PracticalDermatology

Long, lush eyelashes have always been synonymous with beauty, and our desire to enhance our lashes dates back to 4000 BC. Our ancestors mixed powdered antimony, burnt almonds, black copper oxide, and brown clay in a pot and applied the mixture to the eyelash line with saliva. In 1913, a prominent chemist used Vaseline and coal to enhance his sister’s lashes, and in 1923, we witnessed the invention of the eyelash curler.

There are hundreds of eyelash curlers on the market today, suggesting that the demand for lashes that make eyes pop remains huge and largely unmet. These popular beauty tools don’t change the direction that eyelashes are growing and can cause traction alopecia if used incorrectly, overzealously, or too frequently.

The Woodward Laser Lash Lift (WLLL), however, can change the position of the lashes and offers long-lasting results. So far, I have performed close to 75 of these procedures. Patient satisfaction is extraordinarily high, and the risk of complications is exceedingly low.

I use a CO₂ laser with an incisional handpiece to create small point ablations above the eyelashes, usually in two rows of 25 to 30 spots. The orbital globe is protected with a Jaeger plate during the procedure. Proper protection of the globe is of utmost importance. You can actually watch the eyelashes tilt as we make the ablations across the eyelash line. We tend to overcorrect on the operating table because there will be some drop during recovery. There will be visible spots on the lash line for a few days. We have not seen a single infection or eyelash loss.

Top: Before; Bottom: One month post-op.

You can see the bottom edge of the tarsal plate following the WLLL, which makes the eyes look brighter and wider. In general, patients improve about 1 point on a 4-point scale. When compared with upper eyelid blepharoplasty alone, the addition of the CO₂ laser lash tilt technique provides a significant improvement in the upward tilt of the eyelashes.

Moreover, a follow-up study that looks at the lash lift without a concurrent blepharoplasty shows that the results are even more dramatic when the blepharoplasty isn’t done at the same time.

Intraoperative photo; Left: Treated, Right: Not yet treated

Patient selection is important. Many candidates have eyelashes that congenitally tilt downwards. Some WLLL candidates have floppy lid syndrome, which is associated with snoring and sleep apnea. Other candidates may be long-term contact lens wear. When performed on the right patient, the WLLL results speak for themselves. It is easy to learn and can be incorporated into your menu of procedures.