Monica Ray, MD
TOC Eye and Face, Austin, TX
Monica Ray is an ophthalmologist, currently completing fellowship in Ophthalmic Plastic and Reconstructive Surgery through ASOPRS and Facial Cosmetic Surgery through AACS at TOC Eye and Face in Austin, TX. She attended the University of Michigan for her undergraduate degree, and Wayne State University School of Medicine where she earned her medical degree. She completed an internship at Beaumont Hospital in Dearborn Michigan. She finished ophthalmology residency at Case Western Reserve University in Cleveland, Ohio where she served as chief resident. She will be spending two years at TOC Eye and Face during which she will complete her two-year ASOPRS fellowship and a one-year AACS fellowship.
Introduction: Festoons, malar and eyelid edema are challenging facial cosmetic concerns with historically frustrating treatment options. Recently, tetracycline has been shown to be an effective, low-risk, non-surgical approach for managing festoons. Beyond festoons, there are other subtypes of chronic periorbital edema. The purpose of this analysis was to assess the safety and efficacy of intralesional tetracycline injections for the treatment of non-festoon related lower eyelid edema in a cosmetic patient cohort.
Methods: This is a retrospective analysis of patients who underwent intralesional tetracycline injection for the treatment of lower eyelid edema by a single surgeon (TN) in our practice. Patient charts were reviewed for objective outcomes including resolution of periorbital fluid and complications. Subjective pain scores and aesthetic improvements by surgeon and patient were also evaluated.
Results: A total of seven patients who underwent tetracycline injection by a single surgeon (TN) were evaluated. Of these, the average age at time of injection was 57 years. Patients were treated with tetracycline pre-operative, post operatively or as a stand-alone procedure without surgical intervention. Six underwent a single tetracycline injection at the time of this study, with one patient undergoing two sequential treatments. Follow up time ranged from 1 month to 8 months. For all patients there was objective improvement in edema, pain was tolerable and there were no complications.
Conclusions: In this series, the efficacy, safety, and outcomes of intralesional tetracycline injection for non-festoon lower eyelid edema were excellent, with objectively superior aesthetic improvements. Utilization of intralesional tetracycline injection offers a less invasive treatment option that is less costly and resource intensive for patients with mild non-festoon lower eyelid edema who are motivated to pursue nonsurgical rejuvenation.
- Chon BH, Hwang CJ, Perry JD. Long-term patient experience with tetracycline injections for festoons. Plast Reconstr Surg. 2020. 146(6):737e-743e.
- Perry JD, Mehta VJ, Costin BR. Intralesional tetracycline injection for treatment of lower eyelid festoons: a preliminary report. Ophthalmic Plast Reconstr Surg. 2015. 31(1):50-2.
- Godfrey KJ, Kally P, Dunbar KE, Campbell AA, Callahan AB, Lo C, Freund R, Lisman RD. Doxycycline injection for sclerotherapy of lower eyelid festoons and malar edema: preliminary results. Ophthalmic Plast Reconstr Surg. 2019. 35(5):474-77.
Take Home Message
In this series, the efficacy, safety, and outcomes of intralesional tetracycline injection for non-festoon lower eyelid edema were excellent, with objectively superior aesthetic improvements. Utilization of intralesional tetracycline injection offers a less invasive treatment option that is less costly and resource intensive for patients with mild non-festoon lower eyelid edema who are motivated to pursue nonsurgical rejuvenation.