What does Dr. Steinsapir think of the “Madonna Lift?”

For the last few years, the “Madonna Lift” — yes, named for the famed pop star — has received attention for purportedly dramatic results akin to an eyelid lift without the surgery.  The procedure itself involves fractional CO2 laser resurfacing, with a goal to tighten the periocular skin in the eyelids and adjacent facial regions.  Marketing claims for this procedure promise that it will give the effect of an eyelid lift through use of light columns to treat and tighten the skin.  Claims include a diminishing of wrinkles, tightening of the skin, reduction of under eye circles, and elevation of the eyebrows.  In essence, we are talking about the full benefits of an eyelid lift but without any surgery at all.

Does the Madonna Lift live up to the hype?  Reasonably, the Madonna Lift can make a modest difference in your eyes’ brightness, but individuals undergoing the procedure might feel that it didn’t seem worthwhile.  To get real results cosmetic procedure must address the root causes of your concerns.  The best and most natural results come from addressing actual issues — which may include excess tissue or tissue deficiencies or both; stretched, sagging, and sun-damaged skin; ptosis; a drooping brow; or other concerns.  Short cuts may help but they can also be disappointing because the lack the power to make a real difference.

Dr. Steinsapir is a leading advocate of minimally invasive facial cosmetic procedures, including nonsurgical procedures like under eye Restylane, the chemical peel, and Microdroplet BOTOX when indicated.  There are many nonsurgical procedures with minimal downtime that can make a huge difference in your appearance.  However, the key to satisfactory results is catering to your unique facial structure and goals, while choosing the best procedure to match your needs (whether surgical or not)–rather than setting your heart on a procedure full of promises but that may not be right for you.

The Madonna Lift is not a substitute for surgery if that is what you actually need.  This is just another example of a modest procedure with a catchy name.  For real results, we strongly encourage you to seek a personal consultation with a physician who is an eyelid specialist and can advise you on a personalized treatment plan.  This may or may not include eyelid surgery, but the key is that your treatment will be based on your needs rather than a promise of a one-size-fits-all cure with a catchy name.

Dr. Steinsapir is an international leader in both eyelid surgery and minimally invasive, nonsurgical facial cosmetic procedures.  Much of the appeal of the Madonna Lift is the absence of surgery, and it’s of course understandable that you may be hesitant to consider surgery.  Dr. Steinsapir’s philosophy is that all treatments should be both individualized and minimally invasive.  What does this mean?  If surgery is not indicated, he will not recommend it.  And when surgery is indicated to address the cause of your concerns, he opts for a treatment that is conservative and preserves as much of your natural tissue and eyelid contour as possible, enhancing your features, speeding up recovery time, and avoiding the “surgical look” famed by gossip magazines.  Many people see phenomenal results from an upper eyelid blepharoplasty and related eyelid surgeries, and many also see incredible improvements from nonsurgical procedures like undereye Restylane and an individualized chemical peel.  The bottom line is, you may or may not need surgery to get the results you desire — but for an outcome that meets your needs, you should never limit yourself to one procedure just because it was marketed to you.  For the best results, consult with a leading oculoplastic surgeon to determine which treatment plan is right for you.

We invite you to consult with Dr. Steinsapir today, a pioneer in minimally invasive cosmetic facial procedures with particular attention to the eyelid and its balance with the rest of the face.  Dr. Steinsapir has proven results for both surgical and nonsurgical cosmetic facial procedures; and his friendly, approachable, and honest demeanor will help you feel comfortable asking questions, receiving answers, and planning for the procedure(s) right for you.

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.

I am unhappy with my eyelid surgery. What are my options?

Eyelid surgery is one of the most popular cosmetic procedure today.   It has the potential to provide extremely positive results that rejuvenate your appearance and make both an aesthetic and functional difference.  Eyelid surgery can be very technical.  Your surgeon may also be surprised by the disappointing outcome of your surgery.  If you have had eyelid surgery in the past, such as an upper blepharoplasty or Asian eyelid surgery, but are dissatisfied with your results, help is available.

