At Monaco MedSpa we have many nonsurgical treatment options that help reduce eyelid wrinkles, fine lines, bags, malar edema, festoons, sagging eyelids, droopy eyelids, short eyelashes and droopy eyebrows. Sometimes only one treatment modality is needed to restore your eyes youthful look. Other times, a combination of treatments is needed. Among the many non-surgical treatment options we offer to treat eyelids are:

• Tear Trough Filler
• Eyelid Filler
• Temple Filler
• PRP or PRF
• Under Eye Micro-Tox 
• Jelly Roll Botox
• Botox Eyebrow Lift 
• Botox Fox Eye Lift
• Crow's Feet Treatments
• PDO Threads Eyebrow or Fox Eye Lift
• Morpheus8 Microneedling with Radiofrequency 
• Microneedling Alone 
• PLEXR® Plasma Pen Energy Device
• UPNEEQ®
• LATISSE®
• Medical Grade Skincare Creams & Sunscreens

Tear Trough Filler

Tear troughs are the sunken area between the lower eyelid by the nose and the mid cheekbone that can make your face look tired or older. Sunken tear troughs can be caused by aging, genetics and other factors.

• Aging: As we age, our skin and cheek fat pads can slide downward due to laxity in ligaments and tissues and our bones start to demineralize and shrink. These things all combine to create a more noticeable separation between the medial eyelid region and the upper cheek, leading to sunken or hollow-looking lower eyelids.
• Genetics: Some people may inherit sunken tear troughs.
• Other factors leading to sunken, hollow tear troughs include insufficient sleep, sun damage and stress. 
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Sunken tear troughs are treated with hyaluronic acid (HA) fillers. The under eye, lower eyelid tissue is very thin and therefore not every filler can be used in this area. It needs to be a thin filler that does not attract water, so that long-term swelling doesn’t form in the tear trough, lower eyelid region. Here, at Monaco MedSpa, we often treat tear troughs in several sessions because placing small amounts of filler at a time in the area leads to overall better long-term results. 

HA fillers in the tear trough typically last 9 to 12 months depending on how fast your body breaks down the filler and how much filler is placed there.

Eyelid Filler

Sometimes as we age our fat pads start disappearing and/or moving downward with gravity causing the entire upper, lateral and lower orbital rims to appear sunken, bony-looking and dark. This can also be treated with a thin, non-hydrophilic hyaluronic acid (HA) filler placed along the orbital rim in the upper eyelid, lateral orbital region, and/or lower eyelid region.

Hyaluronic acid fillers can also be used to fill upper eyelids that have lost volume with aging and thus appear bony. Restoring lost volume in the upper eyelids creates a more youthful appearance.

HA fillers in the orbital and eyelid regions typically last 9 to 12 months depending on how fast your body breaks down the filler and how much filler is placed there.

Temple Filler

Aging can also cause a loss of tissue, mainly dermis and fat, in the temple region. The temple is located on the side of the eye, between the forehead and ear, and ends just above the high cheekbone. As we age, the temple loses its volume and the skin there becomes very thin and adheres to the bone, leaving a depression or dip on the sides of your face. This causes your lateral eyebrows to start dropping downwards and sometimes gives your face an egg-shaped appearance with the top of your face looking smaller than the bottom. 

Hyaluronic acid and biostimulatory fillers can be placed in the temples to treat temple hollows. They help lift the tail of the eyebrows and to give your face a more balanced appearance. Some temples can be very hollow and therefore sometimes more than one treatment session is needed to fill in the temples and restore their youthful look.

HA fillers in this area typically last 9 to 12 months depending on how fast your body breaks down the filler and how much filler is placed there.

Bio-stimulatory fillers in this area usually require 3 treatment sessions, 6 weeks apart, and typically last 6 to 24 months depending on how fast your body breaks down the collagen they cause your body to produce and how many treatment sessions were done.

