Transconjunctival versus Transcutaneous Lower Eyelid Surgery
Transconjunctival and transcutaneous lower eyelid surgeries are each a type of lower blepharoplasty, a plastic eyelid surgery that can address a range of issues such as excess fat or “puffiness” around the lower eyelid, loose and wrinkled skin. For great results, your blepharoplasty must be carefully planned by your attending surgeon, who will consider the subtle details of your facial anatomy when determining which type of blepharoplasty is right for you, and details such as whether to remove any fat and where, how tight the eyelid skin should be, and how to achieve natural results for overall facial balance.
Lower eyelid blepharoplasty can be approached either through the skin, transcutaneously, or from behind the eyelid, transconjunctivally. There can be very specific reasons for choosing one approach over another. More commonly, surgeons use a particular approach, not due to inherent advatages of the approach but rather that was they way they were trained. For the most part, tranconjunctival surgery is performed by oculoplastic surgoens who by training are comfortable working near the eye. General plastic surgeons and others lack the specialized training in oculoplastic surgery. They prefer an approach to the eyelid that does not require they to work so close to the eye surface. This is unfortunate because the skin incision usually is made through the underlying muscle. This can damage the function of the underlying muscle, the orbicularis ocli muscle. After surgery, this muscle weakness account for the alteration of the lower eyelid contour that is routine associated with transcutaneous lower eyelid surgery.
Here is an overview of some important features of each surgery type:
Transconjunctival Blepharoplasty
• Incision made behind the lower eyelid
• Minimizes the risk of altering the contour of the eyelid margin after surgery
• Arcus marglinalis release can be performed through the same incision, wherein the eyelid fat is preserved and rotated into the hollow under eyes
Transcutaneous Blepharoplasty
• Incision made just below the lower eyelid lashes
• Can possibly damage the function of the orbicularis oculi muscle and affect the lower eyelid contour
• Permits the removal of excess skin
For some, removal of the lower eyelid fullness from behind the eyelid and removal of excess skin from the front is indicated, via a skin pinch technique or an infracillary incision just below the eyelashes that preserves the underlying muscle. Ultimately, the only way to know what treatment method is right for you is to consult with an experienced oculoplastic surgeon who will meet with you, discuss your concerns and treatment goals, perform a physical examination, and work with you to design an approach that addresses your specific anatomical features and overall facial balance. These are highly complex and specialized procedures that require a skilled and experienced hand, and can bring you many benefits both functional and aesthetic. To schedule a consultation with Dr. Steinsapir, a leading cosmetic eyelid surgeon who practices in Beverly Hills and at UCLA, please call us today.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician or surgeon and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
Am I a candidate for a chemical peel?
Overview
The chemical peel is a minimally invasive, nonsurgical cosmetic procedure with the potential to vastly improve the appearance of damaged and aging skin on the face. There are different agents used for chemical peeling, including Alpha Hydroxy agents, Jessner’s Solution, Trichloroacetic Acid, and Phenol. The type or types of chemicals used depends on the type and extent of damage in each region. Receiving a carefully designed and performed chemical peel can make huge and rejuvenating impact on your looks.
Indications
Damaged skin is usually the greatest indicator that you may benefit from a chemical peel. They type and extent of the damage will determine what type of chemical peel(s) is right for you, as determined with your doctor. Sun damage and chronic exposure to UV rays over time is the most common cause of damage to skin, but the damage can also come from acne scars and intrinsic skin aging. Over time, these types of skin damage show up as irregularities in the epidermis, with abnormalities like fine lines, loss of elasticity, scaly skin, creases, brown spots, and a yellowish hue. These details are usually associated with an aged and tired look.
Expertise
For a refreshed look, you need a treatment that will address the root cause of your concerns. While there are “lay peelers” and medi spas that offer chemical peels, these tend to be very mild peels that require you to return for treatment each month, or they are given by underqualified “assistants” rather than a board-certified surgeons. The chemical peel can be understood as both a medical procedure that requires a high level of training and expertise, as well as an art form that necessitates experience and individualization for optimal results.
