Topkine was recently acquired by Allergan. The product is based on the observation that glaucoma patients using prostaglandin glaucoma drops are prone to developing atrophy of the eyelid tissues and loss of orbital volume. Based on this observation, some clinicians patented the application and began developing it as a potential treatment for a fatty eyelid. In my opinion this is going to be a dog of a product. First, the loss of tissue volume caused by the prostaglandins is not strictly limited to decrease fat. The prostaglandins drops also cause scaring and fibrosis of the eyelid tissues. It has been reported that these effects are reversible but I do not believe the evidence for this is strong. In my opinion the effect caused by the prostaglandins is not the improvement one gets by having cosmetic eyelid surgery but rather it produces a change that makes the eyes look older not better. It is my opinion that this treatment, like Kybella, will be another bust for Allergan. I advise caution with this product. Let others be the guinea pigs.
