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By admin on November 16, 2009
Both Botox and Dysport use the botulinum toxin from bacteria to reduce or eliminate certain wrinkles of the face. The toxin has been isolated, purified, and quantified so that the danger is virtually non-existent, when used properly by a physician who is qualified. The action of the toxin is to interrupt the impulse from the nerve to the muscle. This in turn paralyzes the muscle. Many of the wrinkles of the face are caused by continuous and long term contraction of the muscles, such as the frown lines or the Crow’s feet just lateral to the eyes. When these muscles are paralyzed, they cannot contract and create the wrinkles. The Botox/ Dysport must be injected in an exact location for best result and in the proper dose. An example of a complication would be a saggy upper eyelid. This is usually from the Botox being injected too close to the eyebrow or too large of a dose, and the toxin may drift into the muscle that opens the upper eyelid. Thus when this muscle is paralyzed, the eyelid droops.
Other actions of Botox/ Dysport are elevating or sagging the brow, according to where it is injected. Many people want to eliminate the forehead furrows. The problem is, the frontalis muscle in the forehead elevates the brow and at the same time causes the furrows of the forehead. If Botox is used to paralyze this muscle to eliminate the furrow, the brow cannot elevate and will thus sag until the effects of the Botox dissipate. The furrows in the upper part of the forehead, however, can be reduced or eliminated, but the Botox must not be injected within an inch or so of the brow. This may require some trial injections as people are not the same.
When the Botox/ Dysport is injected into the Crow’s feet, the outer brow is elevated, which is usually good, because it sags with age. An added benefit is when the brow elevates, the eyes are more open, a youthful appearance.
Botox and Dysport last about 3-4 months. My suggestion is to inject it every 3 months for a year which atrophies the injected muscle. Then an injection every 4-6 months is usually sufficient.
By admin on November 15, 2009
The eyelids are usually the first thing that gives a person’s age away. It may involve either the upper eyelids sagging or the lower lids, which is usually manifested by “bags.”
Typically the upper eyelids acquire more skin which ultimately hangs down to and sometimes over the edge of the lid and even lashes. Sometimes people inherit excess skin in the upper lids, and this is typical of Asian people or those with Asian ancestry. This problem can be corrected with an upper eyelid lift called an upper lid blepharoplasty. This surgery can be done under either local or general anesthesia. My preference is mild sedation and local anesthesia. The procedure takes an experience surgeon 30 minutes to an hour, according to the amount of skin and whether fat must be removed as well. The results are usually spectacular, if done correctly, and the scars are imperceptible in most cases.
The lower eyelids are often more complex and surgical correction is called a lower lid blepharoplasty. Some skin may have to be removed as well as the fatty “bags.” If the only problem is the loose skin, and it’s not too excessive, a laser may correct the problem satisfactorily by tightening the skin. If removing excessive fat is the only goal, this can be done through an incision in the inside of the lower eyelids called the transconjunctival blepharoplasty, and there is no scar. If necessary, this may be combined with the laser when the skin is minimally excessive. If a skin incision is needed, there is a faint scar in the skin of the lower lid just under the lashes. If both an upper and lower eyelid blepharoplasty is required, they are done at the same time.
One can expect some black eyes post-operatively and swelling for a few weeks. It’s a small price to pay for beautiful eyes for decades to come. Often the eyes look better than they have ever looked before, but proper technique is necessary, and I recommend a plastic surgeon certified by the American Board of Plastic Surgery.