After nine operations to correct the effects of burns suffered in a fire five years ago, Dayna Clower realized that her eyes would never look normal again. Her left eye was surrounded by scars from the skin grafts, and most of the eyelashes and eyebrows did not grow back.
Clower, 22, attempted to wear makeup to improve her appearance but found that cosmetics would not adhere to the scar tissue. Finally, using a machine made by CooperVision Surgical of Irvine, doctors injected an iron oxide liquid pigment around Clower's eyes, simulating the effect of eyelashes and eyebrows.
"I'd do it again in a second," said Clower of the tattoolike procedure, which cost $900. "It's just so nice."
Clower is just one of an estimated 10,000 to 11,000 Americans during the past year to seek permanent eyeliner, a surgical procedure similar to tattooing being marketed by two Irvine companies.
CooperVision Surgical and smaller, privately owned Dioptics Medical Products Inc., are the only manufacturers of the machines and pigment used in the process. The two firms are aggressively competing to carve out their share of what has already developed into a $10-million-plus annual market nationwide, which company officials said could grow several fold in the next few years.
The two companies have been advertising their procedures as a convenient way to look glamorous 24 hours a day, with toll-free numbers listed in the ads for more information, including physician referral for prospective customers.
Doctors say the majority of their customers purchasing the service are professional women in their 30s and 40s who want to look good around the clock, without having to apply eye makeup every morning, or have it smear when their faces get wet. Other reasons include being allergic to regular eye makeup or having poor vision or coordination which prevents patients from applying eyeliner properly. Occasionally the procedure is used for people whose eyelashes and eyebrows have been damaged by accidents or illness.
Steve Nordeck, vice president of operations for Dioptics, said some men have also had the procedure done, including "TV people, news anchors and entertainers."
The firms are pitching the procedure to doctors as a simple way to increase their business. Dioptics brochures point out that rules adopted last year limiting the amount of Medicare payments decreased doctors' income, and many of them are looking for new ways to augment their practice.
Similar procedures have been performed for years by tattoo artists, who use ice cubes to numb the eye area because they are not licensed to administer anesthesia, and who use less sophisticated equipment, according to developers of the new process. Executives of both companies and doctors who implant the pigment stress that their procedures are medically safe and relatively painless, except for the anesthesia injections.
The president of the American Academy of Ophthalmology, Dr. Byron H. Demorest of Sacramento, has said that he does not see any significant danger associated with permanent eyeliner.
"We have no reason to believe that it is unsafe, " said Heinz Eiermann, director of the federal Food and Drug Administration's division of cosmetic technology. He said the agency has studied the pigment used in the process and approved it for use as a cosmetic. However, the process of injections used in permanent eyeliner has not yet been studied by the FDA.
In any event, the two companies received an enthusiastic response from doctors at the American Academy of Ophthalmology convention in Atlanta last November, when both introduced their procedures for applying the permanent cosmetic.
Mariola Haggar, an industry analyst with the investment banking firm of L.F. Rothschild, Unterberg, Towbin, said that eye doctors were waiting in line at the CooperVision booth during the convention, and 600 of them arranged to take courses in how to apply the iron oxide pigment.
"That particular booth was one of the most crowded," said Haggar, adding that ophthalmologists seemed interested in augmenting their income with the procedure, which takes approximately half an hour to perform in a doctor's office, at charges ranging from $600 to $1,600. The pigment comes in several shades to coordinate with a patient's natural coloring.
Both companies offer $500 daylong seminars to train doctors in the correct surgical methods to implant the pigment in patients' eyelids. Working under magnification, surgeons inject liquid dots of pigment into the skin between the eyelashes to give the effect of fuller lashes.
Practicing on Turkey Legs
Nordeck said the doctors practice by tattooing turkey legs.
"We use turkey legs because of the looseness of the skin around the eye area--turkey legs simulate that better than anything," said Nordeck. "We have an eye rubber stamp, and we stamp the eye on the turkey skin."