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THE “EYES” HAVE IT
By: Andrea Strauss, M.D. F.A.C.S.
The eyes are our windows to the
world. We see out and others
look in. They are our most
revealing feature, conveying
both our physical and emotional
states. Are they open and invit-
ing or pursed and angry? Are
they droopy and tired or lush
and sensual? When mascara,
eyeshadow and concealer are
no longer enough to mask the
signs of aging or hide the flaws
we inherit, there are several rel-
atively simple solutions.
Starting around age 25, we
begin to develop loose skin of
the upper eyelids. Mild skin
excess can be improved nonin-
vasively by a one time procedure
known as Thermage (radiofre-
quency skin tightening), per-
formed in the office and involv-
ing no downtime. As skin laxity
progresses, the skin can hang
over the eyelashes and the eye-
lids droop. This not only makes
us look tired and old but actual-
ly interferes with vision. Surgi-
cally removing this excess skin
through an incision in the crease
of the eyelid creates a more rest-
ed, youthful appearance and
restores vision in upward gaze.
This procedure, called an upper
blepharoplasty can be per-
formed outpatient in the hospi-
tal under intravenous sedation
or in the office with oral seda-
tion and local anesthesia. Most
insurance companies consider
this procedure medically neces-
sary when an automated visual
field study (performed by an
Ophthalmologist) shows the
blind spot in upward gaze and
how it improves when the extra
skin is taped up.
A lower blepharoplasty (lower
eyelid surgery) is performed not
for extra skin but for “bags”
under the eyes. This puffiness is
actually fat bulging out from
under the eye. The surgery is
performed outpatient in the
hospital under intravenous seda-
tion and is not covered by insur-
ance. The bulging fat is removed
through an incision just below
the eyelashes. Mild puffiness
can be camouflaged with the
use of temporary fillers such as
Restylane, or collagen stimula-
tors such as SculptraAesthetic.
Wrinkling or crepiness of the
lower eyelid is not an indication
for surgery but can be mini-
mized with Thermage, laser or
products such as Relastin EyeSilk
which is applied to the skin
twice a day.
When eyelashes are short or
sparse they can be improved
with a product called Latisse.
Applied nightly to the base of
the lashes for 2-4 months then
once or twice a week, the lashes
become thicker, longer and dark-
er. Latisse can also be used on
the eyebrows. When daily appli-
cation of eye makeup is too time
consuming or too difficult, per-
manent cosmetics (tattoo eyelin-
er or eyebrow) is also an option.
To find out more about proce-
dures and products to enhance
the eyes call our office: Plastic
Surgical Associates at (908) 725-
4600
for information or to make
an appointment.
Andrea Strauss, MD FACS is
Board Certified by the American
Board of Plastic Surgery with a
private practice at 11 Monroe
Street in Bridgewater, New Jersey.
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