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.
I have had a heavy upper eyelid since childhood. What are my options?
There is often confusion regarding what part of the eyelid is heavy. Eyelid surgeons draw an important distinction between a full upper eyelid fold (which is actually part of the eyebrow just below the eyebrow hair) and a heavy or ptotic eyelid margin. Ptosis means fallen and it is a general term than is used to describe a number of anatomic issues. How we address a ptotic upper eyelid margin and how we deal with a heavy eyebrow are very different. Upper eyelid ptosis where of margin of the upper eyelid rests low on the eye itself, is often present from childhood onward. The condition can pose both aesthetic and functional problems. Depending on the nature of your case, you may be dissatisfied with a “droopy” appearance of the eyelid, you may have concerns about asymmetry noted by other people, or you may have visual impairment and diminished peripheral vision. Heavy eyelids may be described as “bedroom eyes,” or sleepy eyes. Because the heavy eyelid convey a lack of attention, the presence of upper eyelid ptosis can be undesirable in both social and work situations. In contrast, an eye that is open correctly makes you look alert, interested, and engaged and is socially desirable in both work and social situations.
Ptosis usually does not go away on its own, particularly if this is a problem you’ve had since childhood. Ptosis can also develop after childhood. Considering how the upper eyelid tendon in held in the eyelid, it is actually quite amazing that more people do not have this condition. After a few million blinks of the eyelids, it is common to see some degree of upper eyelid ptosis. If you have a bothersome heavy upper eyelid and are beginning to consider your treatment options, it is important to research upper eyelid ptosis and clearly understand your choices. Ultimately there is no substitute for consulting with a qualified oculoplastic surgeon because every eyelid is different.
Correcting eyelid ptosis requires upper eyelid surgery. The challenge is determining the best approach that is right for your needs. This is not a place for having work done by a non-specialist lacking training, skills, and experience. Having ptosis correctly diagnosed increases the likelihood that surgery will correctly address your issues. Having things done the right way the first time is so much better than needing to undo the wrong surgery. Ptosis surgery can often be done in conjunction with other cosmetic eyelid procedures. The surgery will elevate the eyelid to an appropriate, natural level. It can also address eyelid asymmetry. Having the heavy eyelids corrected can make a huge difference in your confidence level, the business world, and personal interactions.
The first step is to consult with a cosmetic surgeon who specializes in eyelid surgery, including concerns related to ptosis, heavy eyelids, and asymmetry. At your consultation, your physician should give you a close and thorough examination, discuss your options and probable outcomes, and the likelihood of a surgery’s success and factors that can complicate surgery. The doctor will also make a formal diagnosis at this time, which will identify the ptosis and any compounding issues. For example, some individuals also have a heavy brow or dark under-eye circles, which may exaggerate the problem. Your surgeon should specialize in understanding on how each part of the face functions and relates to the other parts, and also advocate for nonaggressive surgery for natural-looking results. He or she can then design an individual treatment plan for you that leaves you with an overall balanced look.
The first step really begins by seeing the right surgeon. The key to being happy with your results is to never take a shortcut in choosing a surgeon. Your surgeon must be a true specialist in ptosis correction, and similarly will not take any shortcuts or use a “one size fits all” approach to your care. It is important to understand the value of seeing an aesthetically oriented, fellowship trained oculoplastic surgeon. The plastic surgeon who did your girlfriend’s breast surgery or nose is all too often the wrong choice because they lack specialized training in ophthalmology and in oculofacial surgery. To be a fellowship trained oculoplastic surgeon means the surgeon is board certified in ophthalmology and has spent a minimum of two additional years training in eyelid plastic surgery. Dr. Steinsapir is board certified in ophthalmology and completed three years of training in oculoplastic surgery fellowships and two additional years of cosmetic surgery fellowship training. This advanced training early in his career has helped propel him to the forefront of his field.
A highly qualified cosmetic eyelid surgeon is the best option. Surgeons do vary, so it is recommended that you review unretouched before-and-after photos of eyelid surgery; spend time with the surgeon beforehand discussing your options, plan, and follow-up care; and understand your doctor’s treatment philosophy, which should advocate for a nonaggressive, individualized approach.
Dr. Steinsapir is highly qualified to treat eyelid ptosis, asymmetry, and related concerns. With particular attention to individualized care, multiple fellowships in eyelid surgery, and a specialization in ptosis correction, he can help you with your goal to realize a bright and natural appearance. Dr. Steinsapir is internationally regarded as a top eyelid surgeon. Call us today to schedule a consultation and finally take that next step in addressing your longstanding concern. You shouldn’t have to wait any longer.
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.
Even the Wall Street Journal fails to understand how cosmetic surgeons are trained!
