrinkle score” and “degree of elastosis” were assessed at T0 and T1; investigator Global Aesthetic Improvement scale (iGAIS), external investigator Global Aesthetic Improvement scale (eiGAIS) and participant Global Aesthetic Improvement scale (pGAIS) were also recorded at T1. The treatment has been completed with a session of a vascular 532nm diode laser for treating the fine telangiectasias, immediately before the Endolift® procedure. The lower eyelids have benefited from the possibility that the Endolift® has to remodel and retract the tissues, activate the collagen production, and stimulate the neo-angiogenesis. Results are evaluated at T1, when the skin laxity is reduced and superficial wrinkles are smoothed, resulting in an overall compacting of the skin which is visible and continues to progress over the following months. The only adverse events recorded were redness for 3 hours and a light swelling for 2 days. Snap Back test at T0 was severe and negative at T1; at T0 wrinkle score” was II and Fitzpatrick “degree of elastosis” was 7-9 but at T1 Fitzpatrick “wrinkle score” was I and Fitzpatrick “degree of elastosis” was 1-3; iGAIS, eiGAIS and pGAIS at T1 were all +3. Endolift® can currently be considered one of the leading non-surgical treatments for the laxity of lower eyelids.