June 23, 2011

I am having a complication from a Restylane treatment and my wedding is in six weeks. What should I do?

Wanting to look your best for your wedding day is something everyone is entitled to.  In the event that you experience unwanted effects from your Restylane® treatment, hyaluronidase makes it easy to adjust hyaluronic acid fillers like Restylane, Juvederm®, and Perlane®.  In most cases its best to return to your original doctor who should be eager to make sure you are happy with your treatment and outcomes.  However, there are circumstances where there is simply no substitute for seeing a leading expert to help you get the results you need.

Seeking a second opinion

Dr. Steinsapir often sees individuals frustrated with treatments they received elsewhere.  Surprisingly, many people are not aware that the hyaluronic acid fillers can be adjusted using the enzyme hyaluronidase.  This enzyme is delivered with a small injection during a very comfortable office visit.  Dr. Steinsapir has helped people who put up with unsatisfactory treatments for much longer than they need to. These issues are easily dealt with using the enzyme in one or two visits.  It is the ability to make these adjustments that makes it feasible to provide many of the advanced filler services.

Correcting the problem

Restylane is a long-lasting, but not permanent sugar-gel facial filler that is preferred for improving facial contours due to its natural results, even in sensitive areas like dark circles under the eyes and the lip edge.  Restylane and Perlane offer the ability to modify results when necessary.  This includes treatments that were performed in the past and need fine-tuning.  The ability to adjust a treatment with an enzyme can take a good treatment and make it great.  In some cases, as the body slowly breaks down the material over time, slight irregularities may develop despite the initial quality of the treatment.  Sometimes, the answer is adding filler rather than subtracting volume.  For this reason, it is best to start with a detailed assessment with an expert like Dr. Steinsapir.

Restylane has long-term benefits and it is also easily adjusted even long after a treatment.  These characteristics are essential in the eyelid and surrounding areas.  The skin here is very thin and the tissues are very sensitive, so even small issues show up.  Don’t live with a treatment that isn’t everything you want it to be.  See an experienced cosmetic surgeon who can help take a treatment from like to love.

About Dr. Steinsapir

Dr. Steinsapir is a much sought after oculofacial surgeon.  He is an innovator in minimally invasive cosmetic and reconstructive procedures and has invented new methods for treating with BOTOX, Fillers and cutting edge reconstructive eyelid and midface surgery.  He specializes in high precision eyelid surgery and is a leader in correcting prior facial and eyelid surgery, including multiple revised cosmetic eyelid reconstructions.  He attended medical school at the UCLA and completed ophthalmology residency at The University of Chicago.  He is multiple fellowship trained including three years of fellowship training in oculofacial plastic surgery at UCLA, and a two-year cosmetic surgery fellowship in Rancho Mirage.  He is widely published and lectures to other surgeons nationally and internationally.  He is an associate clinical professor of Ophthalmic Plastic and Reconstructive Surgery at the Jules Stein Eye Institute at UCLA.  His private practice is located in West Los Angeles, immediately serving the Los Angeles and Bevery Hills communities.  Additionally, individuals from all over the country and the world regularly come to Los Angeles for this expert care.

To learn more about Dr. Steinsapir’s specialized Restylane treatments, please contact us today.

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.

June 11, 2011

Can Surgery Remove Persistent Dark Circles?

Dark circles under your eyes can make you look old and can even degrade your self-image.  Diet, exercise, and plenty of rest are cited as solutions for dark circles.  Skin creams and dark circle concealers can provide some help.  Often people are under the mistaken impression that surgery will fix the dark circle.  While there are a small percentage of individuals who will benefit from surgery for their particular type of dark circle, in the majority of cases surgery will be of little benefit and can make the situation worse.

Why don’t cosmetic creams and bleaches work?

Although creams and bleaches don’t work to brighten the area under your eye, a dark circle concealer may do the trick.  Dark circle concealers work by mixing mineral particles in the cream.  These minerals reflect the light to create the illusion that the area under your eye is fuller.  Concealers are less expensive than under eye filler, but concealers stay on the skin just a few hours.  In contrast, and under eye filler service can provide help for up to a year and in some case longer without the need to constantly apply makeup.

