How to Remove Broken Capillaries Above the Eyelids?

Question

Hi. Since having my eyebrows threaded some time ago and been asked to pull the skin taut while she was doing it, I have noticed that some purple/blue veins have appeared above my eyelids immediately after and have not disappeared.Is there any way to have these removed as they were not there before the threading?Thanks, Sandra

Scott Trimas, MD · Answer

Upper eyelid veins and broken capillaries can occur after a browlift or upper eyelid surgery. This can be a very difficult problem to correct due to the thin nature of the skin. One possible option is use of a vascular laser to diminish or perhaps remove those veins. However, if you elect to go that route, make sure that you have an eyeshield placed over the eyes first. We have had very good success treating blood vessels in that fashion.

Michael M. Omidi, MD, FACS · Answer

Thank you for the question! Treating this particular area requires a great deal of finesse so I would recommend doing your research to go with an experienced board-certified specialist. In all likelihood, you would benefit from a laser treatment to eliminate the veins instead of surgically removing them. The laser produces a steam bubble inside the vein, which destroys the vein walls, causing the affected vein to collapse. The body, in turn, naturally absorbs the dead tissue. 
An in-person exam with a board-certified plastic surgeon would be the best way to assess your needs and obtain expert medical advice. Best of luck!

Hratch Karamanoukian, MD, FACS · Answer

A picture would have helped proper guidance. Spider veins of the upper lids below the eyebrow is best treated with long pulse lasers like KTP 532 nm or Nd YAG 1064 nm. An eye shield is necessary for such treatments.

James E. White, MD · Answer

Spider veins of the eyelids can be difficult to treat,.  Agree with topical laser therapy as described.  Our practice has experience with combination laser and micro electtrocautery therapy.   Electrocautery or micro cautery is very helpful to coagulate very small facial veins. [See Veinwave as a brand of micro electrocautery].  The technique involves very small electric currents transmitted to the vessel by fine wire cautery tips--the kind used to complete electrolysis for hair reduction.  The fine wires are pressed to the surface of the skin.  Electric currents are applied.  Sometimes the vessel will coagulate as the electric current will travel down the flow of blood by the path of least resistance.  Other times, the fine wire tip will actually puncture the skin to allow the tip contact with the vessel and blood flowing in the vessel.  Here is where the problems occur with darker skin types.  Collateral damage.  The electrocautery seals the vessel by coagulation, the surrounding skin also sustains coagulation--tissue damage.  Pigmentation changes can occur.  Patients with dark skin colorations can have hypopigmentation [white spots] or hyperpigmentation [dark brown/black spots] at each of the skin electrocautery contact points. Multiple treatment sessions maybe needed for best cosmetic effect..  Eye shields are a MUST during treatment..

	Most cosmetic surgeons who deal with facial veins would recommend a few test spots with a 2-3 month time interval to see how your skin would react to micro coagulation.  Formal consultation is needed to determine your specific skin type and for skin testing.

Grant Stevens, MD · Answer

Greetings~

	Without seeing you face to face it would be difficult to say with any certainty what your treatment options may be.  If the vessels are small and close to brow but not on the lid itself, you may be a candidate for a laser treatment for vessels such as Nd:YAG or KTP.  These lasers are very effective at reducing unsightly vessels with little to no discomfort and downtime.  For any vessels, but especially on the face, it is best to consult someone with a great deal of experience in using lasers for this particular issue. 

	Good luck~

	Dr. Grant Stevens

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