Beware-Non-Surgical Blepharoplasty Or Eyelift by toriola1


									                                     Presented by Daniel Toriola

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                              Beware-Non-Surgical Blepharoplasty Or Eyelift
                                               By Brooke Seckel

   The non-surgical facial rejuvenation revolution is now, prematurely in my opinion, being applied to
eyelids for correction of dark circles under the eyes, removal of eyelid bags and other eyelid aging

Until recently the traditional plastic surgery operation called blepharoplasty has been the “Gold
Standard” for rejuvenation of the eyelids to remove puffiness or lower eyelid bags, loose skin and
hooding of the eyelids. More recent advances have included the use of the CO2 laser instead of a
scalpel for blepharoplasty with a resultant decrease in the amount of bleeding and bruising and thus a
shorter recovery. In addition, transconjunctival blepharoplasty, a technique done through the inside of
the lower eyelid has improved results by avoiding an incision on the outside of the lower eyelid
preserving eyelid support and natural shape. More recently, an internal eyelid ligament release called
an arcus marginalis release, combined with fat grafting, has allowed plastic surgeons to permanently
remove dark circles under the eyes. It is safe to say that in 2006, plastic surgical eyelid rejuvenation
techniques are better, more effective, and when properly done by an experienced plastic surgeon more
safe than ever before.

However, patients’ desire to avoid surgery coupled with advances in non-surgical technology, and also
influenced by the vast number of physicians with no surgical training entering the field of “aesthetic
medicine”, have resulted in many new non-surgical applications in the field of eyelid rejuvenation.
While some non-surgical techniques have been dramatically successful e.g. Botox, many others are
being marketed to patients and offered to patients before safety and effectiveness have been proven in
clinical studies.

Two such techniques being promoted today are of concern to me.

The first is the use of soft tissue fillers to correct dark circles under the eyes. Many physicians are now
injecting fillers like Restylane, Radiesse, Sculptra, Cosmoplast, Cosmoderm, Hylaform and others into
the dark circles under the eyes to plump the dark circle. While acceptable cosmetic results can be
achieved, the risks of injury to the eye are unacceptable, not only in my opinion, but the opinion of the
manufacturers of the fillers. Companies that make the fillers recommend that the fillers not be injected
around the eye. Unfortunately many doctors are not heeding these warnings, I assume out of
ignorance of the vital structures that lie beneath the eyelid and can be damaged by the needle, or lack
of concern for their patient’s safety. It is not a matter of if, but when a patient will be blinded by this

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                                 Presented by Daniel Toriola

technique. If you would like to read the unfortunate experience of many patients who have been injured
by filler injections around the eye check the following link:

The second technique that concerns me is the non-surgical blepharoplasty or eyelift performed by
using a radiofrequency skin-tightening machine on the eyelids, directly over the eyeball. Astoundingly
the demonstration on a web link showed a doctor performing this procedure with no eye protection for
the patient. Radiofrequency is a high-energy heat source that shrinks skin by heating the deep dermis.
Sophisticated cooling devices are used to cool the skin as the radiofrequency energy passes through
the skin so that the skin is not burned. Were the eye exposed to radiofrequency energy the eye could
be severely injured. Thermage, one such radiofrequency skin-tightening device has already been
shown to melt fat beneath the skin resulting in permanent defects or depressions in the skin. I am
concerned about the effect of such high-energy heat on the delicate eye structure and the fat and
muscles beneath the eyelid. The device being promoted had a suction mechanism that pulled the
eyelid up into the radiofrequency head and thus presumably avoided radiofrequency irradiation of the
eyeball, but the patient had no eye protection. Noteworthy is the fact that the doctor performing this
procedure was not a plastic surgeon and I assume was likely lacking in an intimate knowledge of the
surgical anatomy of the eye and the serious complications and their management if they were to occur.

Unfortunately it is up to you, the patient to educate yourself and avoid unproven, risky new techniques
that promise the miracle of non-surgical eyelid rejuvenation or blepharoplasty. Your safest course is to
consult an expert. Seek the advice of an experienced board certified plastic surgeon when considering
eyelid rejuvenation, blepharoplasty or eyelid lift. An experienced up to date plastic surgeon will be
aware of which non-surgical facial and eyelid rejuvenation techniques work and are safe. Avoid the
hype and marketing-if it sounds too good to be true it usually is. With thousands of physicians with no
plastic surgical training entering this field every year these are dangerous times. Do not pay to become
an experimental subject. Caveat Emptor.

Dr. Brooke Seckel

Dr Brooke R. Seckel, Asst. Professor of Surgery at Harvard Medical School was recently named a Top
Doctor in Boston by Boston Magazine. He is also listed as one of the Best Doctors in America. Dr
Seckel is an internationally recognized expert in Plastic Surgery. Dr Seckel’s office is in Boston at
617-262-2208 or at

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                                  Presented by Daniel Toriola

                          New Treatment For Dark Circles Under The Eyes
                                           By Brooke Seckel

Dear Doctor Seckel,

I live in Boston and am scheduled for an eyelid tuck called a blepharoplasty. I read on aol that a new
procedure called the transconjunctival blepharoplasty is better. I have also read about arcus marginalis
release. Can you tell me the difference. I am confused and don’t want to have the wrong operation. My
problem is puffy bags and dark circles under my eyes. I am 38 years old and have good skin. I also
hear this operation can be done with a laser, have you heard of a laser blepharoplasty. Everyone tells
me I look tired. Please help. Thank you, Rose, Boston, MA.

 Dear Rose,

Congratulations on being well read and up to date on the latest plastic surgery techniques!

The transconjunctival blepharoplasty with arcus marginalis release is the best new method for
removing eyelid bags and dark circles under the eyes. I do this procedure with a laser and feel it is the
safest and best way to do the operation.

There are many advantages to the new techniques.

First, with traditional scalpel blepharoplasty an incision is made on the outside of the lower eyelid which
cuts through the supporting muscles of the lower eyelid and skin and muscle are removed. The result
is that after healing the lower eyelid can turn down and have a “sad eyed look” called “hound dog eyes”
or technically an ectropion. If you look at many people who have had the standard blepharoplasty you
will see this.

The transconjunctival blepharoplasty avoids this complication by placing the incision on the inside of
the eyelid thus the muscles are not cut, eyelid support stays in tact and there is no visible incision on
the outside of the eyelid.

The arcus marginalis release is the only method for removing dark circles under the eyes that works.
Usually during this maneuver fat or a tear trough implant is placed beneath the dark circle to plump up
the skin and remove the shadow.

The benefits of using the laser for blepharoplasty is that the laser seals the blood vessels as it cuts
thus there is much less bleeding during blepharoplasty. Since bleeding is the most dreaded
complication of blepharoplasty, I feel the laser is a much safer technique.

If you want to read more about this technique please visit:

Thank you, Dr Seckel

Dr. Brooke R. Seckel is a nationally and internationally recognized authority in Plastic Surgery and the

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                                  Presented by Daniel Toriola

treatment of facial aging. He performs all types of cosmetic, facial and breast plastic surgery, but his
special interest lies in the field of non-surgical therapies to correct and prevent facial aging.

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                                   Presented by Daniel Toriola

Related eBooks:

New Treatment For Dark Circles Under The Eyes
Plastic Surgeons and Plastic Surgery
Blepharoplasty May Make Dark Circles Under The Eyes Worse
Laser Eyelid Rejuvenation
What Is Eyelid Surgery?

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