The darkness of under eye circles is optical.  The skin is dark because there is no fat between the thin lower eyelid skin and the darkly colored muscle just under the skin.  Filling the hollow with hyaluronic acid fillers reduces the area in the lower eyelid that can shadow, improving the dark circle.  Under eye filing with Restylane using the DeepfillTM method developed by Dr. Steinsapir directly helps the hollowness in the lower eyelid, a major factor contributing to the dark circle.

Restylane can help

Dr. Steinsapir finds that under eye Restylane® is the best option for dark eye circles.  Restylane® is a hylauronic acid filler made of up cross-linked sugar gel used to fill wrinkles and provide volume in the face.  “Unfortunately, that lower eyelid circle develops early on the face,” notes Dr. Steinsapir who commonly treats young entertainers who needs to maintain their youthful edge in Hollywood.  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.

When you do decide to have under eye filler, take time to look for a doctor who knows what they are doing.   Dr. Steinsapir reports that when he teaches other doctors to perform the method, he often finds that they lack the detailed anatomic knowledge needed to successfully perform the treatment.  It is also 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.  “Adjustments can easily be made with the Restylane® treatment at any time after the service, which is why the treatment is so powerful,” he notes.  He advises avoiding medicines and herbal products that can thin the blood for about a week before treatment.  If you are taking something prescribed by a doctor, check with your doctor first before stopping a medication.  Also it is advisable not to work-out until 24 hours after a treatment.  These precautions minimize the risk of bruising.

About Dr. Steinsapir

Dr. Steinsapir is a much sought after oculofacial surgeon.  He is an innovator in minimally invasive cosmetic and reconstructive procedures and has invented new methods for treating with BOTOX, Fillers and cutting edge reconstructive eyelid  and midface surgery.  He specializes in high precision eyelid surgery and is a leader in correcting prior facial and eyelid surgery, including multiple revised cosmetic eyelid reconstructions.  He attended medical school at the UCLA and completed ophthalmology residency at The University of Chicago.  He is multiple fellowship trained including three years of fellowship training in oculofacial plastic surgery at UCLA, and a two-year cosmetic surgery fellowship in Rancho Mirage.  He is widely published and lectures to other surgeons nationally and internationally.  He is an associate clinical professor of Ophthalmic Plastic and Reconstructive Surgery at the Jules Stein Eye Institute at UCLA.  His private practice is located in West Los Angeles, immediately serving the Los Angeles and Beverly Hills communities.  Additionally, individuals from all over the country and the world regularly come to Los Angeles for this expert care.

To learn more about Dr. Steinsapir’s specialization in Restylane treatments, please contact us today.

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.

March 28, 2011

I had Restylane service 6 months ago and still have lumps. Can anything be done about this?

Restylane is a long-lasting but not permanent facial filler that is especially suitable for improving facial contours due to its natural-looking results, even in sensitive areas like dark circles under the eyes, and offers the ability to modify your results in the few cases when treatment isn’t completely satisfactory.  The enzyme hyaluronidase makes Restylane injections easily adjustable to a more desired aesthetic, and your doctor can even erase the treatment completely if you determine together that this is your best option.

When we hear from individuals who had dissatisfactory Restylane service long in the past, what is most disconcerting is that the individual was not aware that they could seek a simple adjustment from the start, or that they were not comfortable returning to their original cosmetic surgeon for this procedure.  This may indicate a problem in communication between the provider and the individual receiving services—and while this could simply be a lack of personality compatibility, it’s crucial that you are comfortable openly talking with your doctor about your treatment and any concerns that may arise.

Seeking the Best Restylane Services

While Restylane is considered a safe and routine procedure enjoyed by many who experience its benefits, this does not at all indicate that providing Restylane is an unskilled task.  You should always seek treatment from a leading and qualified provider such as Dr. Steinsapir, who is a cosmetic surgeon and oculoplastic surgeon with a major specialization of his practice being Restylane, including under-eye Restylane.  Your doctor must understand the subtleties of safely placing Restylane for natural results as well as how to adjust it should you have the need, and he or she must understand how Restylane and your facial anatomy interact to a level that could be called an art form.  Your doctor must also understand how to seamlessly adjust your Restylane treatment through comfortable hyaluronidase treatment.

