First Quarter 2010, Volume 24, Number 2

Facial Plastic Surgery Today

Revamping the windows to your soul, cosmetically


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Revamping the windows to your soul, cosmetically

Ask the Surgeon / Health Tip / What’s New

Facial plastic surgeons heed the call, Faces of Honor

The area around your eyes is prone to showing signs of aging long before the rest of your facial features. If you look in the mirror and see a tired, aged, and worn reflection, you may be interested to know that there are ways to improve and rejuvenate! From simple remedies and creams to injections and blepharoplasty (eyelid surgery), you can acchieve a more youthful, bright appearance.

As the skin starts to thin around our eyes, the blood vessels become more apparent, i.e., dark circles. Avoid applying eyeliner or mascara to the lower lashes so that you do not draw attention to the under eye area. Apply a concealer that is yellow or greenbased to counteract the blueness. The product should be hypoallergenic, fragrance free, opaque, and waterproof. Dark circles can also be genetic, due to excess pigment in the skin. Creams with hydroquinone and retinoids (vitamin A derivatives) will lighten dark areas.

Crows feet are tiny wrinkles that radiate from the corner of your eyes. They can be treated through various methods. An injectable filler will plump up the area and soften the wrinkles. Fillers are temporary and will require repeated treatments. Botulinum toxin, BOTOX®, can be injected under the skin to paralyze the muscles in the face that pull the skin and cause wrinkles. The resulting smooth skin lasts from three to six months. Microdermabrasion uses micronized crystals to remove dead cells and smooth crow’s feet and forehead lines. Chemical peels can be used to remove the superficial layer of skin, boost collagen production, and soften wrinkles. Laser resurfacing may also be used to treat crow’s feet. It works by penetrating the outermost layer of skin and is absorbed by deeper layers where it stimulates collagen production.

While minimally invasive techniques are quick and convenient, the results do not last as long. The alternative is eyelid surgery, which is used to reshape and adjust the lids for both cosmetic and functional purposes. Cosmetically, you may want to reduce the excess skin in your upper eyelids to create a younger, more wide-eyed appearance. In upper eyelid surgery, your physician will follow the natural lines and creases of the eyelid in order to keep the scars as invisible as possible. The incision is made and excess fat, muscle, and loose skin are removed.

Fine sutures are used to close the incision and minimize the visibility of any scar. For patients that seek to add a crease to their upper eyelid, a variation of this surgery is used. Patients whose field of vision is limited due to ptosis-drooping upper eyelid that is congenital or develops with age—may be able to receive reimbursement since the procedure is medically necessary.

Most people seek lower blepharoplasty to eliminate the bags under their eyes. The surgeon can make an incision under the lower lashes or from inside of the lower eyelid to remove the skin and fatty tissues. The scar is hidden and self-dissolving sutures may or may not be used. Blepharoplasty provides dramatic results, leaving the skin around your eyes smoother and younger looking.

Your facial plastic surgeon may discuss the option of a browlift. The aging process can cause your forehead skin to sag and your eyebrows to lower over your eyelids. This creates a scowl or angry overall appearance. You may be a good candidate for a browlift. Small incisions are placed just above the brow or in a wrinkle crease. Excess skin is excised, the underlying tissues are tightened, and the incisions are closed. An endoscopic browlift uses an endoscope to perform the surgery, and thus the incisions are much smaller. The result of a browlift is raised brows and smoother skin.

Unlike the low-tech, quick treatments, you should also consider that surgery will require recuperation time usually lasting one to two weeks. After eyelid surgery or a browlift, the eye area may feel tight. Your facial plastic surgeon will give you specific postoperative instructions to ensure a quick and easy recovery.Make sure you keep your head elevated, use cold compresses to reduce swelling, and apply prescribed eye drops to ease dryness or itching. If you have stitches, they will be removed two to seven days after the surgery.