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."
The technique is known medically as blepharopigmentation, and Dr. Giora George Angres of Las Vegas obtained a patent in 1981 for the method he developed. Angres entered an agreement with CooperVision Surgical last year, which is marketing his procedure under the name Natural Eyes.
Dr. Robert Fenzl of Garden Grove, with Dioptics President Diana Starr Langley, developed a similar procedure, called Accents.
Although both doctors said they started their research to develop a procedure for female patients with vision problems who were having trouble applying makeup, response has been strongest from women who were frustrated with conventional eye makeup.
Company officials and doctors using the permanent eyeliner business reject the suggestion that the surgery is just a trend. Using the term "eyelash enhancement," they said that the pigment is applied subtly to give a classic look, rather than follow any current fashion in eyeliner application.
"As long as lashes are going to be in style, we're going to be (in style)," said Angres, who estimates that he has taught the procedure to nearly 1,600 doctors, as well as performing the operation on more than 600 patients. Angres said he has also performed the operation on his wife, who is a model, and whose before-and-after eyes appear in the Natural Eyes ad.
Initially, most doctors doing the procedure were ophthalmologists, who specialize in eye disorders, but plastic surgeons and dermatologists have also shown interest, according to Langley and Nordeck. Both companies will only sell their products to licensed physicians, with Dioptics requiring that doctors take the training seminar and CooperVision strongly recommending it.
Response From Doctors
The response from doctors has been even stronger than the companies had hoped.
"It's been crazy," said Langley. "In the first four months, we sold seven times what we expected to do in a year." Langley said she believes that Dioptics is outselling CooperVision several times over in terms of actual units sold. "For a small little company, that feels pretty good," she said.
Founded six years ago by Langley, who is the sole owner, Dioptics makes synthetic replacement lenses used in cataract surgery, as well as Solarshields sunglasses which filter out ultraviolet rays.
Langley, 32, has had her right eye area tattooed, but not the left, in order to show the before-and-after contrast. When she's not demonstrating the difference, she usually wears regular eyeliner on her left eye and challenges observers to guess which is the Accents eye. Although the comparison has come in handy when Langley modeled for Dioptics brochures, she plans to have her left eye done within the next year because she finds it inconvenient to continue applying eyeliner to that eye.
A dozen of the 27 female employees at Dioptics' Irvine headquarters have had their eyelashes enhanced. Langley said her mother, Lee, 58, vice president of education and support services, and sister Marcia, 28, a sales representative, are now sporting permanent eyeliner, but sister Janice, 30, vice president of finance, wears hardly any makeup and isn't interested in the procedure.
Langley estimates that about 5,000 women in the United States have had the Accents procedure done, and Dioptics is also starting to distribute in foreign countries.
Nordeck said that Accents now accounts for 65% of Dioptics sales, although it was only introduced in November. He characterized Dioptics as a "strong mid-size company" but declined to reveal specific financial figures.
Priced at $2,500, the Accents machine sells for considerably less than CooperVision's, but a package containing the one-use disposable hand piece used in the procedure and the pigment costs $150, according to Nordeck.
"The CooperVision equipment is a different type of equipment--it's a much faster piece of equipment than ours," said Nordeck. "It tends to make more of a line than individual dots. We feel it's easier to go lighter at first because you can always go heavier."
Nordeck said Accents gives more of a "pin-dot" effect, while Natural Eyes produces "a gliding effect." Accents has a one-needle tip, while Natural Eyes has a three-needle tip.
"That's not to say theirs doesn't look good," Nordeck added. "Some doctors prefer ours and some prefer theirs. CooperVision is a good company, and there's enough room for both of us."
Bill Konowitz, director of sales and marketing for CooperVision Surgical, declined to release specific sales figures, but said the company began marketing the Natural Eyes machine and pigment last October and has sold between 500 and 1,000 instruments at $7,000 each, accounting for $3.5 million to $7 million in sales. Individual packets of pigment are $60 each.
Lynne Newcomb, vice president and general manager of the Natural Eyes unit, said that Natural Eyes is "one of the fastest growing products within CooperVision Inc.," CooperVision Surgical's parent company, which is based in Menlo Park and is a leading manufacturer of vision-related products such as contact lenses, drugs and surgical equipment.
$26 Million Profits
Last year CooperVision Inc. reported profits of $26 million, on sales of $255 million. The CooperVision Surgical division reported sales of $77.1 million in 1984.
Newcomb acknowledged that Dioptics, whose machine was available several months before CooperVision's, has so far been the leader in units sold but said she believes that CooperVision has "probably exceeded" Dioptics in dollar volume.
CooperVision offers a trade-in credit to doctors who originally purchased the Dioptics machine but have decided to switch to CooperVision, and Newcomb said that "10 to 15" doctors had taken advantage of the offer.
Newcomb, one of about 25 CooperVision Surgical employees who have had the Natural Eyes applied, said having her own eyes done was a real time-saver.
Newcomb said CooperVision received calls asking, "Can you do eyebrows?" from women whose eyebrows did not grow back after plucking or fell out because of illness. She speculated that eventually the requests for eyebrow enhancement could outnumber those for the eyelash procedure.