Eyeworld

March 2016 • Ophthalmology Business 13 This is also when brow lifts and cheek enhancement with fillers become popular, Dr. Cockerham said. Both the 30s and 40s are a com- mon time to remove scars from acne that patients got earlier in life, he added. In the 50s The 50s are when Dr. Johnson sees more patients consider blepharoplas- ties, eyebrow lifts, and mini facelifts. "These patients also tend to contin- ue with the neuromodulators, fillers, and peels that they've been using all along," he said. Sculptra (injectable poly-L-lactic acid, Galderma Laboratories) and other collagen inductions also are common for patients in their 50s, Dr. Cockerham said. So is intense pulsed light treatment for the skin, Dr. Liegner said. can be beautiful," Dr. Cockerham said. The pale look is something that has had celebrity influence, she added. "Most patients in their 20s are in- terested in preventative medical grade skincare products such as tretinoin and vitamin C serum," Dr. Johnson said. "As patients approach their mid- to late-20s, they start to consider neuro- modulators such as Botox and Dysport [abobotulinumtoxinA, Galderma Labo- ratories, Fort Worth, Texas] to treat fine lines and prevent future wrinkles." Other trends for patients in their 20s include topical skin treatments, lip enhancements with fillers, and perma- nent makeup. In the 30s Fillers that replace volume lost in the mid face are a bigger part of the mix for patients in their 30s, Dr. John- son said. Fillers for the lips, such as Juvederm (Allergan), continue to be popular in this age group. Another option that comes into play in the 30s is the removal of eye bags for patients with allergies or a genetic predisposition to them, Dr. Cockerham said. Permanent makeup also is a con- tinuing trend in the 30s as time is at a greater premium for patients with busy jobs or young children, Dr. Liegner said. In the 40s Looking good for a 25-year high school reunion leads a number of patients in their early 40s to consider blepharo- plasty, Dr. Liegner observed. Blepharo- plasties were the fourth most popular cosmetic surgical procedure in 2014, the American Society of Plastic Sur- geons reported. The number of bleph- aroplasties increased 4% from 2013 to 2014. Another 40-something trend: "Patients in their 40s tend to start to be more open to chemical peels and laser skin resurfacing," Dr. Johnson said. Eight percent of cosmetic procedure pa- tients in 2014 were men, a 1% increase compared with 2013, according to the American Society of Plastic Surgeons. Botox's popularity One universally popular procedure re- gardless of age is Botox (onabotulinum- toxinA, Allergan, Dublin); it's the most popular cosmetic minimally invasive procedure in the U.S., according to the American Society of Plastic Surgeons—and it's a proce- dure that many younger ophthalmolo- gists will perform, said Kimberly Cock- erham, MD, FACS, adjunct associate clinical professor, Stanford Department of Ophthalmology, Palo Alto, Califor- nia, and in private practice, Central Valley Eye Medical Group, Stockton, California. "It's easy and keeps patients coming to your office," she said. Patients are also starting to get Botox earlier. Dermatologist Lance Barazani, MD, Advanced Dermatology, Albertson, New York, used to see pa- tients beginning Botox in their mid-30s and mid-40s, but that's now declining. "It's not uncommon today to treat patients in their mid-20s with Botox, wanting to get rid of the very early signs of aging," he said. In fact, it's often recommended nowadays to get Botox at the first signs of wrinkling to prevent fine lines and wrinkles and ward off the need for more aggressive cosmetic treatment in the future, he said. Beyond just Botox, here are other oculoplastic and cosmetic trends by age, as noted by oculoplastics special- ists. In the 20s The messages of good skincare and tanning dangers have finally reached a younger generation. "There is a trend toward preven- tion with improvements in sun blocks, decreased utilization of tanning beds, improvements in spray tans, and an overall acceptance that looking pale Top plastic surgery trends in oculoplastics Top 5 cosmetic minimally invasive procedures, 2014 1. Botox 2. Soft tissue peel 3. Chemical peel 4. Laser hair removal 5. Microdermabrasion Top 5 cosmetic plastic surgery procedures, 2014 1. Breast augmentation 2. Nose reshaping/rhinoplasty 3. Liposuction 4. Eyelid surgery/blepharoplasty 5. Facelift Source: American Society of Plastic Surgeons continued on page 14

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