Procedures
Surgical and Non Surgical Eyelid Treatments
Non Surgical Treatment for Dark Circles under the eyes and bags under the Eyes (Under Eye Filler)
One of the most common complaints that patients have about their eyes is the
appearance of dark circles under the eyes. Some dark circles can be the result of shadows from
bulging under eye fat or bags, or from under eye hollowness. Under eye hollowness can be caused by either a weak cheek bone and deficient oribital rim, or from deficient under eye fat. Frequently, under eye dark circles are
the result of lower lid hollowness. This hollowness can even occur in younger
patients and is often the result of decreased volume in the lower lid and upper
cheek areas. This under eye hollowness is sometimes genetic. Dr. Aharonov has successfully used facial fillers such as Restylane to restore the natural volume and improve the under eye hollowness. Under eye filler injections have minimized the appearance of persistent dark circles in his Los Angeles
area patients. Restylane and other facial fillers can be long lasting, even up to
a year or greater. Under eye filler injection is quick, virtually pain free, and has little if any down time.
Occasionally, surgery might be the best option for a patient with large under eye bags or under eye puffyness. In these patiens a lower eyelid lift surgery or a cheek lift surgery may be the best solution to minimize under eye hollowness and dark circles. Each patient must be evaluated on an individual
basis, as there are numerous reasons why a particular person has under eye
dark circles. During your consultation, Dr. Aharonov can thoroughly evaluate your specific concern and suggest the best possible treatment for under eye dark circles.
Upper Eyelid Filler: non surgical 3D Upper Eyelid Lift with Restylane or Juvederm
Many times, excess upper eyelid skin is due to volumetric deflation of the upper eyelid
and eyebrow area causing the appearance of hollowness above the eye and drooping of the brow. As we age, we tend to lose fat in this area of the face and eyes.
Think of how young people and babies are often described as having full round faces,
and older people develop gaunt, sunken features. Like a balloon losing air, we develop
the appearance of excess skin in the upper eyelid area as the natural volume of facial
fat decreases with age. In some situations it is best to cut away this extra Eyelid skin if there is too much fatty tissue,
but most patients will benefit more from inflating the brow and upper lid back to how
it was when they were younger. To do this, Dr. Aharonov can either use a Facial Filler like Restylane or Juvederm, and in a matter of minutes can make your upper eyelid and brow look the way it used to, without surgery or downtime. In fact, surgery cutting away eyelid skin in these types of
patients might actually make the eyes seem more hollow and skeletal, imparting a
more aged appearance, even though there is less overhanging skin.
The minimally invasive Eyelid Lift using facial fillers such as Restylane or Juvederm is done in our Beverly Hills office while you are sitting comfortably in a chair. The procedure takes just a matter of minutes, and has
an immediate effect. The upper eyelid filler procedure is painfree after being numbed. The results of the upper eyelid filler injection can last for up to 2-3 years. Although Dr. Aharonov is
a leading Facial Plastic Surgeon, he will always customize your treatment to fit your
individual needs and goals. If a less invasive technique such as filler injections around the eyes will make you look your best,
then he has the skill and expertise to accomplish that and tell you what is best for your needs. The minimally invasive Eyelid
Lift with fillers is a way that your eyes can look years younger in a matter of minutes without
surgery or downtime.
The minimally invasive Eyelid Lift with facial fillers can also be used for patients who have had a surgical
Eyelid Lift by another doctor with resulting Eyelid hollowness or eyelid asymmetry. The eyelid hollowness gives an
overall aged appearance, and can be improved with the use of facial fillers such as Restylane or Juvederm.
Again, the upper eyelid filler injection takes just a matter of minutes and can even be done during your lunch break.
The non surgical Eyelid Lift with fillers restores your eyes to a more youthful state naturally
and easily. During your consultation with Dr. Aharonov, he will discuss all of your non surgical and surgical options regarding your upper eyelids, brows, face or anything else
that might be bothering you. If you decide to proceed with a facial filler
treatment, it can usually be done during that same visit. Dr. Aharonov can also show you many before and after photos of patients who have had eyelid filler treatments or eyelid surgery.
All of Dr. Aharonov's Los Angeles California area patients have been extremely happy with the results of their minimally invasive Eyelid Lift with fillers such as Restylane or Juvederm.
