What Happens to Our Eyelids as We Get Older?
As we age, several changes occur in our eyelids. The thin skin of our eyelids stretches and becomes more redundant,
resulting in excess folds of skin that may actually hang down over the edge of the upper eyelids. This condition is
The muscles beneath the skin also grow weaker, allowing fat to protrude through and cause "bags", which are
particularly noticeable in the lower eyelids. This is referred to as herniated orbital fat. Also, the levator muscle
that lifts the upper eyelids can become weak, causing the upper eyelid to droop. This problem is called ptosis,
Fine wrinkle lines and creases appear in the delicate skin around the lids. Sun damage, minor injuries, acne, and
other skin conditions may also leave blemishes.
What Can Be Done?
The problems caused by excessive eyelid skin and herniated orbital fat can be corrected by a common procedure called
blepharoplasty, in which the excess skin and/or fat are removed. If the only problem is bags beneath the eyes, they
can actually be removed without a skin incision. Correction of ptosis involves reattaching or shortening the levator
These procedures are performed on an outpatient basis, under local anesthesia. The surgery is usually painless and
patients may resume normal quiet activities the same day.
Wrinkles, creases, and damaged skin can be smoothed, softened, and diminished by laser skin resurfacing.
As an ophthalmologist with extensive experience in eyelid plastic surgery, Dr. Andrew Henrick is uniquely
qualified to operate on the delicate tissues around the eye. He can do most of these procedures under local
anesthesia, often right in the office.
Are These Procedures for Me?
Our eyes are our most noticeable feature. Excess eyelid skin, which naturally develops in all of us over time,
can obscure the pleasing natural features around the eyes. You may be perceived as having a tired, sleepy, or
sad look. Women may find it difficult to apply make-up. You eyes may be so tired by the end of the day that you
cannot read or watch TV in the evenings because you simply cannot keep your eyes open. Your vision may even be
partially obscured, particularly to the sides and when looking up. If you have any of these symptoms, eyelid
surgery may be helpful for you.
What Can These Procedures Do for Me?
- *Noticeable, Attractive Eyes
- *Natural and Vital Look
- *Rested and Vigorous Expression
- *Improved Side Vision
- *Ease of Applying Make-Up
- *Restored Natural Eyelid Contour
Do They Hurt?
These eyelid procedures can help you look and see better safely and without discomfort. Dr. Henrick does most
of the procedures described on this page under local anesthesia, even when more than one procedure is
required. Hospitalization is not required and the procedure can often be done right in our office. There is no
pain during the procedure and very little post-operative discomfort. In fact, most patients are surprised how
comfortable they feel after surgery. Although the area around the eyes may be swollen, "black and blue", or
red, for one to two weeks after surgery, sunglasses will successfully camouflage this until it disappears.
<>What is Botox?
<>Throughout history, people have looked for ways to achieve a
younger, more vibrant look by improving their facial appearance. A procedure utilizing Botox®
(Botulinum Toxin) is used for the treatment of facial lines and wrinkles. Botox® has been safely used
for certain medical conditions for more than a decade. This procedure, sometimes referred to as cosmetic
denervation, has been widely used and is considered a safe and effective way of treating aging skin. It is
used to eliminate or reduce worry and frown lines, "crow's feet", laugh lines and other wrinkles sometimes
called dynamic wrinkles.
The procedure works by physiologically weakening facial muscles beneath the
skin that are related to expression lines. The contractions of those muscles result in wrinkles.
Botox® works by blocking the impulses from the nerve to the facial muscles thereby relaxing them. The
result is that the pull of the underlying facial muscles relax causing the skin to flatten. This results
in a smooth, unwrinkled look.
Prior to treatment
Some physicians may recommend avoidance of alcoholic beverages, anti inflammatory medications and aspirin one
week prior to treatment.
A sedative or local anesthetic is not used because the pain
associated with the procedure is minimal. A small amount of discomfort is felt when the needle is
inserted and the liquid injected. This sensation lasts approximately 5 seconds.
Botox® is injected into various locations on the face. The needle is extremely small and only a
tiny amount of liquid is injected at one time.
Following the procedure
Because there is no sedative or anesthetic used,
patients can return to normal activities immediately after the procedure. It is possible to
experience a mild headache after the procedure. The physician may recommend acetaminophen if this
should occur. The physician may also recommend that the patient not lie down for 3 or 4 hours
following treatment. Some facial exercises may be recommended. The treatment takes three to eight
days to take effect. The benefits will last from three to six months. A touch-up may be necessary
1 to 2 weeks after the initial treatment.
When the toxin begins to wear off, the wrinkles begin to reappear; however, they frequently are
not as deep as the original ones. it usually takes two or three injections each year to maintain
the smooth, youthful appearance that is desired. Clinical studies suggest that, after several
rounds of treatment, the patient may require injections less often.
|Before Botox Injections - Crows Feet
||After Botox Injections - Crows Feet
Possible side effects
There are no serious side effects associated this treatment. There may be a small amount of bruising around
the treated areas; however,
this is temporary.
On rare occasions, the needle may puncture a blood vessel which can
result in a black and blue bruise around the treated area. This disappears in a few days.
Another side effect that occurs only rarely is a slight drooping of the eyebrow or upper eyelid.
Fortunately, when this occurs, it corrects itself in two to three weeks. There are no other
visible signs of the treatment.
Prior to treatment, the physician discusses with each patient the side effects connected with
The best candidates for the procedure are those between the ages of 30 and 65. in many
cases, wrinkles in people over 65 are not caused by muscle pull but rather by sun damage;
however, each person is different and must be evaluated by the physician.