Modifying Your Restylane Results

In the event that you experience lumps or unwanted effects from your Restylane treatment, hyaluronidase makes it easy to adjust hyaluronic acid fillers like Restylane, Juvederm and Perlane.  In most cases its best to return to your original doctor who should be eager to make sure you are happy with your treatment and outcomes.  However, if you are concerned about the skill level of your original provider who may not have specialized in facial fillers, or if you are experiencing a breakdown in communication and lack confidence seeking further direction and treatment from this individual, then you may wish to consider seeking a second opinion.

Dr. Steinsapir often sees individuals dissatisfied with treatment received elsewhere, and in many cases he can help you to restore the relationship with your original doctor.  If this is not possible, then you can seek adjustment and further treatments from someone else like Dr. Steinsapir.  It’s very important that you are comfortable with these decisions and are empowered with knowledge and a good communication rapport with your doctor to ensure best results.  If you have been waiting as long as six months to find out if your experience with Restylane is normal and if you can have your results adjusted, we are sorry to hear that you have been needlessly stressed.  Fortunately, Restylane can be adjusted and you may learn that when your treatment is customized and delivered with great skill and precision, impressive results are possible.

About Dr. Steinsapir

Dr. Steinsapir is a much sought after oculofacial surgeon.  He is an innovator in minimally invasive cosmetic and reconstructive procedures and has invented new methods for treating with BOTOX, Fillers and cutting edge reconstructive eyelid  and midface surgery.  He specializes in high precision eyelid surgery and is a leader in correcting prior facial and eyelid surgery, including multiple revised cosmetic eyelid reconstructions.  He attended medical school at the UCLA and completed ophthalmology residency at The University of Chicago.  He is multiple fellowship trained including three years of fellowship training in oculofacial plastic surgery at UCLA, and a two-year cosmetic surgery fellowship in Rancho Mirage.  He is widely published and lectures to other surgeons nationally and internationally.  He is an associate clinical professor of Ophthalmic Plastic and Reconstructive Surgery at the Jules Stein Eye Institute at UCLA.  His private practice is located in West Los Angeles, immediately serving the Los Angeles and Bevery Hills communities.  Additionally, individuals from all over the country and the world regularly come to Los Angeles for this expert care.

To learn more about Dr. Steinsapir’s specialization in Restylane treatments, please contact us today.

February 2, 2011

What are the best lower eyelid options for Asians?

In every instance of lower eyelid surgery for Asian eyes, the best option is simple yet not easy: the best lower eyelid surgery is one that is custom-designed and skillfully delivered based on your unique circumstances, treatment goals, and individual features.  While it is tempting to seek out a solution that works every time for every person, the nature of facial aesthetics makes it impossible for any standardized medical approach to meet everybody’s needs.  A cookie-cutter or assembly-line approach to eyelid surgery and other kinds of facial cosmetic surgery tends to yield results that don’t look natural to your features and instead represent the “surgical look.”

Lower eyelid surgery before and after photo

Lower eyelid surgery before and after photo

Asking  questions like “What is the best Asian eyelid surgery?” is like asking what shoe size is best to wear.  Of course there are many sizes of feet just as there is great diversity in Asian eyelid features, so your best option must be fit precisely for you alone.  This means that even if your friend had amazing Asian eyelid surgery results, you may benefit from a completely different oculoplastic surgery.  The key to finding the right Asian eyelid surgery for you—be it Asian blepharoplasty, Asian canthoplasty, or another specialized eyelid surgery—lies in finding an exceptional oculoplastic surgeon with specialized training and experience in Asian eyelid surgery and whose treatment philosophy is to custom-design a minimally-invasive treatment that enhances your natural qualities.

