Blepharoplasty | Dr. Forley
 
 
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Posts Tagged ‘Blepharoplasty’

LOWER EYELID REJUVENATION

Sunday, July 29th, 2018

A common complaint of patients is that they look tired but don’t feel tired. This is often the result of bulging fat pockets in the lower lid combined with a tight attachment of the skin at the junction of the lower lid and the cheek known as the tear trough. It is frequently one of the early signs associated with the aging process. Dr. Forley approaches this concern with both a non-surgical and a surgical option. Camouflage of the bulging fat can be achieved with the use of an injectable hyaluronic filler at the tear trough to aid in blending the transition across the lid-cheek junction. Although this can improve early changes, the fundamental cause of the problem remains unaltered. An advanced surgical technique that Dr. Forley utilizes to treat this issue involves releasing the attachment of the tear trough below the eyelid from the inside so that there is no external scar. At the same time, the fat from the lower lid is repositioned to extend across the lid-cheek junction. This changes the orientation of the fat so that the bulging is reduced in conjunction with filling the depression below the lower lid. This procedure is known as a transconjunctival fat transposition lower blepharoplasty. During your consultation, Dr. Forley will discuss the options that would work best in your individual situation.

EYELID SURGERY COMPOSITE

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THE AGING EYE

Thursday, December 21st, 2017

The aging appearance of the eye is often a combination of a progressive descent of the brow, heaviness of the upper eyelid, and a baggy appearance of the lower eyelid. The individual contributions of each of these factors varies from patient to patient and each of them can be addressed separately or in a combined procedure.

The key factor in treating the eye area is making the correct diagnosis so that the appropriate procedures are performed. If the problem is a low-lying brow, removing upper eyelid skin can make the brow appear even lower. Conversely, trying to correct upper eyelid skin redundancy with a brow lift will result in excessive brow elevation and a surprised look.

The aging lower eyelid is often a combination of prominent fat pads and a depressed lid-cheek junction or tear trough that creates a circle under the eyelid. Removing fat in the setting of a deep tear trough leaves that problem uncorrected or may even make it appear worse.

This patient example demonstrates a patient with a low-lying brow that creates a heavy appearance at the junction of the brow and the upper eyelid. The lower eyelid has a moderate amount of fat excess and depression of the lid-cheek junction that creates a tired appearance.

BROW LIFT PAGE (1)

Treatment of the aging eye with an endoscopic brow lift and a fat transposition lower blepharoplasty

The patient underwent an endoscopic brow lift and a fat transposition blepharoplasty of the lower eyelid. The brow lift was performed using specialized instrumentation introduced through small incisions within the scalp and enabled a correction of the heavy appearance of the upper eyelid, in this case, without any skin excision. The lower eyelid was improved by releasing the tear trough ligament and draping the excess lower eyelid fat across the lid-cheek junction to fill the depression. This procedure is distinct from more traditional fat removal procedures of the lower eyelid. The combination of surgical procedures resulted in a more youthful and rested appearance that appears natural.

 

 

 

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Publication of Aesthetic Rejuvenation of the Face and Neck

Thursday, March 31st, 2016

Dr. Forley is pleased to announce the release of Aesthetic Rejuvenation of the Face and Neck edited by Dr. Bruce F. Connell and Dr. Michael Sundine and published by Thieme. Following his plastic surgery residency, Dr. Forley was selected by Dr. Connell for his prestigious post-graduate aesthetic surgery fellowship program in California. Dr. Forley was honored to be asked by Dr. Connell to contribute the chapter on Facial Aging that is featured in the new book.

Facial Aging

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TEAR TROUGHS AND BAGGY LOWER EYELIDS

Sunday, April 19th, 2015

The junction between the eyelid and the cheek, also known as the “tear trough”, is an area of the face that makes us appear tired and older when it starts to deepen. It is caused by the anatomic relationship of the eyelid and cheek with bulging eyelid fat and an adherent ligament or fibrous band accentuating the depth and visibility of the tear trough. Frequently, associated shadows that are created will make it appear worse.

rhinoplasty

A more rested, youthful appearance is achieved when the junction between the eyelid and cheek is blended. The use of injectable fillers is an effective, non-surgical way to improve the area by camouflaging the depth of the tear trough through the placement of Restylane® or BELOTERO BALANCE®. Fat grafts can also be used to effectively conceal the depth of the tear trough. Treating the cause of the baggy appearance, however, requires a surgical approach that handles not only the bulging fat but the tear trough ligament that defines the junction between the eyelid and the cheek. The procedure, known as transconjunctival fat transposition blepharoplasty, involves an incision on the inside of the eyelid through which Dr. Forley releases the tear trough ligament from its bony attachment. The junction between the eyelid and the cheek is then filled with the fat of the lower eyelid to create a youthful, natural, well rested appearance. Any excess fat is removed to enhance the final outcome. A long lasting result is achieved with this technique which can be combined with other procedures to reverse the signs of facial aging.

rhinoplasty

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COSMETIC PROCEDURES FOR MEN

Friday, December 30th, 2011

Men have become an increasingly common presence in the plastic surgeon’s office. Competition in the workplace and the prevailing youth culture have combined to create a desire for self-improvement that may not have seemed as important 15 or 20 years ago. The minimal downtime procedures performed today make their acceptance amongst busy professional men and women very high. The most frequent non-surgical procedures men are having done in our office are BOTOX® Cosmetic, injectable fillers, and Ultherapy®. Surgery often is performed to treat baggy eyelids, excess neck, hip, and tummy fat, and gynecomastia or male breast enlargement.