The message that one should only go to a board certified plastic surgeon is the public relations message of general plastic surgeons. While there are many excellent skills that general plastic surgeons offer, it is essential to understand that very few of these surgeons were trained to perform cosmetic surgery in their plastic surgery residency. Additionally numerous surgical subspecialties offer high quality cosmetic surgery and were very extensively trained in these procedures in residency and fellowship programs. In many cases, the subspecialist cosmetic surgeon offers a level of service that is better than what can be obtained from the majority of general plastic surgeons. It is my opinion that general plastic surgeons betrayed their public trust by not doing more to bring up the standard of care in cosmetic surgery and for so long failing to properly train their resident surgeons to properly perform cosmetic surgery. For this reason, the public is often much safer getting their cosmetic surgical care from the subspeciality cosmetic surgeon and not a general plastic surgeon. The Wall Street Journal just published an article that completely ignored this issue. Here is the letter I sent to the Wall Street Journal.
Dear Editor:
I read Robert Johnson’s article “A Nip and a Tuck” about cosmetic surgery for the 65-plus crowd that appeared in the October 31, 2011 WSJ. The article only mentions a single specialty that offers cosmetic surgery: general plastic surgeons certified by the American Board of Plastic Surgery. Either general plastic surgeons are very good at public relations (they are), or the author was unmotivated to provide readers with a balanced perspective. General plastic surgeons are not the only board certified surgeons who offer safe, high quality cosmetic surgery.
For years general plastic surgeons failed to train their residents for cosmetic surgery. General plastic surgery residency instead focused on broad training in reconstructive general plastic surgery. Despite claims to the contrary, treating a burn is not the same as performing liposuction, a facelift, or an eyelid surgery. This lack of leadership has resulted in a less than ideal standard of care for these elective cosmetic surgeries.
Over the past 40 years, otolaryngologists, ophthalmologists and dermatologists have built excellent fellowship training programs in facial plastic surgery, oculofacial plastic surgery, and dermatologic surgery that provide in-depth training in cosmetic surgery to allow these surgeons to offer cosmetic surgery to the American public that is arguably safer and of better quality than that offered by general plastic surgeons. The American Board of Cosmetic Surgery, a non-ACGME board, accredits high quality cosmetic surgery fellowships that are open to a number of surgical specialties including general surgeons, gynecologists, oral maxillofacial surgeons, as well as general plastic surgeons. These highly trained specialists provide a quality alternative to board certified general plastic surgeons who lack formal training in cosmetic surgery. It is now well accepted that fellowship trained dermatologists practicing liposuction are much less likely to be sued for liposuction malpractice than general plastic surgeons to cite just one example.
It is not controversial to state that general plastic surgery residencies do not provide adequate training in cosmetic surgery. Fortunately the field of general plastic surgery has recognized this and now offers a growing number of fellowships in aesthetic surgery for board eligible general plastic surgeons. However, compared to fellowship trained specialists in facial plastic surgery, oculoplastic surgery, dermatologic surgery, and cosmetic surgery; general plastic surgeons still have a ways to go before the public trust in this specialty is truly deserved. Unfortunately readers of Mr. Johnson’s article were left unenlightened about these issues.
Sincerely,
Kenneth D. Steinsapir, M.D., Los Angeles, Ca.
Associate Clinical Professor
Division of Orbital and Ophthalmic Plastic Surgery
Jules Stein Eye Institute
David Geffen School of Medicine at UCLA
What should I expect with my facelift surgery?
Facelift surgery is the most powerful of facial cosmetic surgeries you can undergo. Although we say it in practically every blog entry, in this instance it is more true than ever; choose a doctor who is experienced, up-to-date on the latest techniques, and skilled at performing facelifts. The procedure for facelift has changed significantly in recent years. What is clear is that there is not added benefit for the higher risk, deep plane facelift.
When it comes to choosing the best facelift for you, there is no right answer as to which method is the most effective, natural looking, or successful. A customized treatment plan, established by you and your doctor and based on your features and desires will significantly influence the outcome of your procedure. A facelift will always be a procedure of intelligent choices.
Where is surgery commonly performed and what type of anesthesia?
Typically facelift surgery is an outpatient procedure, but overnight stays may be recommended after deep sedation or general anesthesia. For certain individuals, your doctor can perform your facelift in the office, while you are awake and under local anesthesia. But for most, general anesthesia or deep sedation is the best choice. For cases requiring deep sedation and general anesthesia, Dr. Steinsapir performs surgery at the UCLA Ronald Reagan Medical Center and usually recommends an overnight stay at the surgery center.
Recovery and physical restrictions
A facelift takes approximately four hours. Usually there is minimal discomfort afterward; managed with either over-the-counter or prescription pain medications. You may experience moderate swelling around the eyelids and other areas of the face, but this is normal and is not cause for concern. Most find taking 7-10 days off from work about right. This time frame can depend on the precise nature of you work.