PRP or PRF for Under Eyes, Eyelids & Tear Troughs

Platelet-rich plasma (PRP) and Platelet-rich fibrin (PRF) are substances that come from your own blood. The active components are platelets and growth factors. Platelets and growth factors are small cells and substances that encourage your body to rejuvenate itself and produce new, healthy cells. When the PRP or PRF is delivered into the desired treatment areas, it slowly helps to rejuvenate the tissues and create that desired smoother, youthful appearance.

The difference between PRP and PRF is that PRF is thicker than PRP, but they are the same thing, molecularly speaking. The PRP solution is obtained from your own blood and then is thickened into a fibrin matrix to create PRF. PRF is then placed in the under eye region, including the tear trough area. The active components in PRF are the same as in PRP - platelets and growth factors. These small cells and growth factors stimulate your body to produce new collagen and dermal tissue in the under eye region. 

When PRP or PRF are delivered into the desired treatment areas, including the under eyes, eyelids, and tear troughs, it helps to rejuvenate the tissues in these delicate, thin areas and helps to create a fullness that is similar to hyaluronic acid fillers but more natural-looking because it is using your own blood components. PRF is an ideal option for those patients that do not want under eye filler.

Depending on the hollowness of the under eye area, more than one treatment session may be needed. Almost everyone is a good candidate for this under eye treatment, but a consultation with our doctor beforehand is highly recommended to determine approximately how many PRP or PRF treatments will be required. An area that may be filled with one session of HA filler may require more than one session of PRP or PRF, as PRP and PRF are both thinner substances than filler and tend to be reabsorbed back into the body quicker than HA filler.

PRP and PRF results may last 3 to 6 months depending on the amount of platelets and growth factors a person has. Therefore regular touch-ups every 3 to 6 months are recommended.

Under Eye Micro-Tox 

Have you heard of under eye eyelid micro-tox? This is when you inject very small amounts of Botox or Dysport over the entire lower eyelid. By injecting very small amounts of tox very superficially into the skin layer only, you help smooth out under eye crepiness without affecting the underlying muscle. This is ideal for patients with under eye fine wrinkles and crepey skin. 

Sometimes a combination of hyaluronic acid filler and micro-tox in the under eyelid, works wonders to restore the under eyelid’s youthful appearance. 

Micro-tox usually lasts 2 to 4 months depending on how fast your body breaks down the tox and how much tox is placed there. Not too much tox can be put in that region so it is best to come in for regular touch-ups.

Jelly Roll Botox

The Jelly Roll is a roll that forms in the under eye, right under the lower eyelid margin. It is particularly evident when you smile. Its appearance can be reduced by injecting a small amount of Botox or Dysport there, creating a smoother looking appearance in the lower eyelid.

Jelly Roll Botox usually lasts 2 to 4 months depending on how fast your body breaks down the tox and how much tox is placed there. Not too much tox can be put in that region so it is best to come for regular touch-ups.

Botox Eyebrow Lifts and Fox Eye Lifts 

Did you know Botox and Dysport can give you a Brow Lift? Depending on where you place the tox, you can lift everything from the arch of the eyebrow to the lateral ends of the eyebrow. Or you can lift both areas and get an overall eyebrow lift just by using Botox or Dysport. 

For a Fox Eye Lift you can place Botox on the lateral ends of the eyebrow to achieve that dreamy Fox Eye look. 

Eyebrow Lifts and Fox Eye Lifts using Botox or Dysport usually last 2 to 6 months depending on how fast your body breaks down the tox and how much tox is placed there.

Crow's Feet Treatments

Crow's Feet are those lines that form on the side corners of your eyes when you squint or smile. As you age, the dermis of the skin in this region thins out, losing collagen and fat, making these dynamic wrinkles more prominent as we squint or smile because there is no dermis underneath the epidermis to plump out the skin. Untreated, Crow's Feet lines can sometimes become permanent, called static wrinkles, especially if the skin has been exposed to the sun for many years.

Crow’s Feet can be treated with a variety of treatments. Early in our lives, sunscreen is the best option. In our 20’s we can start with medical grade creams and, as soon as Crow's Feet are evident, treat them with Botox or Dysport.