Non Surgical Treatment of Bulging Eyes or Prominent Eyes with Facial Fillers such as Restylane or Juvederm
Bulging eyes or prominent eyes can be caused by some medical conditions like Grave's
disease, or could be something genetic that some people are born with. In some people
the eyes can seem to be getting more prominent or more bulging as they age. For
people with severe bulging of the eyes, or what is called proptosis, surgery is sometimes
the best solution. Surgical options for prominent eyes or proptosis include orbital
decompression surgery or orbital rim onlay grafting. These surgeries are fairly invasive
and can sometimes have severe complications including to vision.
Proptosis or bulging eyes depends on the relationship between the globe (the eyeball)
and the surrounding orbital rim (eye socket). How far anterior the globe or eyeball sits in
relation to the orbital rim will dictate the degree of proptosis or prominence of the eyes.
This is sometimes symmetric in both eyes or asymmetric with one eye being more
bulging than the other.
Orbital decompression involves enlarging the size of the eye socket by fracturing the
walls of the orbit outwards allowing the globe (eyeball) to settle further back and have
more room so it doesn't bulge as much.
Another surgical option involves building up the surrounding orbital rim (the superior
and inferior orbital rims) by placing onlay grafts on them to make the rims project more
anteriorly in relation to the globe. This leaves the eyeball in the same position (as
opposed to orbital decompression). The eye seems less bulging and less prominent
because the orbital rim is sticking out further.
This same concept can be performed non surgically using facial fillers such as Restylane. The facial filler is used to build up the orbital rim (either the inferior,
superior or both orbital rims) making the eye look less prominent and less bulging.
This is a great option for people with moderate to mild proptosis, bulging eyes, or
prominent eyes. It can be used to make the eyes more symmetric as well. This is a
painless in office procedure that can be performed in a matter of a few minutes. It is
similar in nature to using facial fillers to treat dark circles or under eye bags. It is also a
great option for people with orbicularis hypertrophy (having a thick crease right below
the lower eyelashes) because this problem is usually caused by decreased support of
the globe by a weak inferior orbital rim.
What is Eyelid Lift Surgery or Blepharoplasty?
Beverly Hills Plastic Surgeon Dr. Aharonov performs Eyelid Surgery or Blepharoplasty
to tighten the drooping skin of the upper eyelid or to remove the under eye bags or
puffiness of the lower eyelid. In addition to making you appear older, the aging eye
can make you appear tired, sad, or angry. This is one of the most common plastic
surgery procedures performed for both men and women. It is even performed in
younger patients, as the eyes are subject to your genetics. For many young patients,
lower under eye bags or droopy upper eyelids run in the family, and these patients will
see a dramatic improvement in their appearance and self esteem.
The Eyelid Lift Surgery or Blepharoplasty can be performed to improve one's overall
look or can cause a functional improvement. Often, a drooping upper eyelid from
excess skin or fat can impair one's vision. In addition to the changes associated
with aging, hereditary factors, trauma, infection, or inflammation can cause the
eyelids to droop or sag. After Dr. Aharonov performs the Eyelid Lift surgery, patients
have a more awake refreshed appearance. Patients from all over the Los Angeles
California area see Dr. Aharonov for Eyelid Lift surgery.
Upper Eyelid Lift Surgery (Upper Blepharoplasty)
Sagging skin and excess fat in the upper eyelid can create an aged, tired, or angry
appearance. An upper eyelid lift surgery (blepharoplasty) is a minimally invasive
procedure that is very effective in correcting this condition. The upper eyelid lift is
accomplished by first drawing an incision line in your natural upper eyelid crease.
Once you are comfortably sedated, a fine incision is made along the previously
marked line in your natural eyelid crease. Dr. Aharonov precisely trims the excess
hanging skin, removes any excess fat and sagging muscles are tightened if necessary.
The skin is closed with extremely fine sutures, gradually leaving a virtually undetectable
scar. The result leaves patients with a smoother, firmer upper eyelid. Your eyes look
more awake, alert, and refreshed.