A Variety of Helpful Cosmetic Options

In your search for the right lower eyelid surgery for you, you’ll come across many options that you should carefully and considerately discuss with a top cosmetic surgeon.  Lower eyelid surgery options include blepharoplasty, canthoplasty, eyelid reconstruction, midface options, and treatment of dark circles under the eyes.  Even these specific procedures do not follow a standard blueprint for every eyelid; rather, optimal results are always due to custom-tailoring of the treatment to meet the unique circumstances and enhance your eyelid contour in a way that makes sense for you.

The Right Oculoplastic Surgeon for You

Asian eyelid surgery is a specialized subtype of cosmetic eye surgery, and your doctor absolutely needs to have proven experience and success in helping individuals with Asian eyes to achieve the natural results they desire.  This ability in a doctor is accompanied by the understanding that you have unique eyes, and your treatment plan must reflect this uniqueness.  The goal should never be to “westernize” the eyelid, but to design a minimally invasive treatment approach combined with a high level of skill to obtain results that fit you like a fine-tailored suit.

Consider how Dr. Steinsapir’s extensive experience and education in specialized eye plastic surgery can help you to obtain the best Asian eyelid surgery results.  Dr. Steinsapir is both an oculofacial and cosmetic surgeon with board certification in the field of ophthalmology and a tradition of excellence.  Take a look at his eyelid surgery before and after photos, and consider how his education at UCLA and the University of Chicago as well as multiple fellowships and focused practice can help you finally get the natural improvement you seek.  Please contact us today to learn more at your no-risk consultation.

January 20, 2011

Fixing Lower Eyelid Surgery

Eyelid surgery is a great option for many people seeking to improve their looks and their interactions with others.  You can usually anticipate that your lower eyelid surgery will be a positive experience that improves your appearance and your confidence, but there are still occasions when an individual may need to seek revisional eyelid surgery with a top oculoplastic surgeon, especially if the original operating surgeon was not chosen with the greatest care.  If you are concerned about the outcome of a past eyelid surgery and want to know how to address any issue you perceive, here are a few items to consider as you move forward toward attaining your treatment goals.

Have you had time to heal?

After an eyelid surgery, you might experience some apprehension as you anticipate your results and wonder if you made the right decision.  Most individuals find that they are very happy with their eyelid surgery results, so before you start to fret make sure you’ve allowed yourself healing time to see improvement.  In a very few, rare cases an individual needs to seek immediate medical attention for eyelid surgery complications, but this is not common.

If your concerns are aesthetic, it’s generally advisable to wait six to twelve months after a lower eyelid surgery such as lower blepharoplasty to seek revisional treatments.  This is because it’s important to allow all the tissues to fully heal and observe your final results before modifying the outcome with additional surgery.  Especially in cases when an overaggressive surgery leads to the need for corrective surgery, your corrective surgery should preserve your tissue as much as possible to improve your look rather than making the problem worse.  This is why a conservative approach after ample healing time is most effective.

Since you begin to see the results of your eyelid surgery earlier than the time for corrective surgery, you should be openly expressing any concerns that arise with your original surgeon on an ongoing basis.  If you feel you could benefit from a second opinion with a specialist in eye plastic surgery and its correction, this can also help you to calm your worry and consider your options.

Who can help?

In many cases, individuals worry needlessly about an overall great surgery because they haven’t let themselves heal or are nervous enough to imagine problems that aren’t there.  On the other hand, with any medical procedure you run a risk that it will not go exactly as you had hoped, and eyelid surgery is no exception.  If you want to learn more about whether you might need your lower eyelid surgery fixed, you can be glad that expert help is available.

First you should consult with your original surgeon wherever possible.  Your surgeon who performed your first eyelid surgery should be eager to help you address any concerns you have and find the best solution together.  However, sometimes part of the problem may be that your surgeon lacks the specialized skill in conservative eyelid surgery that is needed for precise and natural results, and in these cases consider consulting with an additional doctor for a new viewpoint based on experience and expertise.