 

First, allow your eyelid surgery to heal. The initial healing after surgery can be a time of uncertainty.  Recovery takes you out of your normal schedule and routine.  Friends and family can make inappropriate comments that lead to second guessing and uncertainty.  Please recognize that family members may be right but they are not eyelid experts.  Surgical results that initially look rough because of swelling and bruising, often settle down and look remarkably better with time to heal.  There are rare, immediate eye health concern, and these should prompt immediate attention from your surgeon.  These included increasing pain, swelling, redness, and bruising, or changes in vision.  When these occur in hours or days after eyelid surgery they can represent vision threatening issues such as bleeding behind the eye or infection.  Immediate care by your surgeon is essential.  If you are having this type of an issue and your surgeon is not immediately available, it is advisable to be seen in an emergency room where the emergency care of an ophthalmologist or plastic surgeon can be arranged.

 

Another set of urgent post-operative issues include difficulty opening or closing the eyelids, double vision, or other restrictions in eye or eyelid movement.  Right after surgery, local anesthesia can account for some of these types of issues, but after 24 hours, the presence of this type of an issue, suggests a mechanical problem created by the surgery.  In some cases, these issues require urgent surgical exploration.  In all cases, you should be seen by your surgeon to assess what is going on.  Recognize that non-eyelid surgery specialists often perform eyelid surgery.  These surgeons lack the ability, skill, training, and equipment to properly examine your eye.  Eye pain and light sensitivity can be caused by a corneal abrasion, corneal ulcer, or intraocular inflammation.  Without a slit lamp and the necessary training, your surgeon cannot diagnosis these issues.  Immediate consultation with an oculoplastic surgeon or general ophthalmologist may be necessary.

 

Once you get about a week out from surgery, the issues tend to be related to eyelid shape, surgical symmetry, visible scars, and eyelid malposition.  Generally, these types of issues get better with time.  However, problems that can persist are evident even this early after surgery.  It can be difficult to determine which issues will settle down and resolve on their own to your personal satisfaction.  It is important to discuss your concerns with your surgeon.  Surgeons will sometimes attempt to minimize your concerns.  This may be appropriate.   It often comes down to a level of trust.  If you feel like your trust and confidence in your surgeon is being abused, that is a significant warning sign.  Patients are not often wrong.  If you have a concern, your surgeon should also be able to see it and explain to you why or why it is not a concern, and what will need to be done about it.  It may be as simple as “we will watch this.”  When your feelings are not validated or your feel you are not being told the truth, there is often a break-down in the doctor-patient relationship.  This is when a second opinion can be helpful.

 

It you have healed and surgery is in the past, this does not mean you have no options.  A detailed personal consultation can establish precisely what is causing your issues and how best to correct the problems.  This type of work requires considerable maturity and experience.  It is often necessary to have unique solutions tailored to you personal situation.  A cookie-cutter approach is not going to do it.  Dr. Steinsapir takes the necessary time to define your problems and the best approach needed to help you achieve your goals.

 

Dr. Steinsapir provides attentive, comprehensive care to ensure you achieve the results you desire, and he always designs your care on an individual basis, making himself available to answer all your questions so you can feel confident both before and after treatment.  He can take over your post-operative care if necessary or coordinate with your surgeon to provide input and suggestions to help speed your recovery.  To learn more about fixing eyelid surgery, please call today to schedule a consultation with Dr. Steinsapir.

 

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 are the treatment options for syringoma of the lower eyelid?

Syringomas on the lower eyelid are a common, benign growth.  Although they tend to be seen more often in women, both men and women can begin noticing them around adolescence.  Syringomas are derived from the eccrine sweat gland ducts and are small or large expansions of normal sweat glands in the eyelids.

Treating Syringomas

Syringomas are difficult to permanently remove because they originate from the deep dermis level of the skin.  The most common forms of removal include shaving, chemical peel, electrocautery, and lasers.  All of these methods are intended to superficially flatten the bumps caused by syringomas.  These treatments often have to be repeated regularly.  Smaller growths are easier to remove using these methods.  Although this is not a long-term solution, it carries less risk of scarring, permanent tissue damage, and slow-healing.

Deep Dermis Treatment

In order to completely remove syringomas, the treatment needs to penetrate the deep dermis under and around your eyes.  There are many different opinions among physicians about which method is the most effective.  Some physicians use CO2 lasers, while others prefer the deeper laser resurfacing of a Fractional CO2 laser.   Likewise, deep electrocautery may also effectively remove the lumps, however, all of these methods carry a risk of scarring.  Even after the syringomas are removed from the deep dermis level they can still return.  The overgrowth of eccrine sweat glands is not related to any external causes, but is a genetic trait that can’t be treated with skin creams.

