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

More and more patients are turning to physicians to help them achieve a more youthful appearance. One of the cornerstones of modern facial rejuvenation is the use of dermal fillers. With the correct dermal filling agent, folds can be softened, lines and wrinkles made much less noticeable, and the face sculpted to give a much more youthful appearance.

All human beings have in their skin a naturally hydrating substance called hyaluronic acid. As we age, hyaluronic acid is lost from the skin. This results in facial wrinkles and deepening folds, and contributes to the jowly look that appears on the face with the natural aging process.

Dermal fillers that contain hyaluronic acid replace the hyaluronic acid that the skin has lost. Two commonly used dermal fillers that contain hyaluronic acid are Juvederm and Restylane. These dermal fillers are injected under the skin in a short office procedure that has no downtime. The procedure has become much more comfortable recently by formulating the hyaluronic acid gel with lidocaine, a commonly used anesthetic. These dermal fillers provide completely natural looking facial rejuvenation in an extremely safe manner. Wrinkles and folds are softened, the skin is smoothed, the lost volume is restored, and the cheeks are elevated. The results generally last for eight to twelve months.

In addition to the loss of hyaluronic acid, the skin also loses collagen during the aging process. Therefore dermal fillers that contain collagen can also be used for facial rejuvenation. Cosmoderm is a commonly used collagen-based dermal filler. Cosmoderm is unique in that it is the dermal filler that can be safely placed closest to the skin surface. For that reason, it is often used to soften the fine etched-in lines in the skin. Cosmoderm is often used in combination with dermal fillers containing hyaluronic acid.

Many other types of dermal fillers are also available, such as Sculptra and Radiesse. What is most important is to select the correct dermal filler based on each patient™s unique facial appearance.

We welcome all patients to our office who would like to achieve a more youthful facial appearance in an extremely safe and non-surgical manner. Dermal fillers, when properly used, play a major role in accomplishing this.

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. Today, surgery only needs to be done on the most severely aged eyelids.

In order to match the correct eyelid rejuvenation procedure to the right patient, we divide the eyelid skin into three degrees of laxity: mild, moderate, and severe. Patients who only have mild eyelid laxity are best treated with the eyelid Thermage procedure. Eyelid Thermage is a procedure that smoothes the texture of the eyelid skin and deceases eyelid hooding and wrinkling. Patients benefit from a single treatment that has no downtime. Patients who have had eyelid Thermage, which is also known as the “Eyes by Thermage” procedure, report that their eyelid sagging is improved and both the upper and lower eyelids are tighter. The eyes look brighter and appear more open. In addition, the improved smoothness of the skin makes it easier to apply eye make-up.

Eyelid Fraxel is intended for patients who have developed moderate laxity and crepiness of the skin of the upper and lower eyelids. The procedure reduces skin crepiness, softens lines and wrinkles, tightens the skin, and produces an overall skin rejuvenation effect. The eyelid Fraxel procedure utilizes Fractional Resurfacing Technology. The laser delivers a series of closely spaced laser spots to the skin while preserving normal healthy skin between the laser spots. This preservation of normal untreated skin between the laser spots results in rapid healing after the treatment. Traditional Fraxel laser resurfacing is generally done as a series of four or five treatments given at monthly intervals. The eyelid treatment is generally done in conjunction with Fraxel laser treatment of the face. The procedure has minimal or no downtime. After completing their treatments, patients can reliably expect the skin to look more youthful and rejuvenated.

Patients with more severe laxity are best treated with the Fraxel Repair laser. With the Fraxel Repair, patients obtain significant tightening of their eyelid tissues in a single procedure, which is a welcome advance. Fraxel Repair eyelid treatment can be done by itself or it may be combined with treatment of the face. Patients who undergo Fraxel Repair treatment should be prepared for three to five days of healing following the procedure.

Eyelid Thermage, eyelid Fraxel, and Fraxel Repair all stimulate the production of new collagen in the eyelid skin and promote tissue tightening. This new collagen is living tissue, and for this reason, the improvement in the eyelids following any of these treatments is long lasting and 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. Botox is used to soften the lines around the eyes (crow’s feet lines). Dermal fillers such as Juvederm and Restylane are used to soften the depressions and folds that form below the eye (known as the tear trough). By combining Thermage or either of the Fraxel lasers with Botox and dermal fillers, nearly all of our patients can achieve very natural eyelid tightening and rejuvenation without undergoing a surgical procedure.

We invite any of our patients who may be interested in non-surgical eyelid rejuvenation to contact our office and make an appointment with either Dr. Amerian or Dr. Anterasian.

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