It takes extensive training, experience, skill, and specialization to be able to perform the best eyelid surgery, and additionally there are very few doctors with focus on skillfully correcting eyelid surgery.  We invite you to consult with Dr. Steinsapir, who makes eyelid surgery as well as corrective eyelid surgery based on years of education, training, and experience a major focus of his practice in Los Angeles and Beverly Hills.  Dr. Steinsapir works from a philosophy that natural results are achieved through conservative surgery that enhances your eyelid’s natural contour.  This approach helps to prevent the need for corrective surgery to begin with.  If you are already concerned about a prior eyelid surgery, or if you are seeking lower eyelid surgery and want to minimize your risk of needing corrective surgery later, contact us today and consider how a fresh opinion from Dr. Steinsapir can help set you on the right track for to achieve your goals.

January 15, 2011

Which chemical peels are best for Asian Eyelids?

There are many types of chemical peels available and many types of concerns they treat, 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.

Before and After Chemical Peel for Asian Eyelid

Before and After Chemical Peel for Asian Eyelid

Before and After Chemical Peel for Asian Eyelid

If you are interested in whether a chemical peel may help your Asian eyelid, please realize that the tremendous diversity between every eyelid, including Asian eyelids, means that there is no one approach that will work for every Asian eyelid.  The right solution for you will depend on other factors, like the precise nature of your concern, the condition of the skin and eyelid, your skin’s pigmentation, and so on.  Your doctor will take all of these factors into and design your treatment approach accordingly.

How can a chemical peel help me?

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.  There are many cases when a chemical peel will compliment an eyelid surgery.  For example, an eyelid surgery like Asian blepharoplasty can correct excessive fullness of the eyelid by removing some of the fat, creating a double fold, or addressing Asian eyelid ptosis.  Since removing extra fat can slightly loosen the skin in that region, a chemical peel can help to firm the skin here.  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, including a chemical peel for Asian skin.  The range in skin colors and complexions is as complex as the range in eyelids, so this is something to consider with your doctor on an individual basis.  Fortunately there are many people with Asian skin complexions 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 often help improve concerns with irregular pigmentation.

Who can provide the best chemical peel for Asian eyelids?

You need an expert in providing the most effective and safest chemical peels in conjunction with the best eyelid treatment available.  We recommend that you consult with a specialist who makes facial and eyelid surgery the core of their practice to help you reach your facial aesthetic goals, and be sure that he or she has extensive experience in your specific concerns. Dr. Steinsapir specializes in both chemical peels and Asian eyelid surgery, with an emphasis on surgery and minimally invasive techniques customized for your particular situation and goals.  Contact us today for your no-risk consultation, where you can learn more about how to best meet your eyelid concerns, and if an individualized chemical peel will help.

November 19, 2010

What happens to my facial fat grafts when I gain weight?

Overview

Facial filler treatments and fat grafting can be excellent ways to soften the facial features by correcting imbalances and deficiencies in facial fat distribution.  Your decision to pursue fat grafting treatment is one you should carefully consider with your doctor, as there are multiple options for achieving your desired look, and the solution that’s best for you will depend on variables like your medical history, present condition, and treatment goals.  Like other treatment options available today, fat grafting is particularly suited for some individual’s needs, while for others there may be other more suitable options.

Fat Grafts and Changes in Weight

If your weight changes just a little, you probably won’t notice much difference in your treatment results.  If you have significant changes in weight, though, you could see some differences in the form of increased facial volume.  This is important to consider before opting for fat grafts.  While you probably aren’t planning on gaining weight, you and your doctor should take into account the likelihood of weight fluctuations given your medical history and current lifestyle.

So what can you expect with changes in weight?  This depends on the individual, but with small changes in weight there is generally little change in the fat graft volume.  However, with an increased weight and body fat, the grafts also increase in volume like the fat compartment from which they were removed.  For example, when the body fat increases 10% or more, the grafted fat also significantly increases in volume.

While the effects of most facial cosmetic surgery eventually diminish over time, it’s important to recognize that fat grafting does yield long-term results.  This is a great benefit for those who seek long-term change, but there are also times when the nature of this treatment can result in an unsatisfactory result even years after the original fat grafting procedure.

Achieving the Best Long-Term Results

In an ideal world we will all of course adopt a healthy, active lifestyle that includes good nutrition and keeps your weight at a stable place where your body works best.  But the reality is that most Americans gain about one pound of weight per year.  While most qualified cosmetic surgeons can comfortably adjust and even reverse treatments with Restylane and other hyaluronic acid fillers, correcting the facial contour after fat grafting is not so simple or straightforward.