Factors for Successful Removal

Smaller syringomas are easier to remove so the earlier you address the problem the better results your doctor can achieve.  Although the bumps can always be removed using chemical peels or shaving, there is a substantial risk of scarring.  Electrocautery and CO2 lasers can damage the delicate tissue around your eye and the deeper the penetration, the more damage can be done.  Removing syringomas requires a skilled hand and experience with lower eyelids.  Dr. Steinsapir utilizes his advanced understands the structure of the lower lid and skin healing to minimize skin damage that can be associated with the treatment of the syringoma.  Generally he will recommend removing one or two syringomas to learn how your skin responds before performing a larger scale treatment.

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 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 should I expect with my chemical peel?

A chemical peel is a great way to refresh your appearance, renew your skin, reduce the appearance of fine lines, and even your skin tone, all in one go. But a chemical peel is no home remedy.  Just because it sounds like an easy, nearly risk-free, non-invasive procedure doesn’t mean that you should try performing one at home.  It’s important to find a skilled and experienced surgeon who has training in the performance of chemical peels.  The results of a properly-performed chemical peel can be phenomenal, so choose your surgeon carefully to ensure the best possible outcome.  There are significant risks associated with these procedures.

Where is Surgery Performed

Chemical peels are an in-office procedure that can be performed in a relatively short period of time.  You can combine your treatment with other in-office procedures when appropriate.  However, trying to perform a chemical peel on yourself is a sure way to turn a safe procedure into a disfiguring one.  Chemical peels are safe and highly beneficial when performed by an experienced cosmetic surgeon.  They are not appropriate as a do-it-yourself, home project to save some money.

It might be possible to obtain the agents used for a chemical peel from unscrupulous merchants from the Internet.  However, if you try to perform this procedure on yourself, you can permanently alter the coloration of your face by introducing irregularities, scars, and hypopigmentation.  Improperly performed, these agents can burn your skin with permanent consequences.  A great deal of skill, judgment, and experience is needed to safely perform a chemical peel.  A surgeon who has mastered chemical peels will also instruct you in follow-up care for your skin after the initial treatment and closely follow you.  With this guidance in monitoring your progress, long-term problems that might develop can be managed, mitigated, or avoided altogether.

Types of Anesthesia

There are many different types of chemical peels.  The type that is best for you depends greatly on your skin type and concerns.  The issues that affect your skin determine the type of peel procedures that will provide the most benefit. Common concerns include: acne with or without scaring, dark spots that have developed over time, skin aging from sun exposure, and intrinsic skin aging including lines.  As peels increase in strength, the need for anesthesia in the form of oral sedation, and local numbing of the face to make the procedure comfortable increases. Also the post-procedure skin care demands increase in complexity and length to ensure that the face heals quickly and with the best possible result.  Please do not underestimate the need for expert care in this regard.

Common Complications

As with any cosmetic surgery procedure, invasive or non-invasive, complications can occur.  Infections may occur anytime after the second or third post-operative day.  The signs are prominent swelling, significant amounts of devitalized skin and redness beyond what would normally be expected, and pain. Infections are often the result of neglecting post-procedure instructions.  It is for this reason that Dr. Steinsapir insists on close follow up. The procedure represents an important investment in time, energy, and expense but it is essential to proper healing.  Other potential complications include: scarring, temporary or long term eyelid malposition, color and pigmentary change, persistent redness, and possible allergic reactions.  There is no way you can handle these concerns on your own after try to do your own chemical peel.

Estimated Time for Recovery

Generally, the deeper facial peels produce results that rival what can be accomplished with surgery.  Redness following TCA 35% can persist for 3 weeks to 6 weeks; following phenol 89%, redness can persist for 3 months to 6 months, and following a Baker’s phenol, it can persist for 5 months to 12 months. However, it will only take 9 days to 12 days to reach the point at which make-up can hide facial redness.  Men tend to heal faster than women.  Only a personal consultation with an experienced chemical peeler will provide a basis for estimating recovery time for your personal considerations.

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 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.

