Facial Surgical Procedures: Stack Treatments for Better Results

The delicate skin around the eye is highly susceptible to signs of aging. Colorado board-certified plastic surgeons Dr. Steven Vath and Dr. Andrew Wolfe go over how procedures including upper and lower eyelid surgery (blepharoplasty), brow lift, BOTOX® Cosmetic, dermal fillers, Pearl fractional laser and intense pulsed light (IPL) can be used to rebuild a youthful and rested appearance to the eye area.
Eyes that appear weathered can be traced back to a number of different factors; allergies, exuberant facial expressions, age, and environmental factors like allergies. The skin around the eyes is thin to begin with, and as the body ages, this skin becomes even thinner. This may lead to various signs of aging around the eyes, most often in the form of dark circles, crow's feet, and puffiness.
Several procedures exist, both surgical and nonsurgical, to help remedy these signs of aging. Common treatments such as BOTOX® Cosmetic and dermal fillers are used to improve wrinkles and crow's feet; blepharoplasty is used to alleviate sagging and puffiness; Pearl fractional laser tightens the skin around the eyes and improves tone and texture and intense pulsed light (IPL) is used to help improve dark circles under the eyes. These procedures are available a la carte, but your surgeon may recommend having them all performed at the same time to optimize results for your facial rejuvenation.

Blepharoplasty
Blepharoplasty (upper and lower eyelid surgery) trims excess fat and skin around the eye to eliminate any "puffiness." Above the eye, excess skin that causes a "hooded" appearance can be eliminated, while below the eye, pockets of fat can be removed and the skin adjusted for correction of undereye "bags." Incisions are almost undetectable after surgery, particularly in the case of lower blepharoplasty surgery using the transconjunctival technique, which places the incision entirely inside the lower eyelid. Blepharoplasty can contribute drastically to a happy and rejuvenated appearance.

Brow Lift
A brow lift is performed a variety of ways; the endoscopic approach or a traditional technique. This procedure is helpful for smoothing the forehead and lifting the eyebrows for a more alert and youthful look. A traditional or coronal brow lift, no longer widely performed, requires an incision that spans from ear to ear across the scalp, and is best suited in cases of significant skin laxity. An endoscopic brow lift uses smaller incisions and an endoscope (a tiny camera) to achieve results very similar to the coronal technique with fewer incisions. The mini brow lift is even less invasive (just small incisions in the hairline near the outer portion of the eyebrows) and focuses on improving the outer brow.

BOTOX® Cosmetic
When we make repeated facial expressions, the muscles used to make them can create lines and wrinkles, commonly called frown lines or crow's feet. With the addition of aging and the loss of skin elasticity, these wrinkles can become more prominent and obvious. BOTOX Cosmetic is a non-surgical treatment that works to block the nerves that cause the facial muscles to contract. It is carried out in targeted areas of the face using a very fine needle, relaxing the target muscles for a rejuvenated facial appearance.

Dermal Fillers
Dermal fillers are a non-surgical approach for reducing the appearance of wrinkles and folds in the face. Fillers also add vibrancy to the skin, filling and smoothing lines and wrinkles from under the skin. Treatments are similar to BOTOX in that they are injected using a fine needle and are relatively quick, however fillers produce immediately visible results. Deciding between the menu of dermal fillers available can be tricky, the decision is best made with your doctor to determine the best product for your procedure.

Pearl Fractional Laser
The Pearl fractional laser is a fractional laser that is used for boosting the skin tone, and is particularly effective in caring for the delicate skin around the eyes. Emitting a patented wavelength of light, the Pearl fractional laser is used on a fraction of the skin in a pattern of "dots," leaving the skin in between unharmed. The body works to repair the treated area, regenerating cells and rebuilding collagen. Patients who have the Pearl fractional laser treatment have reported younger-looking skin around the eyes within a week of the appointment. Pearl fractional laser can be used on its own or combined with a surgical procedure such as blepharoplasty or a brow lift.

Intense Pulsed Light
Intense pulsed light (IPL) is used to treat a wide array of skin ailments, including thin skin around the eyes. This thin skin can create a tired look to the eyes and expose the blood vessels beneath its surface. When these blood vessels swell, they prompt the appearance of dark circles underneath the eye, which can, in turn, lead to an overall sleepy or aged appearance. IPL works by using pulses of light to treat specific areas of the face, which can result in refreshed and rejuvenated looking skin.

Comprehensive Rejuvenation
Although each of these procedures can be performed alone and can help to reclaim the skin around the eyes, but the purpose of this article is to highlight how combining treatments can often be the best recipe for success. For example, eyelid surgery can be combined with BOTOX Cosmetic to achieve a more attractive look along with softened lines around the eyes. Because each procedure targets a particular cosmetic improvement, combining these procedures can result in comprehensive eye rejuvenation, leading ultimately to a more confident and happier you.

Special thanks to Steven Vath, MD and Andrew Wolfe, MD of Rejuvenate! Med Spa. Visit their website for more information about Colorado skin care.