Blepharoplasty
Your eyes are often the first thing people notice about you and are an important aspect of your overall appearance. As we age, the tone and shape of our eyelids can loosen and sag. Heredity and sun exposure also contribute to this process. This excess, puffy or lax skin can make you appear more tired or older than you are. Eyelid surgery or blepharoplasty (pronounced “blef-a-ro-plasty”) can give the eyes a more youthful look by removing excess skin, bulging fat, and lax muscle from the upper or lower eyelids. If the sagging upper eyelid skin obstructs peripheral vision, blepharoplasty can eliminate the obstruction and expand the visual field. (Click for Photo Gallery)
Upper Blepharoplasty
For the upper eyelids, excess skin and fat are removed through an incision hidden in the natural eyelid crease. If the lid is droopy, the muscle that raises the upper lid can be tightened. The incision is then closed with fine sutures.
Lower Blepharoplasty
Fat in the lower eyelids can be removed or repositioned through an incision hidden on the inner surface of the eyelid. Laser resurfacing or a chemical peel can be performed at the same time if desired, to smooth and tighten the lower lid skin. If there is excessive skin in the lower lid, the incision is made just below the lashes. Fat can be removed or repositioned through this incision, and the excess skin removed. The incision is then closed with fine sutures.
Upper and Lower Blepharoplasty
Upper and lower blepharoplasty can be performed together and also can be combined with other procedures such as eyebrow or forehead lift and midface lift.
Who Should Perform A Blepharoplasty?
When choosing a surgeon to perform blepharoplasty, look for a cosmetic and reconstructive facial surgeon who specializes in the eyelids, orbit, and tear drain system. As members of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) Dr. Call and Dr. Harris are not only board certified ophthalmologists who know the anatomy and structure of the eyelids and orbit, but they also have had extensive training in ophthalmic plastic reconstructive and cosmetic surgery.
If you have any questions, email us.
Brow lift
Eyebrow and forehead lifting address eyebrow position and loose or wrinkled forehead skin and underlying tissue. To fully understand the benefits of eyebrow and forehead lifting, one must be aware of the importance of the position of the eyebrows. Eyebrow position changes as we age. Our natural eyebrow position, the effects of gravity and fat deflation, how active our eyebrow and forehead muscles are, and previous eyelid, eyebrow or forehead surgeries (if applicable), all contribute to the position of our eyebrows. The face sends a message, and the position of the eyebrows is a significant part of that message. That message could be, "I feel worried,” “I feel angry,” or “I feel stressed.” The message could also be, “I feel calm, rested, and relaxed.” There are several types of eyebrow and forehead lifts. The type we choose at consultation will depend on your current eyebrow position, facial structure, and on what is possible to maximize your appearance. The main types of forehead lifting are as follows:
Endoscopic Forehead Lift
The endoscopic eyebrow/ forehead lift is very popular. It requires 5 small incisions hidden in the hair and leaves no visible scar. This procedure can lift everything from the hairline to the eyebrows. It tightens and smoothes the entire forehead while lifting the eyebrow area which “opens up” the entire upper face. Eyebrow shape and asymmetry can be addressed with this type of lift. Following the procedure there will be some bruising and swelling. Patients are usually comfortable returning to their normal routine activities in about 2 weeks.
The Pretrichial Eyebrow/ Forehead
The pretrichial eyebrow/ forehead lift requires a long incision. This procedure is ideal for patients who want to both lift the eyebrows and raise and shorten the forehead by removing a strip of skin and underlying tissue along the incision. Because the forehead is shortened, the hairline is lowered which is ideal for those with a high forehead. This procedure lifts everything from the hairline down to the eyebrows and can address eyebrow shape and asymmetry. The scar from the incision, once healed, is virtually undetectable. Following the procedure there will be some bruising and swelling. Patients usually return to their normal daily routine in 2–3 weeks.
The Direct Brow Lift
The “Gull Wing" or direct brow lift requires removing a section of skin and underlying tissue above and following the length of the eyebrows. This procedure is ideal for those who do not want to involve the hairline. The “Gull Wing” beautifully lifts a sagging brow while tightening and smoothing the forehead by pulling the skin and tissue of the forehead down rather than up. It therefore lowers the hairline which is ideal for a receding hairline and/ or a high forehead. This procedure also addresses eyebrow shape and asymmetry. Care is taken to position the scar just along the eyebrows so that it is maximally camouflaged, but some scar can be visible. Patients will experience some bruising and swelling following the procedure. They are usually comfortable returning to their normal routine activities in about 2 weeks.
Who Should Perform The Eyebrow and Forehead Lift?
When choosing a surgeon to perform an Eyebrow/ Forehead Lift, look for a cosmetic and reconstructive facial surgeon who specializes in the eyelids, orbit, and the adjacent structures such as the eyebrows, forehead, cheeks and midface.
If you have any questions, email us.
Botox & Dysport
Botox®, and the new product Dysport®, both are used to reduce facial wrinkles. They work by blocking a part of the nerve ending that causes muscles to contract, reducing the appearance of dynamic wrinkles. Dynamic wrinkles are those that you see when you squint your eyes and furrow your brow, but relax away when your face is relaxed. Over time, dynamic wrinkles lead to the formation of static wrinkles, which are present whether you are flexing the facial muscles or not.
How are Botox & Dysport given?
Both are administered as an injection under the skin with a very fine needle. There is generally little or no discomfort with the injection.
Are there any side effects?
Both medications have the potential to cause an eyelid or brow to droop, although this is uncommon and will reverse itself in a few weeks. If you are allergic to eggs or albumin, you should avoid these medications. There are rare reports of breathing problems after large doses of Botox in neck muscles, but this would be very unusual at the low doses used for facial rejuvenation. You cannot receive either medication if you are pregnant or nursing as their effects on babies have not been studied.
How long will it last?
This varies from patient to patient, but 3-6 months of effect is common in our practice. The medications, after injection, take effect after 3-7 days.
If you have any questions, email us.
Facial Fillers
Facial fillers, such as Juve'derm®, Restylane®, Perlane®, Radiesse® and Sculptra®, are used to treat static wrinkles, restore facial contours and add fullness to the lips. Different filler materials are better suited for different injection sites, and a consultation is necessary to discuss what effect is desired and which material is best suited to the task. Depending on the depth of the wrinkle, some can be greatly softened, while others can be almost eliminated.
How are they administered?
Fillers are administered with fine injections beneath the skin. Some products are mixed with numbing agents, such as Lidocaine, which reduce the discomfort of injection. Some swelling and redness can be expected, sometimes lasting a week or more. Certain patients may bruise at the injection site, which can also take a few weeks to resolve.
Are there any side effects?
Allergy to filler materials is rare, but could result in a red rash or lead to a facial infection. In rare instances where the filler material is not tolerated, or a displeasing result occurs, the filler material can be dissolved with a second injection.
How long will it last?
Initially, the companies producing these filler materials stated they last 9-12 months, however, many patients find they last longer and in our experience some patients have results lasting past 2 years.
If you have any questions, email us.
