Bellafill® by Suneva Medical is a commercial injectable formulation of polymethyl methacrylate (PMMA) microspheres.

Fine Lines & Wrinkles

Acne Scars

Cheek Volume

Chin Shape & Size

Neck & Jawline Definition

Bellafill® by Suneva Medical is used to correct moderate to severe facial wrinkles, lines, and folds. It is also approved by the United States Food and Drug Administration (FDA) to correct acne scars. Bellafill® is formulated with polymethyl methacrylate (PMMA) microspheres that provide immediate volume and plumpness through the collagen gel, while also stimulating natural collagen production by the body. The gel portion of Bellafill® will be degraded over time, however, the microspheres will remain — providing a framework for the body to build collagen on for lasting results. 

Bellafill® requires multiple treatments. The results need to be carefully developed over several sessions, as Bellafill® has a high-risk of being undesirably visible under the skin. For facial wrinkles, Bellafill® provides lasting improvement for up to five years. For the treatment of nasolabial folds, Bellafill® is FDA-approved as a permanent dermal filler. The active ingredient in Bellafill®, PMMA, is generally believed to provide a longer lasting solution than fillers composed of hyaluronic acid like Juvéderm® and Restylane®. Sculptra® and Radiesse®, meanwhile, contain alternative primary ingredients that may provide results more comparable to Bellafill®.

Bellafill®

Fill ‘er up! Well, kind of. Dermal fillers and neurotoxin injections can smooth fine lines and wrinkles to create a smoo

Dermal Filler & Injectable Solutions

Fill ‘er up! Well, kind of. Dermal fillers and neurotoxin injections can smooth fine lines and wrinkles to create a smooth and youthful appearance.

Chin

Head

Cheek

Jawline

PMMA1

- Stop taking blood thinning medications one day prior to surgery. Blood thinners may include Ibuprofen, Acetaminophen, Aspirin, and prescription anticoagulants. 
- No alcohol one day before the procedure
- Reschedule if a rash, cold sore, or other lesion develops

Before Treatment

PMMA2

- Local anesthetic (like lidocaine) applied to injection site
- Injections are made in predetermined areas

During Treatment

PMMA3

- Minimal redness at injection sites
- Cold compresses to reduce redness/swelling and mild pain

Immediately After Treatment

PMMA4

- Avoid sun exposure, alcohol, strenuous activity, and makeup application for 24 hours following the injections
- Avoid touching or excessive movement of the treated area 
- Sleep in an elevated position

24 hours After Treatment

PMMA5

- Practitioners will typically perform a series of injections to avoid overfilling and undesirable lumps or bumps
- Bellafill® slowly augments collagen production over time to maintain volume
- Bellafill® can provide lasting improvements for up to five years

Result Notes

Bellafill® injections are simple, outpatient procedures with minimal side effects and downtime. Here is a general guide for what to expect before, during, and after a Bellafill® injection:

Bellafill® by Suneva Medical is a commercial injectable dermal filler formulation of polymethyl methacrylate (PMMA) microspheres. Bellafill® is a biodegradable compound used to enhance and stimulate collagen production in the body.

How much time do you spend considering the appearance of your belly button? If you’re reading this article, chances are

Abdominal Contour

Belly Button Correction Solutions

Stomach

Abdominal

Belly Button

How much time do you spend considering the appearance of your belly button? If you’re reading this article, chances are at least some.

A procedure that requires small incisions to remove excess and loose skin that causes a belly button bulge.

Changes the appearance or shape of the belly button and can be performed alone or part of another surgery.

For those who are unhappy with the appearance of their belly buttons, an umbilicoplasty can help to repair the aesthetics of the navel after pregnancy, unsatisfied results from a previous tummy tuck, or a naturally protruding "outie" belly button. The navel can also change after significant weight loss or if the patient has experienced an abdominal hernia. While typically performed in conjunction with other surgeries such as an abdominoplasty, umbilicoplasty procedures can be performed on their own as well. 

During an umbilicoplasty, a discreet incision is made deep within the belly button. Excess fat and skin will be removed to achieve a slim, oval-shaped, "innie" belly button. Any small herniations and bulging will also be addressed. Skin will be repositioned so the navel will have a slightly hooded appearance. After reshaping the belly button into a more attractive and natural appearance, the incisions will be closed with sutures. By reshaping the bellybutton, the entire abdominal area can appear leaner and longer.

Umbilicoplasty

An umbilicoplasty is a surgical procedure to alter the appearance of the umbilicus (a.k.a. the belly button).

Mommy Makeover

Belly Button Surgery

Belly button plastic surgery is sought by individuals who desire a new navel appearance or need hernia repair. Navel surgery is also known as umbilicoplasty and is usually performed under local anesthesia. This cosmetic procedure only requires small incisions to remove excess skin that causes a belly button bulge. Umbilicoplasty can correct navel changes such as loose skin created by extreme weight loss or those brought on by pregnancy.

