Check with your ophthalmologist before undergoing popular eyelid enhancements

New medications may promise to grow your lashes. Surgeries are billed to lift your eye lids and shave 20 years off your appearance, and tattoo procedures offer permanent liner.

But before undergoing any of these techniques, you should get an evaluation from an ophthalmologist and reduce the risk of serious adverse reactions, said an ophthalmic plastic surgeon from Baylor College of Medicine.

Often, these procedures are conducted without an appropriate evaluation or are not done by an experienced and qualified professional, said Dr. Michael Yen, associate professor of ophthalmology in the Alkek Eye Center at BCM.

Yen said advertisements about these new procedures and medicines are heavily marketed to a large population, some of who may be at risk for developing permanent, damaging side effects.

"To determine if you are at risk for developing these negative effects, a medical professional must see you in person and perform a complete eye exam," said Yen. "Only looking over the medical history will not suffice."

Recently, a new medication called LATISSE® to help grow eye lashes has come on the market. It is the only eye lash growing medicine approved by the U.S. Food and Drug Administration.

However, an active or a prior history of inner-eye inflammation or allergic reactions to this class of drugs could cause side effects.

This drug falls into the prostaglandin class. The active ingredient is called bimatoprost. It binds to the prostaglandin receptors in the hair root and stimulates the development and re-growth of the hair follicle. Drugs in the prostaglandin class may be used to control blood pressure, contraction of smooth muscle and modulation of inflammation.

"Although it's not very common, this drug can cause pigmentation of the skin even after you stop using it," said Yen. "Also, if the medication is applied to areas other than the eyelid margin, you can get excess hair growth."

A big issue with this drug, Yen said, is that some suppliers offer Internet prescriptions only with a review of the medical history or at a spa.

"This is not enough," said Yen. "It's really important for a qualified expert to examine and evaluate you and your potential risk for developing these effects."

Serious effects, such as changing eye color, have been reported but are very rare, Yen said.

In addition, beware of products that are not FDA-approved, Yen advised.

"We see patients frequently who come in with overly aggressive eye lid surgery," said Yen. "They have been promised to lose 20 or so years with the surgery, when really they cannot tolerate such an aggressive lift."

The biggest concern is that you will be unable to close your eyes because they have been made too tight from aggressive lifting, Yen said.

"This can cause the eyes to become excessively dry and the surface of the eye can become irregular," said Yen. "This can occasionally (not common, but not rare either) lead to significant decrease in vision which may or may not be permanent."

Additionally, Yen said, sometimes the eyelids can be turned outwards (condition known as ectropion) from aggressive tightening.

Every patient is different, Yen said. "It is important for you to undergo a thorough evaluation with your plastic surgeon. Also, make sure you are comfortable and aware of the level of lift the plastic surgeon discusses."

"The goal of eye lid surgery is to create a natural look," said Yen.

Permanently-applied makeup services are becoming more popular, Yen said. "It is important to do research before having eye makeup tattoo applied."

Yen said there are different techniques for the application of permanent eyeliner.

"Some are done by a machine and some by hand," said Yen. "The pigment that is used can be dangerous if it gets too deep into the eyelid."

In terms of safety, Yen recommends choosing an experienced technician who applies the makeup tattoo by hand.

"If the pigment gets inside the eyelid too deep, it can migrate and spread and become very disfiguring," said Yen.

Before undergoing any of these procedures or using these medications, you should consult your doctor, Yen said.