Q:I have noticed that my eyelids are showing signs of increasing laxity. What can I do to tighten the skin of my eyelids without having eyelid surgery?

A: During the past four years, there have been dramatic and revolutionary advances in laser technology. By applying these new technologies to the eyelids, it has become possible to rejuvenate and tighten the eyelid skin in nearly all patients without surgery.

Patients who only have mild eyelid laxity are best treated with the eyelid Thermage procedure. Eyelid Thermage is a procedure that tightens the eyelid skin and deceases eyelid hooding and wrinkling. Only one treatment is needed and there is no downtime. Patients who have had eyelid Thermage report that their eyelid sagging is improved and both the upper and lower eyelids are tighter. The eyes look brighter and appear more open.

Eyelid Fraxel is intended for patients who have developed moderate laxity and crepiness of the skin of the upper and lower eyelids. The procedure tightens the skin more than Thermage, reduces skin crepiness, softens lines and wrinkles, and produces an overall skin rejuvenation effect. There are two ways of performing eyelid Fraxel.

The first method, known as traditional Fraxel laser resurfacing, is done as a series of four or five treatments given at monthly intervals. These treatments have no downtime. Alternatively, patients may consider the Eyelid Fraxel Repair procedure. Eyelid Fraxel Repair has the advantage of completing the eyelid rejuvenation in a single treatment. Patients who undergo Eyelid Fraxel Repair should be prepared for four to five days of healing following the procedure.

Eyelid Thermage, traditional eyelid Fraxel, and eyelid Fraxel Repair all work by stimulating new collagen production. This new collagen is living tissue, and for this reason, the improvement in the eyelids following these treatments should persist for years.

Regardless of which technology is used to treat the eyelids, the rejuvenation may be further enhanced with Botox and dermal fillers. By combining Thermage or either of the two Fraxel lasers with Botox and dermal fillers, our patients achieve very natural eyelid tightening and rejuvenation without undergoing surgery. We welcome all patients to our office who wish to rejuvenate the skin of their eyelids without surgery.

Q: I have noticed that the skin on my face is showing signs of increasing laxity. What can I do to tighten the skin on my face without having a facelift?

A: Up until recently, the only option for tightening the facial skin was a surgical facelift. However, many patients were unwilling undergo the risks and recovery downtime associated with facelift surgery. For these reasons, new and innovative techniques have been developed in recent years that tighten the skin of the face without the need for surgery.

Thermage is a very good procedure for tightening the skin in patients who have relatively minor amounts of facial laxity. Thermage procedures have no downtime. Patients resume all of their normal activities, including work and exercise programs, immediately after leaving the office. The optimum result is obtained approximately four months after the Thermage procedure. Thermage can be used to tighten the skin of the face, eyelids, and neck.

When patients have greater degrees of laxity, Thermage should be combined with a dermal filler such as Juvederm or Restylane. The dermal filler provides additional lifting of the cheeks and softening of the folds on the face. The use of Thermage and dermal filler together will give a completely natural appearing facial rejuvenation.

For patients who wish to achieve greater non-surgical skin tightening, we recommend the Fraxel Repair laser. The Fraxel Repair laser is without doubt our most effective non-surgical tissue tightener. Fraxel Repair treatment results in visible skin tightening and significant improvement in wrinkles, fine lines, and pigmentation in the treated areas. The skin heals with an improved texture. The result is smoother, tighter, and younger looking skin. Usually, only a single treatment is needed. However, some patients may wish to undergo a second procedure to further enhance their results. Fraxel Repair treatment does have some downtime. A full-face treatment generally has approximately five days of downtime.

Today™s options for non-surgical skin tightening are truly excellent and result in completely natural appearing facial rejuvenation! We welcome all patients to our office who would like to tighten their facial skin without surgery and achieve completely natural appearing facial rejuvenation.

Q: I have fat bulges on my tummy, sides of my waist, inner thighs, and back that will not go away with diet and exercise. What are my options for removing the fat bulges?

A: Up until recently, the only available options for reducing body fat to improve the contour and shape of the body were liposuction and other invasive and aggressive surgical techniques. For those individuals willing to undergo an invasive procedure, liposuction remains a good option to remove fat bulges. However, medical science has now developed techniques to reduce fat and improve the contour and shape of the body using non-invasive non-surgical methods. These techniques have the advantages of being extremely safe and having no recovery downtime.

The Zeltiq Procedure is a new non-surgical method of reducing fat to improve body contour and shape. The Zeltiq Procedure reduces fat by cooling it. Ideal candidates for the procedure have discrete and localized fat bulges on the abdomen, love handles, inner thighs, and back. Zeltiq is especially helpful when the fat bulge cannot be reduced by diet and exercise. Zeltiq treatments result in noticeable and natural looking fat reduction in the treated areas. There is absolutely no down time after the procedure, and most patients resume all of their normal activities, including returning to work and exercise regimens, on the same day as the procedure.

The procedure is done by applying the Zeltiq applicator to the fat bulge for one hour. During this time, the applicator chills the fat. The exposure of fat cells to cooling begins a process of natural fat cell removal. Patients remain very comfortable during the time the applicator is on the skin and may do whatever they wish during this period, including reading, working with their electronic devices, or listening to music. The visible reduction in fat will appear gradually over the next two to three months following the procedure.

The Zeltiq Procedure represents a new and very exciting way of accomplishing fat reduction in a completely non-invasive manner! Because of its safety, consistent results, and easy recovery, we expect Zeltiq to become a very popular method of reducing fat. Anyone desiring removal of fat bulges to improve the contour and shape of their body should give consideration to this new method of non-surgical fat removal.