Belotero® by Merz Pharmaceuticals is a commercial injectable formulation of hyaluronic acid.

Nose Shape

Aging Hands

Belotero® is an injectable temporary dermal filler by Merz Pharmaceuticals that is composed of hyaluronic acid (HA). Belotero® is approved by the United States Food and Drug Administration (FDA) to correct common cosmetic concerns including fine lines and wrinkles and chin, temple, and cheek-area definition. 

Hyaluronic acid fillers are the most popularly used dermal fillers in the U.S. and are well-studied for their safety and efficacy. Belotero® by Merz is a product line of injectable gel hyaluronic acid-based dermal fillers uniquely targeted to a specific cosmetic concern and treatment area:

- Belotero® Soft for perioral (a.k.a. smoker) lines 
- Belotero® Balance for moderate perioral lines, nasolabial folds, marionette lines, lips, and the oral commissures
- Belotero® Intense for deep nasolabial folds and oral commissures, and marionette folds
- Belotero® Volume for cheeks, temples, and chin
- Belotero® Lips for lip shape and contour
- Belotero® Revive the newest HA formulation for fine lines

Hyaluronic acid is a naturally occurring compound produced in nature and by the human body. Hyaluronic acid pulls water into the injected area to increase volume and plumpness, smooth fine lines and wrinkles, and stimulate the body’s own collagen production. Hyaluronic acid is considered the most temporary of the dermal fillers. For those seeking more lasting results, alternative products such as Radiesse®, Sculptra®, and Bellafill® may be considered.

Belotero®

Nose

Eyes

Lips

HAfiller1

HAfiller2

- Topical local anesthetic applied to site of injection
- Injections (a combination of hyaluronic acid and lidocaine) are made in predetermined areas

HAfiller3

HAfiller4

HAfiller5

- Results are Immediately noticeable 
- A series of initial injections may be needed to achieve desired results
- Juvéderm® injections generally last six to 12 months

Belotero® injections are simple, outpatient procedures with minimal side effects and downtime. Here is a general guide for what to expect before, during, and after a Belotero® injection:

Belotero® by Merz Pharmaceuticals is a commercial injectable formulation of hyaluronic acid. Naturally occurring in the human body, hyaluronic acid is a compound that increases volume and plumpness for both cosmetic and functional purposes.

A common ingredient in acne treatment medications used to treat mild acne and reduce acne-causing bacteria.

Acne

Most people have used a benzoyl peroxide product for acne treatment. Benzoyl peroxide comes in many forms including cleansers, gels, lotions, soaps, foams, and more. It is important to use products as directed or as instructed by a skincare professional. It has a bactericidal effect on Propionibacterium acnes bacteria associated with acne and does not cause antibiotic resistance.  It often is combined with an antibiotic such as clindamycin or salicylic acid, which has shown to be more effective then Benzoyl peroxide alone.

Apply the chosen benzoyl peroxide based product to the areas of your skin affected by acne. Avoid getting this medication into your eyes, nose, mouth, or on any areas of broken skin since it may cause irritation. If irritation occurs, wash the area with water. Be advised that benzoyl peroxide may have a bleaching effect on hair or fabric.

If diligent use of benzoyl peroxide products do not clear up the skin, or more severe acne breakouts occur, prescription strength medications such as Spironolactone may be necessary to clear up blemishes.

Benzoyl Peroxide

Acne is a common skin condition that takes the form of blackheads, whiteheads, and pimples.

Acne Treatment

In the United States, the most common skin condition both men and women suffer from is acne. Acne is a blanket term that’s used to describe the differing forms of acne vulgaris, which will include many types of acne like blackheads, whiteheads, and pimples. While mild acne or occasional moderate breakouts can be bothersome and difficult to deal with, severe forms of acne vulgaris, like cystic acne and nodular acne can be quite painful and disfiguring.

Skin

bp 1

Little preparation is needed before treatment when using a lower concentration of benzoyl peroxide. If using a prescribed dose, consult with your dermatologist before use. Before application ensure treatment area is clean and dry. 

bp 2

OTC benzoyl peroxide is well tolerated by most people. However, for best results, it is advised to:
- Avoid strong facial cleansers for 1 week
- Avoid sun exposure for 1 week 


During Treatment: Week 1-3

bp 3

Most people see results from benzoyl peroxide after 3 weeks of consistent use although it may take as long as 8-12 weeks to see maximum benefits. Some users may experience the following symptoms:
- Mild stinging or burning
- Itching or tingly
- Skin dryness, peeling, or flaking
- Redness and other irritation


During Treatment: Week 4 and Beyond

bp 4

Benzoyl peroxide is most commonly used as a spot treatment for acne flare ups and should be applied as needed. Use benzoyl peroxide based products as directed. 

After Treatment

Over-the-counter acne treatments have been used for decades to help get rid of unwanted blemishes on the face and body. Benzoyl peroxide is a common active ingredient in acne fighting products and is sold in creams, washes, and foams. Here is a quick guide for what to expect before, during, and after treatment with benzoyl peroxide.