These tendencies lead many cosmetic surgeons to favor the new facial fillers—like undereye Restylane, Perlane, and Juvederm—for most patients.  These fillers do not last as long as fat grafts, but they are very popular and effective because they are safe, provide benefit without the necessity of surgery, can be adjusted with the enzyme hyaluronidase, and have science-based, proven results.

Does this mean that fat grafting is wrong for you?  Not necessarily—fat grafting is an excellent option for certain situations on a person-to-person basis, just as facial fillers and other procedures like the facelift work well for many individuals.  You will need to consult with an experienced cosmetic surgeon before making a final decision that is right for you.

Experience Counts; Consult with the Best

Dr. Steinsapir is a leader in cosmetic facial fillers and other cosmetic facial treatments and surgeries.  In fact, he has served as a physician consultant to Medicis, Inc. (Perlane’s and Restylane’s distributor).  He has developed Deepfill Restylane, the world-renowned method of treating dark circles under the eyes.  His practice emphasizes minimally invasive treatment methods that are customized for the individual’s unique situational needs, with the aim of fast healing time and natural results.  For more information on how Dr. Steinsapir can help you determine your best treatment options, contact us today.

October 19, 2010

What is the difference between canthoplasty and canthopexy?

For those seeking improvement of the overall face, and more specifically their eyes, don’t neglect the significance of the canthus or canthal angle.  The inner and outer canthal angles are the corner of the eyes, and problems with the canthus can lead to a number of aesthetic concerns, like baggy eyelids, drooping eyelids, and eyelid asymmetry.  Effective treatment of the canthus can help you to look brighter, younger, and more open to social interactions.

Treatment Options for the Canthal Angle

There are different approaches to correcting problems with the canthus, and the treatment you get should be individualized for your needs.  Only a highly skilled surgeon who specializes in oculofacial plastic surgery and has the technical skill and artistic eye should perform this procedure, as the revisions must be made with precise control of the contour’s shape and position.

Canthopexy Basics

The canthopexy is a shortcut procedure in which a supportive suture is used to cinch the lower eyelid, reinforcing the eyelid’s position.  There are also more elaborate ways to accomplish this such as with a coronocanthopexy.  The aim here is to tighten the outer corner of the eyelid (more technically called the lateral canthal tendon) without actually taking it apart surgically.  The problem with these procedures is that they do not provide the posterior vector of support that is needed to correct many lower eyelid issues.

Given the concerns with this procedure, why do some still use this shortcut?  The main reason is that many surgeons who do cosmetic eyelid surgery are not fellowship trained in eyelid surgery.  They actually lack the training and experience to perform this technical procedure.

Canthoplasty: Definitive Treatment for the Eyelid Corner

The canthoplasty, on the other hand, is the definitive procedure for reforming the outer corner of the eyelids.  This procedure is often used as part of other eyelid surgeries and is a better option for tightening the lower eyelid.  Here the lateral canthal angle is used as a point of entry to perform other procedures from behind the eyelid so that scarring is not visible, and the angle too is corrected surgically.  At this time your doctor can precisely control how tight the eyelid will be as well as where the lateral canthal angle is positioned.  A qualified eye plastic surgeon will be able to perform this procedure readily, while a generalist typically doesn’t possess the kind of specialized knowledge needed to create a symmetric, aesthetically pleasing outcome.

Correcting Prior Canthal Surgery

With the proliferation of surgeons attempting canthal surgery without the appropriate training, skill and experience, there is a recent epidemic of unsatisfactory results from these shortcut procedures.  The good news is that virtually all of these can be improved with revisonal surgery by an experienced eyelid specialist like Dr. Steinsapir.

