Question: I know eyelid surgery is sometimes performed for medical reasons if sagging upper eyelids interfered with vision. Is this ever true for browlift surgery?

Answer: Occasionally a patient will have such low-set brows that a standard blepharoplasty alone is not going to be able to completely improve their visual deficit.  In that case, a browlift in conjunction with the blepharoplasty may be covered by insurance though frequently it can be difficult to get the insurance company to pay for that treatment.

No Comments »

Question: What is a lower eyelid “skin pinch”?

Answer: Lower eyelid skin pinch is a procedure where excess skin is removed in the lower eyelids.  This is typically performed in patients who do not have true bags in the lower eyelids, but they have a significant amount of wrinkling due to redundant skin.  The procedure is performed as it is described where local anesthetic is placed under the skin and then a small device is used to pinch the skin allowing us to determine exactly how much excess skin is safe to remove.  This excess skin is then removed and very fine sutures are placed to close this small incision.  The sutures are removed in three or four days and the resulting scar is just below the eyelashes and once healed is exceptionally inconspicuous.

No Comments »

Question: I keep hearing about something called laser blepharoplasty. Can you explain what this is? Is it still surgery?

Answer: A laser blepharoplasty is a relatively standard blepharoplasty procedure that simply uses a CO2 Laser to make some of the incisions and to help with coagulation.  I have not seen any good head-to-head studies showing a significant advantage using a laser and, in fact, theoretically the CO2 Laser will actually cause surrounding thermal injury that would be unwanted in most circumstances and I, therefore, continue to employ a more standard approach of using a very fine scalpel for skin incisions and super sharp scissors for any tissue treatment under the skin.  A jeweler’s forceps bipolar cautery is used to precisely control any very minor bleeding and this, therefore, limits the surrounding injury and tissue damage and, in my opinion, allows for a faster recovery.  The majority of my patients look quite good in three to four days when their sutures are removed.

No Comments »

Question: I had eyelid surgery approximately two years ago, now I have small wrinkles under my eyes. Is this normal? I recently moved to Milwaukee and would like to know if you can remedy this and if it would require another surgery.

Answer: It is certainly not unusual for people to have a small amount of wrinkling under their eyes after a blepharoplasty since that is highly dependent on the patient’s skin elasticity as opposed to skin excess.  I would have to evaluate you personally to determine whether or not you do truly have a skin excess or if it is just the inability of the skin to rebound when you squint, but there are options available that would not require you to undergo another surgical procedure.  One would be some sort of laser resurfacing where the skin is treated to improve the collagen in the skin and this will then in turn improve skin texture, tightness, and wrinkle reduction.  For a no downtime option, Ultherapy can actually be used on the lower eyelid skin especially the newer transducer that treats 1.5 mm below the surface.  The results are not as significant as a full laser resurfacing but, considering there is absolutely no downtime involved with it, it certainly is still an option.  If you do have a significant amount of excess skin causing the problem then you may want to consider a simple in office pinch procedure to the lower lids where the excess skin is removed, sutures are placed, and these are removed in three or four days.  As you can see, there are a variety of options depending on your particular problem and tolerance of any downtime and I would, therefore, recommend a consultation with a board-certified facial plastic surgeon.   

No Comments »

Question: I would like to get blepharoplasty and a mini facelift. Can I do them at the same time or should I do one before the other?

Answer: A blepharoplasty can easily be performed at the same time as a mini lift and, in fact, it is very common for me to perform eyelid surgery in conjunction with mini lift procedures.  The eyelid sutures are typically taken out in three to four days while the mini lift sutures are taken out in six or seven days.  Most patients look quite good after that first week and are ready to return to nonstrenuous activities.

No Comments »