Blepharoplasty (Eyelid Surgery)

If you are in your 30s or early 40s, you may already have noticed your upper eyelids starting to sag. Puffy "bags" may be forming beneath your lower lids, as well. As you move through your 40s, the eyelid sagging can worsen, and eyelid wrinkles may begin to form.

These changes occur because over the years, eyelid skin thins out and loses tone and becomes more susceptible to the unyielding force of gravity. The fat that cushions the eyeball gradually herniates forward, causing bags in both eyelids. Additionally, the muscle responsible for opening the eyelid can become over-stretched, causing the lid's natural position to drop. Sagging upper eyelids may result in hooding over the eyes.

As a result, your eyes look smaller and your face looks older and more tired.

To correct premature aging of the skin around the eyes, plastic surgeons perform eyelid surgery, also known as blepharoplasty or eyelid-lift. The procedure can rejuvenate your whole face by removing excess fat and, if necessary, excess skin and muscle from the upper and lower eyelids. An outpatient procedure, blepharoplasty is sometimes performed in conjunction with a brow-lift or face-lift.

Blepharoplasty achieves several goals: it tightens droopy or hooded eyelids, restores contour to the lids, and eliminates fatty bags under your eyes.

After surgery, your eyes will appear bigger and brighter, giving you a more alert, youthful appearance. Blepharoplasty is the second most popular facial cosmetic procedure in the United States.

Facelift

Also known as a rhytidectomy, a facelift is a surgical procedure that eliminates excess fat, tightens loose muscles underneath the skin and removes sagging skin. It is most effective for the lower face (jowls and neck). Many facelifts are done in conjunction with other procedures including forehead lifts, eyelid surgery, chemical peels and laser resurfacing. While a facelift cannot stop the aging process, it can often 'set the clock back' for a decade or longer.

A mini-facelift is a modified version of a facelift. In general, mini-facelifts are performed on younger patients who do not require extensive correction to their face and neck. With a mini-facelift, the surgery itself is not as involved and the amount of scarring, swelling and discoloration is not as extensive.

 Chemical peels

Day in and day out, our skin takes a lot of abuse. The sun is our biggest enemy, sending a relentless barrage of harmful UV rays causing skin to prematurely age and wrinkle. (And we’re still sun-worshippers—go figure!) Environmental pollutants stress the skin even more. Add on the effects of aging, and it’s no wonder that we look in the mirror and see wear and tear that we’d like to reverse.

More and more women and men look to their plastic surgeons for skin revitalization and resurfacing to regain a fresher, more healthy and young-looking complexion. Chemical peel, one such revitalizing treatment, is extremely popular; thousands of chemical peels are performed by plastic surgeons each year. In fact, it’s cited as one of the top five cosmetic procedures for women by The American Society of Plastic and Reconstructive Surgeons.

The results of a chemical peel can be very impressive.

There are different types of chemical peels which produce different results, but all are similar in this respect: a chemical solution is applied to remove the damaged outer layers of skin so that new, regenerated skin replaces the old. As a rule, the deeper the peel, the more profound the results and the longer the recovery time.

Light Peels

Alphahydroxy acids (AHAs) include glycolic, lactic, or fruit acids, and are mild chemical solutions that lightly peel skin, often resulting in brighter-looking, smoother skin. These "lunch hour" peels are often done repeatedly over time, and can even out fine wrinkling, uneven pigmentation, and smooth out rough, dry skin or a mild acne problem.

Medium Peels

Trichloroacetic acid (TCA) is used when a medium depth peel is indicated for skin that has moderate sun damage, fine lines and weathered skin. TCA peels can correct pigment problems and superficial blemishes, and sometimes two or more treatments, spaced out over weeks or months, are required for best results. A full-face TCA peel usually takes about 15 minutes. The Obagi or "Blue Peel" is one specific brand you may hear of.

Deep Peels

Phenol acid is the strongest of the chemical solutions and causes a deep peel. A phenol peel is a drastic, one-time procedure that offers dramatic and long-lasting results. Anyone with extensive wrinkling, lots of brown age spots, mild scarring or with pre-cancerous growths, could be a candidate for this procedure. A full-face phenol peel can take from one to two hours. The phenol peel results in permanently lighter skin. To protect it, a sunblock must be used at all times.