Seek Treatment with the Best

If you are seeking canthal surgery or would just like to learn more about whether it may be a good solution for your concerns, we invite you to a no-risk consultation with Dr. Steinsapir, a cosmetic eyelid surgeon in Los Angeles.  Dr. Steinsapir is a caring physician who attended medical school at UCLA, trained in ophthalmology at The University of Chicago, then completed a two-year fellowship in orbital surgery at the UCLA’s renowned Jules Stein Eye Institute, where he also completed a one-year fellowship in oculofacial plastic surgery.  Following this is also did a cosmetic surgery fellowship in Rancho Mirage.  He is now a leader in the field of eyelid surgery, providing minimally invasive solutions with the goal of achieving a balanced, natural result.  Please contact us today to learn more.

September 8, 2010

How do fillers improve my dark circles?

Dark circles under they eye are a common problem that can affect people of all ages.  Effective treatment must address the root cause of the problem, which is why putting on makeup or a face cream does not resolve the issue.  If you are dissatisfied with your appearance because of under eye hollows that give you a tired, haggard, or sunken appearance, consider how an under eye filler like Restylane can improve your image.

Under Eye Restylane Before and After Photo

Under Eye Restylane Before and After Photo

What is the root problem of my dark circles?

While a number of factors contribute to the dark circles under the eyes, lack of soft tissue volume is one of the most important factors.  What we observe here is a deficiency of subcutaneous fat including the fat just underneath our skin.  Just as too much fat is not attractive or good for our health, neither is too little fat.  As we age, many people find that they have problems with fat distribution over the body, having too much in some areas and too little in others, such as the area around the eyes.

With under eye circles, the concern is deflation of the malar fat pad, which composes much of the cheek soft tissue.  This can happen because of gravity, stress, age, or even our genetic tendency.  Skin optics also contributes to the darkness we associate with the dark circle.  The lower eyelid skin is very thin and immediately lined by a flat muscle just under the skin called the orbicularis oculi muscle.  This muscle helps close the eye and also contributes to the smile lines.  The muscle is dark red.  Light that passes through the skin strikes this dark muscle where the light is absorbed.  With little light bouncing back into the skin, this skin appears dark.  In comparison the skin of the cheek just adjacent to the thin eyelid skin has a layer of yellow fat immediately under the skin.  Light passing into the skin a this point strikes the yellow fat and instead of being adsorbed, it reflects off of the fat helping the overlying skin look lighter.  Dark concealers generally contain reflective material such as mica to increase skin reflectivity or are opaque to block the absorption of light at the skin surface.  Unfortunately these products do not eliminate the shadowing that occurs here because of the lack of volume.

Dark circle treatment that works is available through the midface lift, a surgery that corrects the shift in fat distribution, and also through under eye Restylane, a facial filler that restores the tissue deficiency under the eye.

How do fillers resolve the key issue?

Fillers can resolve the deficiency by taking the place of the fat volume that is supposed to be there.   This corrects the hollowed area by addressing the lack of volume and improving the way that light interacts with the tissue in this area.  We have found that Restylane filler is the most suitable filler here because it is safe and does not tend to clump or migrate.  Since there is so little fat here and the skin is thin, there isn’t tissue for the filler to “hide” behind, which is why it’s so important to choose the right filler.   It is also why it is so important to choose the right cosmetic surgeon to perform your service.

Restylane for under eye bags can be modified with the injection of hyaluronidase, an enzyme that breaks down hyaluronic acids including Restylane.  This means that if you have a lump or a bump that needs to be adjusted after initial treatment there is a mechanism to permit this adjustment.

How can I find out if filler will help me?

You need a consultation with physician considered one of the top practitioners in correcting dark circles and other cosmetic facial and eye concerns.  Dr. Steinsapir is one of the best cosmetic surgeons in Los Angeles, and he specializes in minimally invasive techniques to enhance your features through natural results.  His practice is one of the few in the world that makes eye hollow treatment a major focus of practice.  To learn more about Dr. Steinsapir’s prestigious educational and experienced background, as well as how safe treatment with under eye Restylane can help you achieve your desired look, contact us today for a no-risk consultation.

August 12, 2010

Will BOTOX help my dark circles?

BOTOX is a great product for the right circumstances.  In order to understand if BOTOX will help the dark circles under your eyes, you need to first know how BOTOX works and what causes dark circles.

BOTOX and Restylane Before and After

BOTOX and Restylane Before and After

Why does BOTOX work?