NON-SURGICAL

BOTOX® Cosmetic

Botox® Cosmetic provides a non-surgical way of reversing the crow’s feet, laugh lines, and frown lines produced by the underlying contraction of facial muscles. “Also known as Bro-tox, Botox is one of the most popular non-surgical cosmetic treatments for men” say Philadelphia dermatologist, Dr. Ringpfeil. It works by enabling a smooth skin appearance as a result of blocking the muscle contraction and overlying skin wrinkling produced by nerve impulses. The untreated muscles will allow for normal facial expression to remain unaffected. The treatment lasts from 4-6 months and is performed 2-3 times per year to maintain youthful appearing skin.

Injectable Fillers

Injectable dermal fillers composed of hyaluronic acid, such as JuvedermUltra and Ultra Plus, Restylane®, and Perlane® are indicated in the treatment of folds, wrinkles, or hollowing that results from facial aging. “By adding volume, wrinkles and folds appear smoother and facial contours appear more youthful” says Dr. Forely. The duration of effect is up to 12 months.

48 year old male before treatment

48 year old male before treatment

6 years following ongoing treatment with Restylane®

6 years following ongoing treatment with Restylane®

Another filler we offer is Sculptra® Aesthetic. This product is composed of poly-L-lactic acid (PLLA), an injectable biocompatible material that stimulates the production of the skin’s own collagen. The natural appearing restoration of youthful facial contours is made possible by the skin thickening that results from the gradual deposition of the new collagen. Generally a series of 2-3 treatments at 6-week intervals are necessary to achieve the desired effect. The youthful appearance that results from the treatment can last up to 3 years at which time maintenance treatments can be utilized.

Ultherapy®

Ultherapy® is a new type of non-surgical treatment that uses ultrasound energy to safely lift and tone the skin without any downtime. The ultrasound image on the viewing screen allows Dr. Forley to see precisely the level at which the ultrasound energy is being delivered. Ultherapy® apparatThe deep layers of the face and neck that have lost their elasticity and firmness over time are targeted by the heat-producing sound waves. Although one treatment is frequently all that is needed, more significant facial and neck sagging may require an additional treatment after 3-6 months. The duration of results can vary but you can generally expect up to 2 years of benefits from Ultherapy®.

SURGICAL

Blepharoplasty (Eyelid Surgery)

Eyelid Surgery 75 year old male before

75 year old male before surgery

Eyelid Surgery 2 years following upper and lower

2 years following upper and lower eyelid surgery

Loose, sagging, bulging tissues of the eyelids can make the eye appear smaller and lead to others asking if you are tired or stressed. Blepharoplasty or eyelid surgery removes excess loose skin and fatty tissue that produces sagging and heaviness of the upper or lower eyelids. The eye appears larger, less tired, more open, and brighter.

Liposuction (Neck, Hips, & Abdomen)

Liposuction is a contouring procedure that removes bulges to achieve a more aesthetic blending of body outlines. The type of physical appearance men desire can be counteracted by age, heredity,lack of exercise, and poor eating habits. Long lasting results are achieved when surgery is combined with a program of fitness and nutrition. Liposuction removes excess localized fat deposits through tiny incisions using small tubes or cannulas. The overlying skin contracts to fit the new profile. Areas such as the neck, hips and abdomen are the most often targeted areas for men.

Liposuction Before

Before

Liposuction 6 months after liposuction of the hips

6 months after liposuction of the hips

Gynecomastia (Chest)

Gynecomastia 36 year old male before

36 year old male with gynecomastia

Gynecomastia 8 months after gynecomastia surgery

8 months after gynecomastia surgery

Excessively large male breasts, known as gynecomastia, can produce a feeling of self-consciousness about body image that can inhibit lifestyle choices and daily activities. In most cases, the glandular and fatty tissue enlargement of the male breasts begins during puberty. It is usually a benign condition, but can be associated with hormonal abnormalities that may need additional evaluation. Gynecomastia procedures improve the large breast size by reducing the volume and prominence of the breast fatty tissue using liposuction and directly removing excess glandular tissue via an incision at the lower edge of the areola. Skin excision is rarely necessary as it will generally retract during the healing phase. In addition to the improved appearance, patients also find they are comfortable participating in social or sports activities that they were either unable or unwilling to do before surgery. During your consultation Dr. Forley will discuss and recommend those options that he feels will give you the best result.

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