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Eyelid and Facial Surgery Although changes due to age occur throughout the body, they are often first noticed around the eyes. Common age-related problems include wrinkles, the loss of skin tone, changes in skin color caused by sun exposure, excess skin and fat in the upper eyelids, and the formation of "bags" under the lower eyelids. These changes can make us look older and can cause a tired appearance and a sense of heaviness around the eyes. Oculoplastic Surgery Oculoplastic surgeons are trained in plastic surgery as it relates to the eye and surrounding structures. They have also completed full training as eye physicians (ophthalmologists) and have an intimate knowledge of the structure and function of the areas around the eyes. Surgery aimed at improving appearance is always performed with consideration to maintaining the health of the eye. Your surgeon will conduct an evaluation and discuss the findings with you, as well as your expectations, concerns and questions, to ensure a satisfactory outcome. Blepharoplasty As we age, most people develop excess skin in their upper and lower eyelids. Often, the eyelids also appear like they have "bags". This is due to the presence of fat. Surgery to improve appearance from these changes is called "blepharoplasty". Blepharoplasty surgery can be performed on both the upper and lower eyelids. Upper Eyelid Blepharoplasty Your surgeon will determine whether you have excess skin, fat, or both and guide treatment toward your particular situation. If the eyebrows are also droopy, your surgeon may decide that you might also be a candidate for surgery to raise the brows. Surgery is performed using a local anesthetic. The incision is placed in a naturally occurring crease in the upper eyelid skin in order to hide the incision. Surgery typically takes 1-2 hours and you are able to go home the same day. Usually, you will be seen at one week to remove stitches from the skin. Some bruising around the eyelids occurs in all patients and is typically present for 1-2 weeks. Make-up can be resumed approximately 1-2 weeks after surgery. Lower Eyelid Blepharoplasty As with the upper eyelids, blepharoplasty for the lower eyelids may involve removing excess skin, fat, or both. Surgery may either be performed in the same manner as upper eyelid surgery by making the incision in a natural crease, or it may be performed from the inside of the eyelid. Your surgeon will discuss these options with you based on your examination. Brow Lift In some patients, the eye brows may be in a lower than normal position. This causes skin to droop and bunch up over the eyelids. Your surgeon will examine the position of the brows and discuss whether you are a candidate for this procedure. BOTOX® cosmetic BOTOX® cosmetic is a naturally occurring substance that prevents muscles from contracting. It has now been used for more than 20 years to treat a variety of medical conditions caused by overactive muscles. BOTOX® cosmetic also assists in reducing the appearance of certain types of wrinkles. This is due to the fact that some wrinkles appear more prominent when muscles in the face contract (such as during smiling or frowning). The most common sites for BOTOX® cosmetic use are at the outer corners of the eyes ("crowÕs feet"), furrows between the eyebrows (frown lines), and forehead wrinkles. Not all wrinkles are due to muscle contraction. Those wrinkles that are present when the face is relaxed may require other treatments. During your evaluation, your doctor will discuss such options with you. Treatment with BOTOX® cosmetic typically takes approximately ten minutes and can be performed in the office. Anesthesia is not required, as discomfort is usually minimal. There may be slight redness after treatment where the BOTOX® cosmetic is injected. This is temporary and can be minimized by application of ice. BOTOX® cosmetic takes several days to begin working. The results often last 3 months before additional treatment is required, but your doctor may want to examine you a few weeks after your first treatment in order to assist in guiding further treatments. The goal of treatment is to soften the appearance of wrinkles but to allow patients to have normal facial expressions. Side effects are rare and will be discussed with you during your evaluation. Fillers Those wrinkles that are made more prominent when muscles of the face contract ("dynamic wrinkles") are best treated with BOTOX® cosmetic. Some wrinkles are present when the face is not contracted ("static wrinkles"). These cannot be treated with BOTOX® cosmetic, but they may be appropriate for treatment with a substance to "fill" the depressions to minimize their appearance. Several types of fillers are available and your doctor will discuss these options with you during your evaluation. Treatment usually takes thirty minutes and is performed in the office after the area is numbed with local anesthetic. Many patients experience mild swelling for a few days after treatment, but this is temporary. Depending on the type of filler used, results may last up to 6 months before additional treatment is necessary. |
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