Feeling Pressure to Look Feminine

With an abundance of fashion magazines like Cosmopolitan, Vogue, and Elle there is a lot of pressure to look a certain way in order to be considered “feminine;” full pouty lips, large eyes, flawless skin, and high, full cheeks are the aesthetic standard these days.  The internet has only become a tool to fuel this obsession with female perfection, but the reality is, makeup and Photoshop go a long way in making starlets and models meet the modern standards of beauty.  Nevertheless, the desire by women to meet the ideal is strong, and it doesn’t always require major surgery to achieve.  More often than not, it’s the little touches that make the big difference and starting small can preserve a more natural look and prevent you from looking like you’ve had major surgery.

Lips

Your lips are one of the first parts of your face to appear aged.  With a loss of volume and an increase of lines around the the mouth makeup has a tendency to exacerbate the problem by feathering.  Full soft lips are not just a sign of beauty, but also a sign of youth.  Fortunately, your lips are one of the simplest fixes without the need for surgery.  Fillers can provide a very natural solution to lips that are thin or losing volume.

With so many fillers available on the market today – Restylane®, Radiesse, Perlane, Juvederm, Artefill, Sculptra, Matridex, and even silicone oil – it can be easy to feel overwhelmed by the options.  However, not all of these fillers should be used as lip fillers under normal circumstances.  Hyaluronic acid fillers like Restylane, Juvederm, and Perlane are much more suitable for lip augmentation than permanent and semi-permanent fillers.  This is because they are much more forgiving, do not tend to lump, and can be simply and easily adjusted with the enzyme hyaluronidase.

Dr. Steinsapir prefers the use of Restylane as the best filler for lip volume deficiencies.  This is because the lips are very sensitive and irregularities can arise.  Fortunately, Restylane doesn’t tend to form bumps, and an experienced physician specialist can skillfully place Restylane for natural looks and long-term benefits.

Under Eye Fill

Dark circles under your eyes, or even a hollowness above your cheekbones is easily improved using a similar method as with the lips.  Dr. Steinsapir also prefers Restylane to reduce the appearance of dark circles because it can be easily adjusted.  Despite what the old wives tales say about dark circles and getting enough rest, persistent dark circles are actually the result of your lower eyelid muscle showing through the delicate and thin skin of your lower lid area.  When there is no subcutaneous fat between the skin and the muscle, the area appears dark and sunken.

The treatment requires a skillful hand but once placed and adjusted, the treatment is completely natural and can’t be detected by others. No wonder this has become the most popular eye dark circles treatment.

It is critical that the injecting physician assess how you do after the treatment because a certain percentage of treatments require an adjustment.  Dr. Steinsapir explains that everyone holds a slightly different amount of water in the tissues and small areas of fullness can spoil an otherwise great result.  For this reason, he encourages his patients to follow up about a week after treatment to assess how the service has settled.

Microdroplet BOTOX® and Dysport®

Of course, forehead wrinkles and brow lines are considered unfeminine, even among the older generations of stars like Diane Keaton, Susan Sarandon, and Jane Fonda.  Despite all of these women being over 60, all their photographs show them with smooth foreheads and full cheeks despite their features showing other signs of aging.  Maintaining a youthful appearance is a large part of looking feminine because it’s these features in women that are signs of femininity.

Unlike standard treatment methods, Microdroplet™ BOTOX® and Dysport create brow lift without forehead paralysis.  Microdroplet™ BOTOX® works with greater precision with your facial muscles.  The care and interest Dr. Steinsapir has shown in inventing this treatment demonstrates his dedication to achieving a beautiful, more youthful appearance without impeding the ability to express emotion.

Standard injection methods tend to freeze the forehead.  The forehead can’t move and the eyebrows drop like stones.  What looks good is a gently lifted eyebrow, no crows feet lines or brow pinch, and a forehead with reduced lines that is still able to move.  Imagine a BOTOX® or Dysport® treatment that allows you to have natural expressions!

Chemical Peel

Flawless skin has always been the ideal for beauty and as we all age, men and women alike, our skin develops flaws and spots that may not have been there when we were young.  But cosmetic products are not marketed to men so there is even more pressure on women to maintain clear, beautiful skin.

There are many types of chemical peels available and they treat many types of concerns, so it can be difficult to figure out which chemical peel is right for you.  But the chemical peel is truly an art form with versatile abilities depending on your needs, so it’s vital to understand that for a successful face peel with profound results, you’ll need an expert in performing facial peels who has extensive treatment experience and understands how to combine science and aesthetic planning for the best results possible.

