Most of us think of eye doctors as people who cure vision-related diseases or replace our natural lenses with artificial ones when cataracts thicken. Yet the growing trend toward improved facial aesthetics means we don’t just see better under their care: We can feel better about the way others see us.
Insurance companies consider many of these treatments in this field to be cosmetic, so it’s natural to think about them when using up a Flexible Spending Account balance. If you haven’t considered facial aesthetics, you’ll be surprised to hear your options. Every part of the face from the brow to the lips can come into play. (Learn more on our Aesthetics services page.)
These come in two categories: Neuromodulators and fillers. Neuromodulators are FDA-approved medications such as Botox or Dysport, which reduce wrinkles and fine lines by relaxing muscle contraction. This is performed through multiple small injections. Areas commonly treated include forehead, brow and crow’s feet. The procedure is performed in the office in just a few minutes, and the effects typically last three to four months. A physician can use these products to reduce frown lines or wrinkles around the lips.
Fillers, found under names such as Restylane and Juvéderm, use hyaluronic acid to add volume or reduce deeper lines and wrinkles. They can be injected into cheeks or lips, put under the eyes to soften periorbital hollows or placed inside frown lines. This task takes perhaps half an hour in the doctor’s office and lasts eight to 18 months. These require more healing time than neuromodulators, though still only a week or so for swelling to go down.
These procedures all take place around the eyes and fall into three categories: upper eyelid blepharoplasties, lower eyelid blepharoplasties and brow lifts. These facial aesthetic improvements involve more time and expense but last longer, often a couple of decades.
Upper lid blepharoplasty is the simplest and most common of the procedures. It reduces the heaviness of the upper lid while removing excess skin and fatty tissue. Lower lid blepharoplasty reduces bagginess under the eyes in the tear troughs and tightens the skin of the lower eyelid.
Doctors prefer to work on both eyes in the same day and can do uppers and lowers in one surgical appointment. Roughly 30 minutes to do both upper lids. This surgery can even be performed in the office, calming patients with a Valium and local anesthesia. They generally sedate patients outside the office when doing lower lids, to aid in comfort. This procedure takes about 90 minutes for two eyes.
Patients can expect bruising and swelling for roughly two weeks, though not significant pain. Icing, reduced physical activity and ointment to ward off infection lead to a speedy recovery.
When Facial Aesthetics Become Crucial
Though drooping eyelids almost never blind a person, they may interfere with driving and reading. In some cases, a descending eyebrow interferes with the visual field. That’s when a doctor uses one of three methods to adjust the patient’s brow.
A surgeon can make an incision above the eyebrow, removing skin to elevate the brow. However, that’s not the best approach cosmetically. Doctors would rather make an incision across the entire forehead at or behind the hairline. They can also do an endoscopic lift, which requires small incisions at the temples and in the center of the forehead. The latter two options leave less visible scarring and raise the brow more robustly.
Brow lifts can take a couple of hours. Combine them with upper and lower blepharoplasties, and a surgeon can perform a four-hour procedure while you’re under general anesthesia. Brow work has a longer recovery time, because it induces more soreness, bruising and swelling.
These surgical procedures should last at least 15 to 20 years. But if you opt to have them in middle age, you may need to get work done again someday. Our tissues thin out, fat moves forward in the face, and gravity continues to tug our skin downward as we age.
To schedule a consultation at Horizon Eye Care, call 704-365-0555 Monday – Thursday, 8:00 a.m. to 5:00 p.m. and Friday 8:00 a.m. to 3:00 p.m. You may also log into our Patient Portal to request an appointment.