Common complications after surgery
Facelift surgeries performed by a skilled and experienced surgeon rarely have complications. The deep plane facelift mobilizes the tissue under the facial muscles and can injure these motor nerves causing facial weakness. The incidence is small but not zero. The risk amounts to only a very small percentage of individuals who receive this treatment experiencing this complication, but there is just no reason to risk this nerve damage when other methods of facelifts are available. In fact, there is essentially no cosmetic benefit to the deep plane facelift compared to other lifting methods. Other complications can include significant bruising and very rarely infection.
The time frame before full recovery
Recovery periods for facelift procedures vary greatly depending on the type of facelift surgery your physician and you decide on. Typically however, you can expect to return to work after 6 to 10 days. After 2-3 weeks, others are unlikely to detect that you just had surgery. Facelifts are not considered fully healed until about 6 months after. Once you have recovered fully, the results of surgery are very long term.
About Dr. Steinsapir
Dr. Steinsapir is on active staff at the UCLA Hospital and Medical Center at the David Geffen School of Medicine as an associate clinical professor of Ophthalmology in the Division of Orbital and Ophthalmic Plastic Surgery. UCLA is consistently rated the best hospital in the West and ranked at the top with a handful of medical centers in the United States. Many surgeries are performed on an outpatient basis at the Surgery Center at the UCLA Medical Center. Dr. Steinsapir addresses a broad array of oculofacial reconstructive concerns. Contact us today to schedule a personal consultation with Dr. Steinsapir.
Can I visit the United States for Reconstructive Surgery?
When it comes to reconstructive facial surgery, Dr. Steinsapir has extensive experience with eyelid, midface, and orbital reconstruction including repair of prior unsatisfactory eyelid surgery, removing unsatisfactory facial implants, correcting eye changes associated with thyroid eye disease, orbital and tear duct surgery, and repair of the eyelid after skin cancer removal or trauma.
Many people travel from across the United States as well as internationally to have surgery with Dr. Steinsapir. He is world-renowned for his leadership in facial cosmetic surgery. If you are considering traveling to have reconstructive surgery or other cosmetic treatment with Dr. Steinsapir, here are some important considerations that will help you have the best experience possible.
Consult First
Many people who travel for cosmetic treatment feel they should be able to have surgery at the time of their initial consultation. They want to take care of everything in just one trip, so they may fly or make a long drive to Los Angeles, have their consultation, and have surgery all during the same trip. This idea may seem appealing because you only have to book a flight and pack your suitcase once, and you may even save a little money—but please reconsider this approach. Dr. Steinsapir doesn’t believe in performing an initial consultation and surgery at the same time. Even if you save a few dollars in airfare, in the end this amounts to hasty and high-pressure decisions. Your choice to move forward in having surgery with the right doctor is important, and it’s not a good idea to cut corners here.
Reconstructive surgery should be something you and your surgeon approach calmly, thoughtfully, and with confidence. Instead of too much pressure, Dr. Steinsapir strongly advises and encourages you to take the time to make sure you have found the right doctor and right treatment approach. He wants you to have time to think about the options and be completely comfortable with the proposed surgical plan.
Take Time to Reflect
Consulting now and having surgery later is a sound approach for anyone seeking the right cosmetic treatment with any doctor. Although admittedly not convenient, slowing down, thinking about your choices and being fully comfortable ensures that you can make a fully informed choice without the pressure of time. When you consult with Dr. Steinsapir, he won’t pressure you into committing to surgery. It is better for everyone if you have the opportunity to meet with the surgeon, then have time to think about the issues discussed well before undergoing reconstructive surgery.
Make Thoughtful Decisions
Even if you’re traveling from very far, Dr. Steinsapir will not perform surgery at the time of your initial consultation. The best surgery is always performed with the utmost of care, consideration, research, and planning. You should go into surgery comfortable and confident that you have made the right decision.
About Dr. Steinsapir
Dr. Steinsapir is on active staff at the UCLA Hospital and Medical Center at the David Geffen School of Medicine as an associate clinical professor of Ophthalmology in the Division of Orbital and Ophthalmic Plastic Surgery. UCLA is consistently rated the best hospital in the West and ranked third among all medical centers in the United States. Many surgeries are performed on an outpatient basis at the Surgery Center at the UCLA Medical Center. Larger procedures may also be performed on an inpatient basis at the Jules Stein Eye Institute. Dr. Steinsapir addresses a broad array of oculofacial reconstructive concerns. Contact us today to schedule a consultation, followed by a brief consideration of the more common reconstructive issues that bring people to see Dr. Steinsapir.