Chemical peels can effectively treat facial concerns like aging skin, fine wrinkles, dark spots, acne, creases, loss of elasticity in the skin, and other concerns.  This frequently makes the chemical peel an excellent alternative to surgery that removes excess skin for the lower eyelid.  A chemical peel in the eyelid region is a minimally invasive procedure that preserves your natural features while rejuvenating your appearance.

Pigmentation is always an important consideration to any chemical peel.  The range in skin colors and complexions is complex, so this is something to consider with your doctor on an individual basis.  Fortunately there are many people who can and do benefit from chemical peels.  Your doctor can tell you more about skin-types as classified by the Fitzpatrick scale, and let you know what that means for you and your candidacy for a chemical peel.  A chemical peel can also help improve concerns with irregular pigmentation.

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 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.

Invisible Eyelid Surgery―Be Careful What You Look For

Throughout Los Angeles and Beverly Hills there is a buzz about a “new and innovative” procedure that promises eyelid surgery without scarring.  The promise of no scars following surgery sounds appealing; who doesn’t want to walk away from surgery with all the benefits of a refreshed look without the evidence of surgery?  But as the old adage goes, “if it sounds too good to be true, it probably is.”

How does invisible eyelid surgery work?

According to the doctor who “invented” this procedure, invisible eyelid surgery involves both “subconjunctival blepharoplasty” (usually called transconjunctival blepharoplasty) and a simultaneous “advanced” laser treatment performed by a dermatologist.  Using a micro-fractional CO2 resurfacing laser to treat lower eyelid skin by “tightening” the area following removal of fat through an incision made on the inside of the lower lid (transconjunctival incision), this procedure touts a younger and refreshed appearance of both the upper and lower lids without cutting surgery.  And all this has a recovery period of about a week and no one will be able to see any evidence that you’ve had surgery!  Now that sounds too good to be true.

Why the skepticism?

When you break down the idea of “invisible eyelid surgery” into its basic parts, all you’re really left with is lower eyelid blepharoplasty and CO2 resurfacing; two procedures that have been offered by cosmetic and oculoplastic surgeons for years.  Invisible eyelid surgery isn’t a new idea as the advertising physician would have you believe.  It’s simply two existing procedures packaged together and given a brand new name!  No surprise this is often how “new” things are invented in Beverly Hills all the time.

The risks of transconjunctival blepharoplasty

The idea behind the transconjunctival blepharoplasty is to remove the lower eyelid fat pads to eliminate puffiness around the lower lid that makes you look tired and aged.  But transconjunctival blepharoplasty is not without some serious risks that, if performed without skill or experience can result in permanent damage.  This approach of permanently removing eyelid fat is an old approach to lower eyelid surgery.  It can be effective for a small number of people.  The more current approach is preservation of this fat using a procedure called an arcus marginalis release.  Simply throwing away the fat can cause a hollow lower eyelid.

The risks of CO2 laser resurfacing

Deep CO2 laser resurfacing has fallen out of fashion because of the negative experience many have had healing from these treatments.  There is a very real risk that your skin will suffer from permanent depigmentation, and that the scarring caused by such treatments will likely affect the texture of your face.  This is because the treatment depth needed to improve deep facial lines makes post laser resurfacing scars, particularly skin texture changes, relatively common.  In fact these types of skin texture changes and skin depigmentation are so common that many surgeons think that this is the expected outcome of the service!

Micro fractional C02 laser is an effort to reduce this damage.  These treatments do provide freshening of the skin but generally are not powerful enough to reduce lower eyelid lines.  Chemcial peels, although they require much more training than a laser treatment are still the preferred methods.  In some cases, the chemical peel was all that was needed for the lower eyelid contour to be much smoother even without lower eyelid surgery!

What kind of eyelid surgery will work for me?

Dr. Steinsapir says this a lot, so it should come as no surprise: the best lower eyelid surgery is customized for the individual and designed to meet his or her particular features, goals, and medical needs.  This means that the lower eyelid surgery ideal for one person may be a specialized type of blepharoplasty while for another it may be a midface lift designed to correct tissue descent and return it to its proper anatomical location in the lower eye area.  Once you and your oculoplastic surgeon determine the best procedure, together, you and your surgeon must customize it even further to fit your features and obtain natural results.  Dr. Steinsapir observes: “people don’t do well with a one size fits all, cookie cutter approach.”

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 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.

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