As we age and our Crow's Feet become more prominent, treating them with a combination of small amounts of non-hydrophilic, thin HA fillers and Botox or Dysport may be required.

As we further age or if left untreated for too many years, in addition to fillers & Botox, Crow's Feet may require microneedling, resurfacing lasers, resurfacing with Morpheus8 microneedling with radiofrequency treatments, or Plexr Plasma Pen wrinkle vaporization and fibroblast stimulation treatments.

Crow’s Feet Botox lasts 2 to 6 months. Crow’s Feet HA filler treatments last 3 to 12 months. Crow's Feet energy-based treatments such as lasers, Morpheus8, or Plasma Pen may last up to 12 months. 

All these treatments may require multiple sessions until desired results are achieved. How long each treatment typically lasts really depends on the person’s metabolism, their ability to break down the products or collagen made, and the amount of sessions done or products used. 

PDO Threads Eyebrow or Fox Eye Lift

Droopy eyelids can be treated with PDO threads and that dreamy Fox Eye look can also be temporarily achieved with PDO threads.

The PDO threads are placed at the sites of the eyebrow that will be lifted, usually by the upper temple and forehead regions. The overlying temple and forehead skin needs to be a certain thickness, otherwise you will see the thread. You will also need to sleep face up, otherwise you may push the thread down if you sleep on your sides or stomach. 

Eyebrow threads tend to not last as long as PDO threads placed elsewhere in the body because they are thinner and your body tends to metabolize them in 3 to 6 months. Your body breaks down thin PDO threads faster than it breaks down thicker PDO threads. Thicker PDO threads can be placed to lift the cheeks but may be too thick to place in the temple or forehead to lift the eyebrows. Therefore, since not everyone is a good candidate for a PDO Thread Eyebrow of Fox Eye Lift, a consultation is required beforehand to see if you are a good candidate for this procedure.

PDO Threads Eyebrow or Fox Eye Lifts last anywhere from 3 to 6 months depending on how fast your body breaks down the threads, how many threads are placed, and if you can sleep on your back with your face facing up.  Regular touch-ups are recommended.

Morpheus8 Microneedling with Radiofrequency 

Morpheus8 Microneedling with Radiofrequency is one of the best treatments for eyelids available to thicken the dermis and treat eye bags. Using both the Prime and Resurfacing cartridges, Morphues8 can target many eyelid problems such as thinning dermis, malar and undereye bags, festoons, crepey skin, and Crow’s Feet.

Morpheus8 is a state-of-the-art fractional bipolar radiofrequency energy device. It has an interchangeable portfolio of microneedling tips to deliver customized fractional radiofrequency eyelid treatments. Depending on the settings used, it can target all your skin tissues, from your epidermis, to your dermis, to your fat adipose layers, causing subdermal and adipose tissue remodeling.  It is safe to use on all skin types.

Morpheus8 utilizes dozens of tiny, hair-thin electronic micro pins to deliver rejuvenating energy pulsations at various depths and energy levels.

At shallow depths, Morpheus8 can resurface the uppermost layers of the skin, treating the sagging skin and the fine wrinkles of the eyelids without affecting the fat layers.

At moderate depths, it reaches the dermis and induces fibroblasts to create new dermis (elastin, collagen and dermal proteins), giving your eyelid tissues a rejuvenating, lifting effect.

At higher energies and deeper depths, it eliminates unwanted fat underneath the dermis, thereby contouring the targeted area, getting rid of fat cells there and reducing malar edema, fatty eyelid bags and periorbital festoons. 

At the right depth and energy level, it can significantly improve the appearance of your eyelids , giving them a smoother, younger appearance.

One to three treatment sessions usually 6 to 8 weeks apart may be required. Results can last for up to 1 year or more depending on your body’s ability to make collagen and dermal proteins. Once you achieve your desired results, annual or semi-annual periodic touch-up sessions are recommended. 

Sometimes Morpheus8 treatments are combined with other treatments such as PRP, HA filler, Botox or Plasma Pen treatments. Usually these are done after the Morpheus8 healing period and can result in some phenomenal results. 