Lower Eyelid Lift Surgery (Lower Blepharoplasty)
Excess fat and skin in the lower eyelid can contribute to an aged and puffy appearance. In a lower Eyelid Lift Surgery (Blepharoplasty), an incision is concealed along the inner surface of the lower eyelid, called the transconjunctival lower blepharoplasty. Dr. Aharonov either repositions or removes excess fat without changing the shape of the eye. If there is hollowness beneath the eye, the bulging fat bags can be repositioned to fill that area, thereby effectively eliminating two major eye complaints. In instances where there is unsightly excess wrinkled skin in the lower eyelid, a well concealed incision is made just under the lash line. The loose lower eyelid skin is trimmed away, creating a tighter, smoother under eye appearance. This procedure is also referred to as a “skin pinch”. As the bruising and swelling subside, the incision line will gradually become virtually undetectable. The lower eyelid and surrounding area will reveal a smooth, firm contour giving you a youthful and vital appearance. Dr Aharonov customizes eyelid surgery to the individual needs of his Los Angeles area patients. These procedures usually last only one to two hours in an outpatient surgery center in Beverly Hills, but the improvements in appearance and self esteem are dramatic and long lasting.
Wrinkles or Crow's Feet
These are best addressed by Botox or Dysport, as the Eyelid Lift surgery does not treat wrinkles. At the time of your consultation in his Beverly Hills office, Dr. Aharonov can discuss
all of your options with you. He specializes in Botox and Dysport treatments that smooth the wrinkles
and furrows, without leaving you with a frozen unnatural look. All of Dr. Aharonov's Los
Angeles area patients are extremely happy with their Botox treatments.
Asian Eyelid Surgery (Westernization or Double Eyelid Surgery)
Many patients of Asian decent request eyelid surgery to create a more open
appearance of the eyes and achieve greater definition in the upper lids. Asian
Eyelid surgery (blepharoplasty) is a modified upper eyelid lift in which small amount
of skin, tissue, and fat pads are removed to create an upper lid crease that did not
formerly exist. Asian eyelid surgery requires a great deal of technical skill as it
involves the “design” and placement of a new crease in the upper lid. It also takes
technical aptitude to successfully seal the wound and conceal the incision in the
newly created crease, while maintaining harmony with the rest of the face.
Brow Lift or Forehead Lift
A low positioned brow may cause the upper eyelids to hang lower, obscuring the
eyes called hooding. This can also contribute to the aged appearance of the eyes.
Depending on the individual patient, a Brow Lift Surgery may be more effective at correcting the problem of drooping upper eyelids, or may be done along with an
Upper Eyelid Lift Surgery. Additionally, a Brow Lift Surgery will smooth out lines
or furrows on the forehead. Dr. Aharonov prefers to use a minimally invasive
technique for his Brow Lift surgery, known as an endoscopic brow lift. A few small
incisions are hidden in the scalp within the hair and a tiny camera or endoscope is
used to perform the Brow Lift. With a Brow Lift or Forehead Lift, the eyebrows are elevated and properly positioned, the heaviness from the upper eyelids is
decreased, and frown lines and forehead wrinkles are diminished giving a natural
more rested appearance.
Preparing for Upper or Lower Eyelid Lift Surgery: Preoperative
Information
Dr. Aharonov will most likely ask you to see your primary physician for a physical exam
and blood tests. Your medical history, including any medicines that you take should be
discussed with Dr. Aharonov. You should stop taking aspirin or anti-inflammatory
medicines such as Alleve, Motrin or Advil one week prior to surgery to minimize
bleeding during surgery and bruising after your brow lift surgery. A list of over the
counter medications and supplements to avoid will be given to you during your
preoperative consultation. You should avoid alcohol or salty foods for three days prior
to surgery to decrease fluid retention and swelling. You should discuss all of the
medicines that you are on with Dr. Aharonov. If necessary, you may take your essential
medications with a tiny sip of water in the early morning on the day of your Eyelid Lift
surgery.
It is also essential that you disclose any medical conditions that involve the eye such
as glaucoma, dry eye, detached retina, and thyroid disorders such as Graves’ disease,
underactive or overactive thyroid, cardiovascular disease, high blood pressure,
circulatory disorders, or diabetes.
You should be in the most optimal nutritional state prior to Eyelid Lift surgery. An
adequate diet with certain vitamin supplements such as Vitamin C is recommended.
Dr. Aharonov can discuss nutritional supplements with you during your preoperative
consult.
You will receive a recommended course of treatment based on your physical features,
the condition you wish to have corrected, what is causing that condition, and your
realistic goals for improvement. Dr. Aharonov will also answer your questions at that
time. Remember that by carefully following Dr. Aharonov's advice and instructions, both
before and after surgery, you can do your part to ensure the best possible outcome.