BOTOX is a naturally-occurring muscle relaxant and a highly purified protein called Botulinum toxin A.  It was originally used by ophthalmologists to treat muscle spasms near the eyes, and from there doctors noticed that those who received treatment had the added benefit of a soft, relaxed, more youthful appearance.  The key reason for this improvement is that BOTOX encourages overactive muscles to relax.  Often worry wrinkles, crow’s feet, forehead lines, and pinched eyebrows are the result of repetitive facial expressions, stress, and these too-active muscles.  By selectively weakening the muscles responsible for these unappealing features with controlled precision, a skilled cosmetic surgeon can restore facial balance and prevent lines from being further “etched” into the skin.

So, now you know what BOTOX does: it relaxes muscles that are too active, and is thus a great remedy for the problems caused by tight muscles.  The next question we must then examine is, What causes the under eye hollow?  After all, effective treatment must address the root cause of the problem.

How did I get dark circles under my eyes?

Dark circles under the eyes are almost always caused by a tissue deficiency.  The dark under eye hollows that many people observe as they age is a problem of imbalanced fat distribution.  Specifically, as the malar fat pad descends, our eyes become hollow and cheek bones may look gaunt, even as our lower face becomes saggy and creased.  The natural fullness under the eyes and in the cheek has suffered from time, gravity, and stress – with the tissue ultimately ending up in the wrong place.

The dark circles that result are actually an optical effect.  The natural tissue under the eye creates a fullness associated with youth, and when light hits our face, the underlying tissue or subcutaneous fat appropriately absorbs the light, and we have a soft, alert, natural appearance.  However, when we have dark circles under our eyes there is not enough fat to interact with the light that hits it.  Instead, the light is absorbed by the dark muscles and blood vessels under the eye, which is what causes the dark area that makes us appear tired and worn out.  You may be full of energy, but as long as you do not have enough tissue just beneath your eyes, they will look hollow. Covering them with makeup, sleeping in late, or taking multivitamins will not correct this look, because in the end you still have not addressed the tissue concern.

Effective Treatment Addresses Underlying Problems

Treating under eye hollows must address the cause.  While BOTOX is a safe and excellent option for many facial concerns and may compliment a dark circle treatment by restoring an overall balance to your face, BOTOX alone is not the answer to resolving your issue with dark circles.  What we have found to be the most effective in this area under eye Restylane, an effective non-surgical approach, and, when surgery is appropriate, a vertical midface lift with a hand-carved orbital rim implant .

The vertical midface lift is a powerful surgery that restores natural balance to your face and resolves the under eye hollow by lifting the soft cheek tissue back into the area under the eye and lower eyelid, where it belongs.  After this procedure, most people find that they not only look more alert instead of worn out, they also look much younger!  The surgery corrects the harsh edges and imbalance of facial tissue that has been brought on by gravity and time.  The reason the results appear so natural is because this cosmetic facial surgery restores your natural facial structure.  For this reason, this approach is often used to address issues from prior unsatisfactory lower eyelid surgery.  Dr. Steinsapir will assess you to determine the best options for your goals.

Deepfill Restylane is Dr. Steinsapir’s method for correcting dark circles.  Dr. Steinsapir developed this minimally invasive, nonsurgical method with those in mind who may not feel they are ready for surgery due to personal reasons.  It is also a great option for those who have less severe hollows.  Restylane is the most effective facial filler in the sensitive area around the eye, making up for the marked tissue deficiency

Finding the Best Advice

The best person to help you understand whether Restylane, a midface lift, BOTOX, or another procedure is right for you is an experienced facial cosmetic surgeon who specializes in these treatments.  We invite you to consult with Dr. Steinsapir, one of the best cosmetic surgeons in Los Angeles who specializes in both oculofacial plastic surgery and minimally invasive cosmetic surgery.  Dr. Steinsapir strives for a natural appearance that takes into account the entire facial balance, obtaining results that work for your individual features.  He has innovated Microdroplet BOTOX and Deepfill Restylane, and he can help you find a treatment plan that is best for you.  Please contact us today to schedule your private consultation.

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