Dr. Steinsapir makes the chemical peel a major specialization of his private practice in Beverly Hills, where he provides sophisticated customizing chemical peels. He did not invent these skills after taking a weekend course. He was extensively trained in chemical peels as part of a two-year cosmetic surgery fellowship. Since his training, Dr. Steinsapir has developed his own system to make a full-face chemical peel a remarkably comfortable experience. The procedure is very effective due to a high level of individualization in your treatment planning, as well as the fact that Dr. Steinsapir always personally performs your chemical peel and never relies on “physician’s assistants” and technicians to administer your treatment. We welcome you to call us today to learn how a chemical peel by Dr. Steinsapir can rejuvenate your features.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician or surgeon and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
Will I save money by having a facelift now?
You may be asking the wrong question. There are certainly advantages to a well-timed facelift for the right candidate; and resolving concerns today can act as a preventative buffer for issues in the future or an escalation of your current concern. But framing the timing of a facelift — or any cosmetic procedure, for that matter — as a matter of saving money or finding a “good deal” will set you up for disappointment.
The bottom line is: yes, correcting problems from onset is usually a good idea and can prevent or delay future issues, but quality cosmetic surgery does cost money. If you simply seek out the surgeon willing to give you a facelift at the lowest price possible, you are probably going to be disappointed.
Preventative Measures
When most people think of cosmetic procedures, they think in terms of correcting problems and flaws they already perceive, which may be causing them trouble in personal or professional relationships, or diminished confidence. But another way to look at facial treatments such as a facelift is to consider how an early correction of issues such as facial lines and sagging cheeks can prevent them from turning into a larger and larger issue down the line. A facelift or any other facial cosmetic surgery cannot reverse or cease the effects of aging, but it can slow down the signs with results that are long-lasting.
If you consider how often you smile, frown, furrow your eyebrows, go out into the sun, or look in the mirror and notice that your features seem to be drooping more and more as the years go by — essentially countless times every day — it makes sense that these repeated stressors will show their effects more with time. If you are already a candidate for a facelift, delaying treatment will only reveal that your concerns gradually worsen. This is a normal part of aging but not one we are stuck with.
A candidate for a facelift is usually somebody who presents with a neck cord, a band of skin and muscle under the chin. If you are showing the early signs of aging but do not yet have this neck cord, your facial concerns can typically be addressed with a minimally invasive cosmetic procedure that does not involve surgery. This may be BOTOX, a facial filler, or other means of facial rejuvenation. It truly depends on the unique nature of your experience and anatomy. Just as it’s important to know when a facelift is indicated, it’s equally important to know when a nonsurgical approach will help. Either way, an early consultation with an expert can save you years of worry and concern as you decide whether to get a facelift today, ten years from now, or never at all. A qualified surgeon can help you make these decisions.
A Bargain Isn’t the Best Deal
When you are ready to commit to aesthetic facial improvements by means of cosmetic surgery, this comes with putting value in the leading treatment providers and specialized, experienced surgeons. Great results can be affordable and reasonable, and most top surgeons offer payment options from which you may choose; but you will need to be willing to invest in your facelift if you want the best results.
For the Best Care…
Choose a surgeon with specialization and fellowship training in facial cosmetic surgery, with an emphasis on minimally invasive methods. It is essential to have surgery that is specifically tailored for your face. This means that your doctor will see you as an individual, provide you with an individualized consultation and physical examination, then personally design a program of care that is catered to you. Your doctor should value a natural look, with minimally invasive techniques and quick recovery. Especially important is the experience level, reputation, and specialized training of your doctor. Please note that many great general plastic surgeons do not have the level of training and qualifications required to perfect the details of a facelift and other procedures for which an understanding of how to create facial balance is an absolute must.
We invite you to consult with Dr. Steinsapir, a leading oculofacial cosmetic surgeon in Beverly Hills and at UCLA . He is broadly trained and offers unique personal service including tailored facelifts. He is an leader in minimally invasive procedures and offers surgery both at his office surgery center and the UCLA Medical Center. At an individual consultation, Dr. Steinsapir can help you determine which treatment is right for you at the right time.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician or surgeon and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
Can I have upper eyelid surgery without looking like I have been operated on?