Microneedling Alone 

Microneedling is also known as collagen induction therapy. Collagen production is induced by creating micro injury in the area treated, which is then filled in and repaired by surrounding cells with new skin and dermis. 

When the body is injured, specifically the skin, it responds by rejuvenating the injured area and increasing collagen production to heal the area. This treatment works according to that premise. Microneedling uses a pen-like device that contains sterile thin microneedles. During the treatment, these tiny microneedles create nonvisible microchannels that will induce the production of collagen in the eyelid region, which will help improve fine lines and wrinkles in this area.

Microneedling can be done by itself or with PRP or other topical skin treatments such as peptides or exosomes.

Oftentimes, more than one treatment is required. Over time, after several treatments, the eyelid area treated appears smoother and younger looking. 

Anywhere from 1 to 4 treatments, 4 to 6 weeks apart, can be done. Treatment sessions will be specifically tailored to obtain optimal results and vary per individual and severity of wrinkles. Maintenance treatment sessions should be done every 6 to 12 months or as needed.

PLEXR® Plasma Pen Energy Device

The PLEXR® Plasma Pen is an energy device that is one of the best treatments to treat eyelid and periorbital fine lines and wrinkles. It utilizes plasma energy to create a hot beam that vaporizes wrinkles, causing the treated skin to thereby contract. As the treated skin heals, it further tightens the epidermis through fibroblast-induced collagen production, causing a rejuvenation of the skin texture, resulting in a smoother, more supple eyelid skin appearance over the next few weeks. 

Skin tightening treatments with the PLEXR® Plasma Pen occur via two mechanisms: vaporization of the wrinkle and fibroblast-induced collagen production. There aren't many treatments available that can address crepey, wrinkly skin in the Crow's Feet area and eyelids. However, this treatment is truly ideal to address those concerns in these areas.

The good news is that our PLEXR® Plasma Pen treatment can permanently smooth and tighten your skin. The results are long lasting. However, it does not stop the aging process. Over time, you will notice changes in your skin, because of gravity, pollution, and other environmental and genetic factors.

One session may be all you need, but multiple treatment sessions may be required. Treatments should be scheduled 6 to 8 weeks apart, and two to three treatment sessions may be necessary to obtain optimal results. Touch-ups every couple of years may be necessary due to the natural aging process.

UPNEEQ®

UPNEEQ® is the only FDA-approved prescription eye drop for acquired ptosis (low-lying lids) that lifts your upper eyelids to open up your eyes. As we age, our upper eyelids tend to become droopier. These eye drops can help lift the eyelids by a few millimeters making the eye appear more open. Some people also just have genetically low-lying upper eyelids. These eye drops can also help lift genetically low-lying lids. 

These eye drops can be applied every morning or whenever you want, like right before a party. Results last up to 8 hours, so get ready for a selfie marathon because you will absolutely fall in love with your new eye look! 

Did you know that studies have found that open eyes and eyes that have a larger visible iris make the eyes look more attractive to others? Studies have also found that overall facial attractiveness increases with larger uncovered eye surfaces.

So if you are looking for your eyes or overall face to look more attractive for a party or just in everyday life, UPNEEQ® may be exactly what you are looking for.

Since these eye drops are a prescribed medication, a virtual or in-person consultation is required with our doctor. Call us at 786-536-6117 for your consultation appointment today!

LATISSE®

LATISSE® is the first prescription product that is an FDA-approved treatment to treat inadequate eyelash growth. LATISSE helps to grow eyelashes for people with lashes that are not long enough.

LATISSE® is believed to prolong the active eyelash growth phase. And, in studies, it has been clinically proven to make eyelashes fuller, longer, and darker when used nightly for 16 weeks.

LATISSE® comes in a small eye drop bottle with applicators. It is applied nightly directly to the skin of the upper eyelid margin at the base of the eyelashes using the sterile applicators provided in the kit. It is applied only to the upper eyelid not the lower lid. 