Some wrinkles of the face are not caused by the muscles pulling on the skin and therefore
are not disposed to this treatment. These include wrinkles caused by the structure of the
skin which are the result of trauma, scarring, or sun damage. The procedure works best on
the wrinkles appearing in the upper one-third of the face, because its use on the lower
two-thirds might cause distortion of a person's smile or facial expression.
What results can be expected?
This procedure will smooth wrinkles
that are caused by frown and worry lines, "crow's feet", and laugh lines; however, it is
not designed to take the place of the standard facelift or other facial surgical
procedures. It is often used in conjunction with other procedures.
Botox® injections may not be suitable for persons with pre-existing medical
conditions or allergies. The physician will take a complete medical history to
determine if the patient is a good candidate for the treatment.
if you are interested in learning more about the Botox® treatment, please
contact our office and we will be happy to answer your questions.
|Before Botox Injections - Frown Lines
||After Botox Injections - Frown Lines
Dermal Wrinkle Fillers
When facial wrinkles are not completely removed by Botox, or are in an area not
suitable for Botox injections, they can be filled with a variety of substances to
“erase” them. These are injected directly into or just under the skin
and cause it to swell, thus minimizing the wrinkle indentation.
A popular substance for a long time has been collagen. However, allergic
reactions have been reported and allergy testing should always be done prior to
injecting collagen. Collagen lasts about 3 months before needing to be repeated
because it is absorbed by the body. A more recent addition to these substances
is hyaluronic acid, a molecule normally found between the body’s cells
that acts like a binder. It is purified from roosters’ combs, in the case
of Restylane, or synthesized by bacteria, in the case of Captique. Both of these
have been shown to be safe and do not require allergy testing. Furthermore, they
can persist in the skin for 6 to 8 months prior to being absorbed. Another
injectable substance, Radiesse, consists of microscopic calcium particles
injected under the skin. These can persist up to 2 years prior to complete
absorption. Touch-ups can be done for any of these substances before complete
absorption to maintain the favorable appearance.
Prior to treatment
It is best to avoid aspirin,
ibuprofen, and vitamin E for at least one week prior to treatment to reduce
An anesthetic cream is placed on
the sites that will be treated at least 30 minutes prior to the injections.
This anesthetic will reduce the sharp pain of the needle. As the substance
enters the skin, burning or aching may be experienced. Ice applied over the
treatment areas just prior to injection will help minimize the discomfort.
Small amounts of the filler are injected just under the wrinkles.
Multiple skin punctures may be required to achieve the desired effect.
Once the injection has been completed, the skin may be massaged to help
spread and smooth the filler underneath.
Following the procedure
usually return to normal activities immediately after the procedure.
Strenuous activity should, however, be avoided for 24 hours to minimize
bruising. Some redness and bruising of the treated areas may occur but
should resolve within a few days. Any discomfort may be treated with ice
applications and acetaminophen. Immediately after treatment and for a
few days afterwards, the treated areas may swell. The swelling will
resolve in a few days.
The final result will become apparent after about a week.
Additional touch-up injections may be performed one to two months
later, if desired. As the material is gradually absorbed, the wrinkles
will again deepen after several months.
Possible side effects
Aside from mild
redness, bruising, and swelling, no serious side effects have been
reported. If the treated area appears or feels “lumpy”
due to uneven distribution of the filler, massage can be used to
smooth the material into better position.
The best candidates for the
Dermal fillers are best suited for the
deep wrinkles between the nose and upper lip, on the sides of the
mouth, and any frown lines remaining after Botox injections. They
may also be used to smooth the pucker lines around the mouth, and
to fill in depressed areas between the lower lid and nose (tear
trough). For dynamic wrinkles, those caused by muscle contraction,
Botox should be used first followed one or two weeks later by
dermal fillers for enhancement. Fillers will not take the place of
a face lift to tighten sagging skin, but can be used afterwards
for any remaining fine wrinkles.
Are These Procedures Covered by Insurance?
Insurance will pay for upper eyelid surgery to correct ptosis
or excess upper eyelid skin when the field of vision is
affected. In such cases, the procedures are considered
functional and not cosmetic. We are a participating provider
for Medicare and many insurance plans as well. We will bill
your insurance company for you.
If your field of vision is not affected or if only the
lower eyelids are to be done, insurance companies ill not
cover these procedures because they are considered cosmetic.
Botox injections are not covered for cosmetic purposes,
but may be covered when used to treat tics or twitching of
the face and eyelids.
If Insurance Will Not Cover My Procedure, How
Much Will it Cost?
The cost varies depending on which procedure is
required but our staff can give you the exact cost once
Dr. Henrick has evaluated your condition. He will gladly
discuss fees and payment policies with you. Financing is
available. Visa and Mastercard are accepted.
How Do I Learn More?
If you are a new patient to us, your evaluation will
begin with a complete eye examination, with one of our
Board Certified Ophthalmologists. Following this, a
free cosmetic consultation with Dr. Henrick is
available. If we have seen you for a complete eye
examination within the last two years, only a short
follow-up visit will be needed. Dr. Henrick can then
tell you if eyelid surgery will help you and exactly
what will be required in your case. Free monthly
seminars are given to further answer these and any
other questions you may have. To schedule a
consultation or reserve a place at one of Dr.
Henrick's seminars please call us at (949)588-2020.
We’ll be happy to answer any questions and to
arrange a consultation at your earliest convenience.