One of the first signs of aging (and one that starts at a very young age) is volume loss around the eyes. It usually makes us look tired and not as refreshed. Volume loss is inevitable but can manifest itself in different ways. Some people start to hollow out and will show more eyelid, while others will have droopyness of the upper eyelid skin and brow as it seemingly deflates and loses support.

Most people wish they can have their youthful eyes back. These people are usually good candidates for eyelid filler injections or fat injections. Some people did not like the look of their eyes when they were young--they thought their upper eyelids where too puffy and full. These people would probably benefit from upper eyelid blepharoplasty or upper eyelid lift.

Below is an example of a young patient with hollowing of her upper eyelids. She felt this made her look tired and she wanted her youthful full eyes back with a lower crease. Restylane was used to lower her crease and give her fullness back.

Contrast this to the patient below who also had upper eyelid fat loss leading more to a deflated brow and upper eyelid and sagging and drooping. Restylane was also used to reinflate her deflated upper eyelid.

Filler treatment in the upper eyelid is safe and log lasting. The only issues I have encountered have been an occasional bruise, swelling for a few days, and very unusually a small lump which can be massaged away or dissolved.

To learn more about upper eyelid filler treatments visit our non surgical upper eyelid lift page

By Gal Aharonov

Thinner people with high cheek bones age with their cheeks looking more and more obvious in proportion to the rest of their face. When you are young there is more facial fat and padding around the cheek bones, in the temple, and in the submallar area (area below your cheek bone). As we age we slowly lose the fat and padding in our face: our temple become more hollow, we lose fat under our cheek bone, and our skin becomes thinner. Imagine having a rock under a thick comforter... It is difficult to see the edges of the rock under there. As we age that thick comforter turns to a thinner sheet and now all of a sudden you can see the outline of the rock. That is sort of what the cheek bone is like in people who have high cheek bones. this does not happen in people who's cheeks are mostly composed of fat. Those people end up with flatter cheeks as they age.

The treatment for you is not to shave down your cheek bones, which would be dangerous. The treatment is to add volume around the cheek bone--add padding like a thicker comforter. Your temple can be filled out as can the area below your cheekbone. This will soften your look and make your face more like it used to be when you were younger.

Notice how this patient's natural cheeks seemed large and artificial before. Fillers where used to soften the look of her cheeks.

To learn more about facial fillers go to our liquid facelift and facial filler information page

By Gal Aharonov

Upper eyelid blepharoplasty, or upper eyelid lift is a relatively quick procedure with minimal downtime. This procedure can be done while you are asleep, or can also easily be done with you being awake in the office. Local anesthetic is used to numb the area up. After you are numb the procedure is pain free and very comfortable. The entire procedure takes under one hour. Sutures are taken out about 6 days afterward.

If you are a good candidate for an upper eyelid lift or blepharoplasty we can discuss all your options. Having the procedure performed in the office under local anesthesia also saves a significant of money because it eliminates the costs of anesthesia and the operating room fees.

To learn more about eyelid surgery as well as other eyelid options that are non surgical, please visit our eyelid procedure page.

By Gal Aharonov

A common question asked during consultation for chin augmentation with a chin implant relates to chances of the implant moving after placement. There is always a chance the implant can shift or move slightly after placement but this is unusual and even if it does happen it is usually an insignificant amount. I secure all my chin implants with absorbable sutures to reduce the chance of the chin implant moving or shifting.

The typical incision is about half an inch and is under the chin. I prefer this route over going from inside the mouth because it is much more common to have the implant be misplaced or for it to move when placed from inside the mouth. There is also a slightly larger risk of infection from inside the mouth. There are many different shapes and sizes of chin implants, and the one that is right for you will be discussed during your consultation. Chin implants typically have tapered tails that extend from the middle on each side that allow natural blending with your native jaw bone. These tails are tucked under the periosteum almost like your arm fits into a sleeve. In doing so, the chin implant becomes quite stable in terms of position and is inhibited from moving left or right and up or down. At this point in the operation, it is actually quite difficult to remove the implant even with surgical instruments. I also fixate the implant with absorbable sutures placed just under the jaw bone. This provides added stability until the implant area is fully healed.

Using this technique I have been highly successful in placing chin implants for augmentation of the jawline. Chin implants are sometimes used in conjunction with angle of the mandible implants which are placed from inside the mouth.

To read more about chin implants as well as angle of the mandible implants please visit our information page on facial implants.

By Dr. Gal Aharonov

Artefill is a filler that is effectively permanent due to the fact that the body cannot degrade it. It is composed of tiny microspheres in a suspension of bovine collagen. The collagen gets degraded over time but the microspheres remain and induce an inflammatory response by the body which deposits new collagen around it.

Because the results of Artefill depend on each individual's response to it, there is a certain amount of unpredictability. It is therefore prudent to initially under correct with artefill and use it in stages until the desired outcome is achieved.

Like most of the other fillers, Artefill is only FDA approved for injection into the nasolabial folds. Like all the other fillers, practitioners can use it in off label ways and inject it anywhere else they deem to be safe. That is where different doctors might have varying viewpoints as to where it is safe to inject.

The only places I would inject Artefill are in the nasolabial folds, bridge of the nose, high cheek bone area, and prejawl sulcus. All these places are conducive to deep injections on or close to the bone. The deeper the material is injected the less likely it is to cause troublesome lumps or other issues.

Because Artefill contains bovine collagen, a skin test is needed about a month prior to administration of Artefill to make sure you do not have an allergy to it. This is done for free in our office.

By Dr. Gal Aharonov