After evaluating the condition of the patient’s skin, skin type and the severity of discoloration and wrinkling, your plastic surgeon can determine which type of chemical peel is right for you. Most peels can be performed on the face, neck, chest, hands, arms and legs.

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Neck Liposuction

Liposuction, also known as lipoplasty or suction lipectomy, is the process of removing unwanted fat from specific areas of the body. The most common treatment areas include the upper thigh area known as 'saddle bags', the abdomen, the flanks and love handles. Other treatment areas include facial accumulations of fat, double chins, hips, buttocks, thighs, knees, arms and ankles. For men, liposuction can be used to correct gynecomastia (enlarged breasts). While no method of liposuction is a substitute for good nutrition and physical exercise, liposuction can remove stubborn areas of fat that won't respond to traditional weight loss methods.

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Dermabrasion

For at least fifty years, we have been a nation of sun worshippers. We’ve basted and baked our faces and bodies on beaches, in back yards, and now, in tanning booths. The very thing that we have equated with a healthy look, has, in fact, had the opposite effect. We now know harmful UV rays are the cause of premature wrinkles, uneven skin coloration, and pre-cancerous growths.

More and more women and men look to their plastic surgeons for skin revitalization and resurfacing to regain a fresher, more healthy and young-looking complexion. Dermabrasion, one such revitalizing treatment, can reverse the outward signs of aging as well as improve the appearance of acne scars and remove pre-cancerous keratoses. In addition, dermabrasion is useful in treating skin problems such as unwanted tattoos, scars caused by chicken pox or accidents, and other disfiguring conditions.

During dermabrasion surgery, the plastic surgeon uses a high speed rotating abrasive brush or diamond-impregnated burr (kind of like a mini-sander) to remove the outermost layers of damaged skin. The doctor controls how much skin will be removed and determines how deeply to penetrate the skin layers depending upon the degree of wrinkling or scarring. This abrasive or planing action evens out the skin, and a new layer of smoother, fresh skin will emerge.

Dermaplaning is a deeper planing of the skin often indicated when scars are very deep and/or crater-like. The surgeon uses a dermatome, an instrument which has an oscillating blade, to evenly skim off layers of skin to make the scarred area more even with the surrounding skin. Dermaplaning might be used in conjunction with dermabrasion, or other procedures such as face lift or chemical peel.

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Skin Resurfacing with Erbium-Yag Lazer

Today we’re a lot more savvy about the harmful effects of the sun on our skin. Skin experts have educated us on the importance of using sun protection to avoid the ravages of damaging UV rays. Many of us were part of a real outdoor generation that worshipped the sun. As kids, we suffered frequent sunburns. As teens, we purposely baked and basted our skins to achieve a deep, dark tan.

Ultraviolet injury is cumulative over a lifetime. Add the effects of aging, gravity, and environmental pollutants—you’re faced with wrinkles, brown spots, light or dark discoloration, roughness, sagginess. And of course, sometimes our skin problems can be blamed on accidents, illness or nature.

More and more women and men look to their plastic surgeons for skin revitalization and resurfacing to regain a fresher, more healthy and young-looking complexion. Laser resurfacing (also called laser peeling) is one such resurfacing treatment often favored when skin problems are moderate to severe—wrinkles especially around the eyes and mouth (crow’s feet and lipstick lines), uneven pigmentation including port-wine birthmarks, skin blemished with scars from accidents or acne, and some tattoos. The procedure can be done in conjunction with another cosmetic procedure such as a facelift or eyelid surgery.

A laser is a high-energy beam of light that can selectively transfer its energy into tissue to treat the skin. In simplest terms, it’s another tool the plastic surgeon can use—a high-tech scalpel, if you will, that allows for great control and finesse. Some skin problems are best treated using a laser, and some conditions are better treated using another method or technique.

Laser devices are used to remove damaged upper layers of skin, allowing a fresh layer to emerge. Two types are often used: the carbon dioxide (CO2) laser and the Erbium:YAG laser. They work in slightly different ways and are selected for use for specific situations.

Though still a fairly new surgical method, laser resurfacing has been shown to produce less (if any) bleeding, bruising and post-operative discomfort than is typically seen with other resurfacing techniques.

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