This questions cuts both ways. What you are hoping for in having surgery is an improved look. What the question gets at is whether you will end up with the operated look. No one wants the surgical results of famous people talked about in the tabloids, such as the singer Kenny Rogers or the socialite Jocelyn Wildenstein. As much as it would be great to say that overaggressive, unnatural surgery results are a thing of the past, it is simply not true. Avoiding this type of result not simply a matter of choosing a surgeon with the right training and credentials. The advice of seeking a board certified general plastic surgeon does not guarantee any level of expertise when it comes to eyelid surgery. In fact general plastic surgeons are poorly trained in eyelid plastic surgery compared to oculoplastic surgeons. Even training in oculoplastic surgery is not guarantee of natural results. The truth is that good people are were you find them, and this is true for highly qualified cosmetic eyelid surgeons.
The surgical look can come from removing too much tissue in the upper eyelid, or creating an upper eyelid crease that is too high. Dr. Steinsapir advocates for a more conservative approach that preserves as much tissue as possible, complimenting your natural eyelid structure. “Surgeons misunderstand the goal of cosmetic eyelid surgery. The surgery should be invisible leaving the eyes natural and alive,” notes Dr. Steinsapir.
A carefully planned surgery takes into account your goals, the balance of all your facial features, and functionality. There is no one-size-fits-all approach, so take time to find a doctor who individualizes each treatment and makes upper eyelid surgery a major focus of his or her practice. A specialized physician will be able to answer your questions, discuss your options, and show you before-and-after photos of eyelid surgery examples, without special lighting, retouching, or camera tricks. Provided you take the time to seek out a great surgeon, don’t opt for shortcuts, and are willing to listen to expert medical advice, there is no reason to expect nothing but the best.
In medicine there is no such thing as a no-risk surgery. For this reason, your potential surgeon needs to spend time talking with you to investigate your personal history in detail. They need to perform a very detailed and comprehensive examination. This should be followed by an equally detailed discussion regarding risks, benefits, alternatives and the likelihood of surgical success. If your surgeon cuts corners in the consultation process, it is reasonable to assume that they may cut corners in the surgery as well. If your surgeon spent only a few moments with you and did not bother to examine your face and eyelids before referring you to the practice closer, it is reasonable to ask yourself if your are in the right place.
The details of your upper eyelid surgery will depend on your individual eyelid contour, the specific improvements you are seeking, and a detailed examination and treatment plan created specifically for your needs by a specialist in oculoplastic surgery. Dr. Steinsapir is respected across the world as a leader in eyelid surgery with natural results, and he practices both in Beverly Hills and at UCLA, where he is an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute. He is dedicated to the needs of his patients and provides a rare level of unique personal care. We invite you to consult with Dr. Steinsapir to learn if upper eyelid surgery is right for you. Please call today to learn more about how eyelid surgery can help you improve your appearance and your confidence.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician or surgeon and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
What is Microdroplet botulinum toxin treatment?
Microdroplet™ botulinum toxin treatment, or more simply called Microdroplet™ BOTOX®, is a specialized method of cosmetic BOTOX® treatment protected under US Patent 7,846,457 B2. This treatment was designed and researched to address the problem of the “forehead freeze” sometimes seen in standard BOTOX® treatments, improving this minimally invasive cosmetic procedure with more reliable, precise, and natural results. In short, Microdroplet™ BOTOX® improves upon earlier treatments by avoiding the “flat” or “frozen” or “nonexpressive” look that is sometimes associated with BOTOX®. BOTOX® is an extremely popular cosmetic service for good reason–it’s safe, it’s effective, and its benefits are clinically proven. Now with Microdroplet™ BOTOX®, you can achieve a youthful appearance that elevates the eyebrows and improves forehead lines, but still retain your full range of natural facial expression.
How does Microdroplet™ BOTOX® work?
Microdroplet™ BOTOX® utilizes the same foundational principles that make BOTOX® effective. Botulinum toxin or BOTOX® is a natural muscle relaxant that, with proper placement, can restore balance to the face by correcting overactive muscles often responsible for wrinkles, creases, and forehead lines. What is unique about the breakthrough Microdroplet™ BOTOX® method is the highly controlled placement of tiny microdroplets of botulinum toxin to treat the muscles responsible for pulling the eyebrows down, without “treating” other parts of the face that don’t need it. Microdroplet™ BOTOX® is an individualized treatment targets the precise muscles responsible for your concerns, meaning that you achieve positive results but still maintain normal forehead movements and expressions.
How was Microdroplet™ BOTOX® developed?