Droopy Eyes after a Midface Lift
Complications following a midface lift are especially disconcerting because they can affect the basic functions of your eyes. Whether your eyes begin to droop, tear, or fail to blink, any change in the way your eyes and face function is reason enough to contact your doctor. But sometimes, surgeons panic in these situations and respond with a fix-it mentality and may be encouraging you to undergo corrective surgery immediately. Your surgeon may just want to take care of the problem as quickly as possible and as a result, you may be receiving mixed messages from your physician about the best course of action. However, immediately following your facelift may not actually be the right time to fix the problem.
Undergo a consultation
Before taking any action to correct your midface lift complications, carefully weigh your confidence in your current surgeon. There is no substitute for an in-depth personal consultation because discussing your problem with your doctor over the phone doesn’t allow him or her to see and fully understand the physical issues. Occasionally, the description of what is going on and the actual physical complications are not the same.
If you are not 100 percent confident in your surgeon and are casting about for opinions from strangers, listen to your feelings. Do not blindly follow the recommendations your original surgeon or any surgeon if their recommendations do not make sense to you. While you may not like your appearance and may be experiencing profound disappointment, these issues are seldom a medical emergency. Don’t commit to a second surgery unless you have a clear understanding of the following:
- what is going on and why these complications are occurring,
- what type of surgery your doctor has planned,
- why a surgical solution is necessary at this time,
- the risks of a second surgery, and
- the probability of success or failure.
The risks of midface and lower eyelid surgery and corrective surgery
Lower eyelid surgery and midface surgery have significant risks associated with them. Your surgeon may not fully understand these risks. If you’re experiencing complications it does not mean that your surgeon did anything below the standard of care. However, how your surgeon addresses the problem can make a profound difference and he or she should not rush the process.
The anatomy described in some of the most important and most recent papers in the field of lower eyelid and midface surgery done through a skin incision under the lower eyelashes (infracillary incision) is inaccurate. Dr. Steinsapir recently reviewed the literature on this subject and presented it before the Fall 2010 American Society for Ophthalmic Plastic and Reconstructive Surgery Scientific Symposium. Some of the core papers describe anatomic hypotheses rather than proven anatomic fact. For example, the soft tissue of the cheek is mobile (i.e. it slides when we smile), and the lower cheek is also mobile over the lower half of the face. In this location, the nerves responsible for facial expressions around the mouth travel in such a way that it is possible to safely dissect this plane in the lateral half of the lower face; this is a key aspect to the so-called deep plane facelift.
Similarly, surgeons dissect under the skin and lower eyelid muscle to perform midface lifts. Published papers appear to support the hypothesis that this midface lift technique can be performed without injuring the nerves that feed the eyelids. Unfortunately, a hypothesis is a scientific guess, it does not make an established anatomic fact. There is also clear evidence in published papers suggesting that the nerves that supply the lower eyelid orbicularis oculi muscle travel in this so-called glide plane, which is actually just somewhat mobile fat and loose connective tissue between the cheek bone and the orbicularis oculi muscle.
So why do doctor’s still perform this kind of surgery despite the risks? Despite the inaccurate papers, it is possible to dissect in this plane without significantly altering the nerve supply to the orbicularis oculi muscle in some individuals. Yet others may not do well. This may have to do with how aggressive the surgeon is and the exact nature of the distribution of these motor nerves, which do vary somewhat from person to person. Additionally, when this dissection is carried out laterally into the crowsfeet area, it is also possible to do significant damage to the nerves that provide innervation to the orbicularis oculi muscle in the upper eyelid as well. This is significant because the elements of the orbicularis oculi muscle near the lower eyelid margin are responsible for blinking the eye closed. Without this critical blink function, tears are not moved across the corneal surface properly resulting in dry eye and tearing issues. When the lower eyelid slumps, it does not properly cover the lower portion of the eye and there is increased corneal drying.
The remedy for midface and lower eyelid surgery complications
To address eyelid complications from a midface lift or lower lid surgery, the best answer is to avoid further eyelid tightening and allow the tissues to heal. In six months or more come back and address the situation with your surgeon if problems persist. By preserving as much of the lower eyelid and not cutting out tissue―as would be the case if your doctor were to try to fix the problems immediately following your initial surgery using a technique called canthoplasty―there are many more options and increased likelihood of an improved outcome if you allow the tissue to heal. While in the healing process, keep lines of communication open with your surgeon or look for oculoplastic surgeons for consultation who have as a focus of their practice the repair of unsatisfactory cosmetic eyelid surgery. Be skeptical of solutions that must be done “urgently” or don’t make sense. While very few of these complications mend themselves, with time it may improve so that less work may be needed than first thought.
About Dr. Steinsapir
Dr. Steinsapir trained alongside the inventor of BOTOX and has performed thousands of BOTOX treatments in Los Angeles since 1988 and recently patented his Microdroplet BOTOX technique. He is a board certified eye surgeon and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California 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. 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.