Anesthesia for Upper or Lower Eyelid Lift Surgery (Blepharoplasty)
Dr. Aharonov performs all Eyelid Lift surgeries in an AAAHC accredited outpatient surgery center in Beverly Hills. Board certified anesthesiologists, which are medical doctors, perform all of his cases. Dr. Aharonov prefers to have a physician caring for your anesthetic needs during your Eyelid Lift or Brow Lift surgery, as their experience
minimizes the potential of unpleasant postoperative side effects. For his surgical
cases, Dr. Aharonov uses an extremely safe combination of iv sedation and local
anesthetic, not general anesthesia. This technique provides superior operating
conditions combined with maximal patient safety and comfort. In all likelihood, you
will awaken with very little discomfort, nausea, or anesthetic side effects. In his
Los Angeles area surgery center, all of the appropriate monitoring, medication and
emergency equipment are available at all times. On the day of surgery, you will meet
your anesthesiologist and can discuss any questions that you may have.
Healing After Upper or Lower Eyelid Lift Surgery (Blepharoplasty)
You should expect mild aching or itching after Eyelid Lift Surgery. This mild discomfort is
usually well controlled with Tylenol and cold compresses. There will be swelling of the
eyelid area, which usually peaks on the morning after surgery. The swelling will mostly
resolve over the next ten days to two weeks, but some patients may experience some
mild puffiness for a longer period. There are ways to minimize the swelling, including
cold compresses, avoiding salty foods and alcohol. Salty foods and alcohol cause your
body to retain fluid. Areas of inflammation, like eyelids healing from an eyelid lift, are
common targets for extra swelling. Frequently patients report that they appear worse in
the morning and better in the evening. Lying flat while sleeping can exaggerate swelling
and bruising, which improves over the course of the day. However, it is much more
important for the healing process after your Eyelid Lift Surgery to sleep comfortably,
then to try to sleep upright to minimize swelling. A moderate of amount bruising after
Eyelid Lift Surgery is to be expected. This will begin to fade in several days, and
should be gone after two weeks. Most patients are ready to go out in public after
about 10 days.
Activity Level and Exercise After Eyelid Lift Surgery (Blepharoplasty)
You should relax during the first two days after your Eyelid Lift Surgery. After that,
normal daily activities should be resumed, but strenuous activities or exercise
should be avoided for 2-3 weeks. Vigorous aerobic exercise and heavy straining
or weight training can all increase swelling in the inflamed soft tissues of the eyelids.
Light exercise such as walking can be done during this time.
Cosmetics After Eyelid Lift Surgery (Blepharoplasty)
One of the most common questions after eyelid surgery is when can you start to wear
makeup. In general, you should wait for the sutures to be removed and the swelling to
begin to resolve. Always consult with Dr. Aharonov first, as you would not want to apply
cosmetics to an open wound. This will greatly increase your risk of infection and impair wound healing, possibly leaving a much more noticeable scar than would have
otherwise resulted. Always use a new bottle or tube to decrease the chance of
contamination. Your eyelids may be tender after your eyelid lift surgery, so you may
want to avoid makeup or use a tinted moisturizer specifically designed for the eyes.
In the Beverly Hills area, there are many aestheticians who specialize in post op
makeup camouflage. Dr. Aharonov can give you a referral if you wish. Many
companies sell makeup specifically designed to camouflage the discoloration
associated with an Eyelid Lift Surgery. A green cream concealer will best hide red
bruising, and a yellow cream concealer will hide purple bruising. Avoid glittered or
frosted eye shadow in the early weeks after eyelid surgery, as these may contain
particles that can irritate healing skin. All of Dr. Aharonov's Los Angeles area
patients have been extremely happy with the results of their Eyelid Lift Surgeries,
and have had no difficulty returning to work or going out in public after
approximately 10 days.
Risks of Eyelid Lift Surgery or Blepharoplasty
As with any surgical procedure, there are risks involved. You and your surgeon will work
together to minimize these risks and maximize your results. Follow your surgeon's
instructions both before and after your eyelid lift surgery. Always be completely honest
about your medical history and habits including smoking, alcohol or drug use. Be realistic as to your expected outcome. You will look like a refreshed rejuvenated version of yourself, not like a young version of someone else.
Minor risks of the procedure include bleeding, infection or numbness at the incision site,
unfavorable scarring, or asymmetry. These risks are very rare, and when they do occur,
are usually temporary. There are many steps that both you and Dr. Aharonov can take to
minimize the appearance of eyelid surgery scars. In the overwhelming majority of patients,
these scars are virtually undetectable.
Non Surgical Eyelid Lift