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: What can I do to give my face a more youthful look without undergoing surgery?

A: Many people today are concerned about the cosmetic appearance of the vertical lines between their eyebrows. These lines result from repeated contraction of the muscles in this area. When the muscles between the eyebrows contract, they draw the eyebrows together, causing the skin to furrow, fold, and wrinkle. Botox improves these lines by blocking the contraction of these muscles and relaxing them. As a result, the vertical frown lines between the eyebrows are much improved.

The discovery that Botox improved the cosmetic appearance of the vertical frown lines led to the FDA approving the use of Botox for cosmetic purposes in 2002. Since then, Botox has been found to be effective for many other cosmetic indications. For example, virtually everyone is also familiar with the ability of Botox to reduce horizontal forehead lines and the crow's feet lines around the eyes. In addition, when properly placed, Botox can be used to elevate the eyebrows to give a brow lift, soften the vertical lines in the upper and lower lip (called smoker™s lines), turn up the corners of the mouth, relax the bands and wrinkles in the neck, and soften lines and wrinkles around the nose and chin.

Botox is administered with an ultra-fine needle into the treated areas. Discomfort is minimal and no anesthesia is required, although patients may have numbing cream if they wish. What is most important is to not overdo the treatment in order to retain a relaxed look with natural facial movements. Patients return to their normal activities immediately after leaving the office.

Botox is extremely safe when used in the very tiny doses that are required for cosmetic procedures. Due to its safety and consistently excellent results, Botox has become one of the main pillars of non-surgical facial rejuvenation. Over two million Botox treatments are given each year in the United States. Treatment with Botox has become the single most popular cosmetic procedure in this country and around the world.

We welcome all patients to our office who would like to have a more youthful appearance without undergoing surgery. Botox, when used at the proper doses and in the correct locations, plays an important role in accomplishing this goal.