If you are looking for longer lashes, LATISSE® may be exactly what you are looking for.

Since these eye drops are a prescribed medication, a virtual or in-person consultation is required with our doctor. Call us at 786-536-6117 for your consultation appointment today!

Medical Grade Skincare Creams & Sunscreens

Every time we hear people say they don’t believe that creams work, we shake our heads in disbelief. The human skin has so many receptors that transport anti-aging goodies into our dermis. From retinoid x receptors to vitamin receptors to estrogen and other hormone  receptors. These skin receptors deliver anti-aging ingredients to the areas of the dermis where they are most needed - in wrinkled  or volume depleted areas.

Human skin cells have receptors that metabolize multiple vitamins, not just vitamin C. Sodium-dependent vitamin C transporters (SVCTs) are responsible for transporting vitamin C from the plasma into the skin and across its layers. Vitamin C is needed to make collagen. 

Retinoids bind to retinoid X receptors that promote epidermal proliferation. There are many microscopic skin receptors on our skin that help transport anti-aging ingredients into the deeper layers of our skin. These ingredients are then used by our dermal cells and enzymes to continuously restore our dermis and epidermis.

Medical grade skin care creams are a great way to help keep the skin and dermis looking young and wrinkle-free. While they may not prevent fat pads from descending or losing volume or prevent our bones from shrinking, they can treat fine lines and improve our skin hydration and turgor, helping us maintain a smooth, supple and youthful skin texture.

Medical grade skincare creams contain larger amounts and higher percentages of active ingredients (the goodies). This tends to make them more effective than non-medical grade creams. 

Medical grade creams also tend to not have the harmful chemicals that non-medical grade creams contain, such as sulfates, certain alcohols, ammonias (DEA, MEA, TEA), mineral oil, oxybenzone, benzophenone-3, octyl methoxycinnamate and parabens, which have been linked to cancer, increased wrinkles or reproductive issues. 

So when it comes to skincare, one of the best things you can do is use medical grade skin care creams, especially around the eyes. Eye creams need to be specifically made for eyes because eyelid tissue is very thin and can be very sensitive to certain ingredients. 

Using a daily mineral zinc-based sunscreen on your face, eyelids, neck, and decolletage is one of the first things you should do early on in your life to prevent wrinkles. Applying sunscreen every morning on your eyelids is essential to keep your delicate eye skin from getting damaged by the sun's harmful UV rays. UV rays destroy collagen, elastin and skin cell’s DNA and will age your skin faster than anything. Ultraviolet (UV) radiation can damage the DNA of collagen and elastin in the skin, which can lead to premature aging and skin cancer.

UVA rays can also penetrate deep into the skin and damage collagen fibers in the dermis. This damage can cause the skin to produce abnormal elastin, which can then lead to the production of enzymes that malfunction and degrade collagen. Over time, this process can cause wrinkles and leathery skin. UVA rays can also damage epidermal cells and capillaries, and can generate free radicals. Daily sunscreen is a must!

Monaco MedSpa is proud to offer a large selection of medical grade skincare products, including eye creams, that are carefully selected by our physician, Dr. Barrueta.

We also have our own skincare line.

Monaco MedSpa Skincare products are made using the highest concentration of each ingredient possible in order to get you transformative, anti-aging results, without containing any sulfates, hormones, parabens, imidazolidinyl urea, petrolatum, propylene glycol, cocamide DEA, Prop 65, formaldehyde, 1-2 dioxane, hexylene glycol, or decelyne glycol. Visit our MedSpa to see our wide selection of medical grade skincare products.

Take Home Message

The eyes are not only the windows to the soul, but they are also usually the first thing someone notices when they first meet you and they are usually the first thing to give your age away. Nowadays, there are so many non-surgical things we can do to keep our eyes looking youthful, that it is hard to determine what our best option is. Since everyone has different concerns and there is no “one size fits all" treatment when it comes to the eyelids and eye region, a consultation with our doctor is really the best way to determine what the best eyelid rejuvenation treatment is for you.