Dermal fillers are injectible, soft tissue implants that can be permanent, semi-permanent, and temporary. They are used to replace lost volume after age or disease-related bone, fat, and collagen loss. They can be used in many different aesthetic regions throughout the body, especially the face and hands. This discussion will focus on the application of […]

The face ages through what are called the “3 D’s” – descent, deflation, and demarcation. UV damage to the skin, loss of collagen in the dermis, loss of subcutaneous fat, and loss of bone density contribute to the 3 D’s. Therapeutic techniques must address the underlying anatomic basis for the cosmetic problem. It is useful […]

Dermal filler injections are second only to Botox in popularity for non-surgical facial rejuvenation. There are a number of different ways to provide anesthesia during dermal filler injections. These include ice, topical anesthetic, dental blocks, and local anesthetic mixed with the filler itself. The choice of anesthetic depends on the type of filler used and […]

Blepharoplasty (Blepharo- means “eyelid”, and -plasty means “change”) is the most commonly performed facial plastic surgery procedure. This is because the eyelids account for a large part of the expressiveness of the face. When you look at someone, you look at his or her eyes. If the eyelids are sagging, droopy, or puffy, the face […]

Ptosis (pronounced to’sis) simply means droopy eyelid. It is one of the most common eyelid problems. The lid may droop slightly, or cover the entire pupil. Ptosis can restrict and even block normal vision. It can be present in children and adults, and is usually treated with surgery. When ptosis is present at birth, it […]

Tearing can be a difficult problem for both patient and doctor alike. Tearing, which is the actual spilling of tears down the cheek, differs from “watering,” where tears well up without spilling down the cheek. The distinction between tearing and watering is important, because tearing implies a partial or complete blockage somewhere along the tear […]

Nonspecific orbital inflammation (NSOI), also known as psuedotumor, is disease of the eye that not uncommonly presents to the emergency room or ophthalmologist. Typically, its onset is acute and manifests with severe orbital pain, swelling around the eyes, limitation and pain with eye movements, and even loss of vision. It is easily confused with infection […]

There are two different types of rhytids (wrinkles): static and dynamic. Static wrinkles are those lines in the face that persist after muscle tension is relieved. Examples include, glabellar lines (vertical lines between the brows), perioral lines (upper lip and smile lines), nasolabial folds, dimples at the outer corners of the mouth, and frown lines […]

Injuries to the globe, eyelid, lacrimal system, and orbit should considered when dealing with facial trauma. Careful ocular and adnexal exams are necessary to diagnose hidden ocular injuries. Furthermore, it is easy to focus on an obvious or serious ocular injury and lose sight of concomitant injuries. Expect the unexpected. To begin with, obtain a […]