 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
|
In other patients, the concern is drooping of the eyebrows, also known as lateral hooding. This phenomenon is usually the result of altered tone in the muscles of the forehead, and increased elasticity of the skin. Other characteristics of this condition include horizontal furrows in the forehead, or deep vertical creases between the eyebrows (frownlines). Laterally, this laxity can contribute to the prominence of "crow's feet." In this patient population, trimming of eyelid skin is not sufficient to correct the problem. Instead, for these individuals, a forehead lift is likely to provide the most satisfactory results. You can look at a mirror in your home and determine whether you may be a candidate for such a procedure. Place the fingers of your left and right hands several inches above the left and right eyebrows, respectively. Now, gently exert upward traction to raise the eyebrows by half an inch, or so. If this maneuver reverses the upper lid laxity and "opens up" your eyes, then the forehead lift may offer the greatest likelihood of a satisfactory result. The forehead lift involves placement of one or more incisions that are hidden in your hair. These incisions provide access to the area beneath the skin and muscles of the forehead. The procedure can be done in the traditional manner ("open") or through tiny incisions that allow placement of fiberoptic cameras (endoscopes) for visualization. Tissues are re-positioned superiorly resulting in elevation of the forehead, eyebrows, and lateral eyelid skin. In some cases, excess skin is trimmed away. In other instances, stitches are placed beneath the surface to secure the skin in a new position. A brow lift is a procedure that can be performed alone or with another procedure. Generally, this type of surgery is completed when the patient is under anesthesia. Most patients prefer to go home on the same day. However, if several procedures are scheduled, you may be more comfortable staying overnight. Dr. Wall will make a recommendation during your consultation. Overall, this procedure can take years off of an individual's appearance. When the swelling has receded you'll be delighted by the change. Friends will comment that you look more refreshed and rested. Your eyes will no longer be hidden. The worry lines of the forehead will be far less prominent. And best of all, the results of your surgery will last for years to come.
Blepharoplasty Universally, the eyes are considered to represent one of our most attractive features. However, as we age, the skin and tissues around the eyes are among the first to show the passage of time. The eyebrows droop, folds develop on the upper lids, fine lines appear at the corners, while bags or dark discoloration appears beneath the eyes. Of course, not everyone experiences all of these changes. Certain features are accentuated by hereditary factors, weight gain, or smoking. Many patients are alerted to these changes because friends comment that they look tired. In other patients, a furrow between the brows gives them a stern or an angry appearance. For those in the business world, they desire the "edge" that is provided by looking younger and healthier. Fortunately, many procedures are available that can refresh the eyes and restore a more youthful appearance. Cosmetic eyelid procedures are one of the most frequently performed procedures in females, and the most commonly performed aesthetic surgery in males. During your initial office visit, Dr. Wall will inquire about your medical history (e.g., high blood pressure, thyroid disease), and about any specific "eye symptoms" that you may be experiencing (e.g., dry eyes, allergies, light sensitivity). Photographs will be taken from a number of vantage points to assist in explaining features unique to your anatomy. Dr. Wall will then assess the thickness, texture and elasticity of your skin, the severity of wrinkles and folds, the tone of the facial muscles, the prominence of the cheek bones, and the shape of the nose. These photographs will assist in explaining how a person's facial anatomy "frames" the eyes. And, depending upon what features are of concern to you, Dr. Wall will review the options available for transforming your appearance. For patients concerned about redundant skin in the upper eyelids, a procedure is available to remove excess tissue (while concealing the incision in a natural crease in the upper lid). For those individuals with central furrows, an injection of BOTOX® may be sufficient to soften the appearance. Deeper lines and crease ("crow's feet") are best managed with laser resurfacing or light acid peels (e.g., "fruit acids"). In cases where prominent "bags" or pouches are present below the eyes, a procedure is available to reduce the size of the "fat pads" which cause this deformity. A small incision can be placed on the inside surface of the lower eyelid to gain access to these pads. (An external skin incision is not required). Other patients are displeased by the "lateral hooding" which is caused by sagging eyebrows, as well as the skin and muscle located above the eyes. This "heaviness" is best addressed by raising the eyebrows through small incisions placed at the top of the forehead. If an incision is required, the stitches will be removed after four or five days. The incision lines fade over several months. With surgery around the eye area, the most common post-operative symptoms are swelling and bruising. The degree to which you may be affected by these symptoms depends upon the procedure, whether you bruise easily, and whether you take certain medications (e.g., aspirin). For the great majority of patients, bruising resolves within a week. Make-up can be applied until the last traces have resolved. Some "puffiness" may remain around the eyes for two to three weeks. Until the swelling has completely disappeared, you may notice some dryness or altered tearing. You may find your eyes are temporarily sensitive to light. Dr. Wall may recommend eye drops to relieve burning or itching. You may find it helpful to wear sunglasses for a couple of weeks to protect your eyes from the wind and sun. Most patients are able to return to work or to social engagements in seven to ten days. Friends will recognize that you look rested or refreshed. Rather than being hidden, your eyes will once again reflect the vitality that you feel inside.
|
When someone is unhappy with the appearance of their eyes, it is important to identify the particular features that are of concern. Typically, the appearance of "heaviness" about the eyes is the result of either of two factors. The first is redundant upper eyelid skin. This problem is best addressed with the 
During your office appointment, Dr. Wall will review the merits and limitations of each approach. Photographs will be taken from a number of vantage points to assist in explaining features unique to your anatomy. Certain procedures are better suited for particular groups of patients. For example, in younger patients, an injection of Botox in the central area is often sufficient for softening frownlines. In patients with excess skin laxity, an open approach may be preferable, as extra skin can be removed. Again, these approaches all share the advantage of concealing incisions above the hairline. However, in patients with a relatively high hairline (or in men with a receding hairline) Dr. Wall has to be more cautious than in someone with a lower hairline. By straightening the wrinkles and elevating the brows,
there is the risk of pushing the hairline back further on the head. This is not an acceptable appearance, particularly for women who wear their hair back (rather than down over the forehead). 
The eyes have long been recognized as the "windows to the soul." They reflect our moods and emotions. They can be bright or dark, joyous or sad, alluring or angry. Although similar in everyone, they are unique to each of us. 