The placement of Microdroplet™ BOTOX® is positioned according to the depth, treatment patterns, volumes, and other technical factors developed by patent holder Dr. Steinsapir who researched and invented the method, which is regarded today as revolutionary. The method is so unusual that is was granted a very rare United States patent. Dr. Steinsapir trained alongside the inventor of BOTOX® and has been providing BOTOX® since 1988, along with other specialized facial cosmetic procedures. Upon observation, Dr. Steinsapir noticed that many individuals received great benefits from treatment yet still experienced some side effects. This is why he developed Microdroplet™ BOTOX®, to continue helping individuals achieve the results they desire and maximize natural improvements. To learn more about how an individualized Microdroplet™ BOTOX® plan with Dr. Steinsapir can benefit you, call us today to schedule a consultation.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician or surgeon and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
What is the right age for cosmetic eyelid surgery?
If you’re looking for a simple timeline of when to get eyelid surgery based on what year you were born, you won’t find that here. In fact, you won’t be able to find a reputable answer outside a doctor’s office, because your plan must be expertly developed on an individual basis. There are numerous reasons to seek cosmetic eyelid surgery, including even functional concerns, personal aesthetic preferences, and to reduce or even prevent the signs of aging. But we all age in different ways and at different times, and added to that there is vast natural variation between human eyes—meaning that a one-size-fits-all answer is never a good idea.
This is not to say that timing is not a factor in your treatment, and this is something you can discuss at a personal consultation with a respected oculoplastic surgeon. Time-related issues you may consider are where you are at in your career, if any important events such as weddings or family reunions are upcoming, or if you’ve simply feel it’s “time” to stop wondering and have your questions answered by a specialist. Eyelid surgery continues to be one of the most powerful and popular cosmetic surgeries performed. Individuals often consider eyelid surgery between jobs, prior to weddings, or other major life events.
At the time of your consultation, you surgeon should carefully assess your aesthetic concerns, medical history, and perform a complete examination. A thoughtful surgeon will assess both your aesthetic issues and any functional components that also need to be considered in planning eyelid surgery. The best blepharoplasty in the world wouldn’t benefit you if issues such as eyelid laxity or ptosis are not also addressed at the time of eyelid surgery. Your potential surgeon will discuss with you the details of surgery, potential complications, reasonable alternative to surgery, and even the likelihood that surgery will accomplish your goals.
There is not one “right age” for eyelid surgery. The right eyelid surgery for you will start with a personal consultation to develop an individual plan. Call Dr. Steinsapir today to schedule your personal assessment.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician or surgeon and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
Will under eye Restylane eliminate my dark circle?
Controlled placement of Restylane filler under the eye can greatly improve the appearance of dark circles, making this a popular and safe cosmetic treatment for those wishing to rejuvenate their facial appearance for a more youthful, alert, and bright affect. While these benefits are well researched with documented outcomes, medically speaking under eye Restylane does not “eliminate” the dark circle. A basic understanding of the cause of dark circles under the eyes, and how they can be helped with Restylane, will clarify what this treatment can and cannot accomplish.
Ultimately the cause of the dark circle is an optical perception, meaning the reason we see a dark circle on some individuals’ faces is due to the pattern of light interacting with the skin and tissue in that region. Dark circles are the visual result of a thin lower eyelid skin, which lies directly over the orbicularis oculi muscle, a dark red muscle. In addition to thin skin, with area commonly has a relative volume deficit compared to the adjacent cheek. It is the volume deficit that that can be improved through treatment with under eye Restylane. Restylane does not eliminate the absorption of light caused by the dark muscle just under the lower eyelid skin. However, the volume improves the way the way the light reflected from the skin surface appears, and the volume deficit which contributes to the dark circle. By improving factors that contribute to the the dark circle, Restylane can make significant improvements in the under eye area helping this area look fresher and more youthful. In a nutshell, under eye Restylane improves the under eye volume deficit and for many this makes a profound difference. Because the treatment can be accomplished with a comfortable office service and typically lasts a year or more depending on the amount of volume replacement, many individuals find this a great alternative to lower eyelid surgery.
To learn more about leading options for addressing your dark circles or other aesthetic facial concerns, schedule an individual consultation with Dr. Steinsapir to develop a personalized plan.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician or surgeon and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