Benzoyl peroxide is an over the counter topical medication used to treat mild to moderate acne.

Biostimulators gradually restore volume and improve skin quality by stimulating natural collagen production.

Uneven Skin Tone/Texture

Facial Volume

Biostimulators are a category of injectable treatments, including products like Sculptra® and Radiesse®, that work by stimulating the body’s natural collagen production over time. Unlike traditional dermal fillers that provide immediate volume, biostimulators gradually improve skin structure, elasticity, and thickness by triggering neocollagenesis. These treatments are commonly used to address volume loss, skin laxity, and signs of aging in the face and body. Results appear progressively over several weeks to months and can last longer than traditional fillers. Multiple sessions may be recommended for optimal outcomes.

Biostimulators

Body

Biostimulators 1

Consult with a qualified provider to determine candidacy and treatment plan.

Biostimulators 2

The biostimulator is injected into targeted areas using a fine needle or cannula.

Biostimulators 3

Initial swelling subsides and collagen production gradually improves skin quality and volume

Days to Weeks After Treatment

Biostimulators 4

Results vary depending on the product used, number of sessions, and individual collagen response.

Biostimulators are injectable treatments that stimulate the body’s natural collagen production to improve skin firmness, volume, and overall quality.

Birthmarks often tend to be hereditary while others can appear due to pigment cells or crowded irregular blood vessels.

Removes moles by using a cylindrical tool to take out the overly pigmented skin cells.

Larger moles on the face or neck can be considered unsightly for some, however, they can be easily removed by a dermatologist. Once the doctor has determined the mole to be benign, it can be removed in a simple, in office procedure that requires minimal recovery. For moles that are deeper than the skin's surface and smaller than 8mm in diameter, a punch excision can be used to excise the growth. Superficial moles can be removed with an even simpler shave excision and deeper moles will require a more invasive surgical excision. Moles and other pigmented birthmarks can typically be removed in one visit. Vascular birthmarks that present in red or purple tones will require laser or light therapies to remove. 

Before a punch excision to remove a benign mole procedure, the doctor will cleanse and anesthetize the area with a local numbing agent. Once the area is thoroughly numbed, the doctor will use a skin punch instrument with a circular blade to remove the mole. The punch tool allows for dissection into the subcutaneous fat, helping ensure the growth does not return. After the mole has been removed, the excision site will be closed with sutures and covered with a bandage.

Punch Excision of a Mole

The punch excision technique for mole removal allows for penetration into more layers of skin to remove deeper moles and birthmarks.

A sharp razor is used to remove unwanted growths in a quick procedure done at a dermatologist's office.

Moles are collections of pigmented cells within the skin. While some may consider moles a part of their signature look, such as Marilyn Monroe or Cindy Crawford, others find these growths unsightly. Superficial moles can be removed in a simple, in office procedure by a dermatologist. Larger moles that extend deeper into the dermis may require a more invasive punch removal or surgical excision. Birthmarks that are vascular such as Port Wine stains, cannot be as easily cut off and would need treatment with either laser or light therapies. 

Once a skincare professional has determined the mole to be noncancerous, the growth can be removed. Before the mole is excised the doctor will inject a numbing anesthetic beneath the mole to not only reduce the amount of discomfort experienced by the patient, but also raise the mole for easier removal. Next, the doctor will use a sharp razor to expertly remove the growth. Patients may feel a pushing sensation or pressure in the area of the mole but typically do not feel pain. After the mole is completely removed the doctor will apply an antibiotic ointment and sterile bandage.

Shave Excision of a Mole

The shave excision technique for mole or birthmark removal allows for quick, minimally invasive lesion removal.

Cuts out a mole deep into the fat region to remove the lesion in its entirety.

A surgical excision of a mole,  also called a “full-thickness excision", removes unwanted growths down to the subcutaneous fat. By removing the mole from deep within the skin, the growth should to return and be permanently removed. While a punch excision also removes moles down to the subcutaneous fat, the cylindrical tool used cuts out portions of the skin into perfect circles and is only suitable for growths smaller than 8mm. If a punch excision was used for a growth larger than 8mm, issues with closure become more apparent with the circular shape of the cut not allowing for good alignment, creating excess skin when sutured. 

A surgical excision of a mole typically only requires a local anesthetic. Once the area is thoroughly cleansed and numbed, the unwanted growth will be removed down to the subcutaneous fat. The incision will be closed with sutures and covered with a protective bandage.

Surgical Excision of a Mole

The surgical excision technique for mole or birthmark removal allows for removal of deeper and larger skin lesions.

Lessens the appearance of vascular and pigmented birthmarks using a fractional laser to target specific birthmarks.

Birthmarks are skin lesions that you are born with.  They come in a variety of shapes, sizes, and colors.  Birthmarks are categorized as either vascular or pigmented.  

Vascular birthmarks are caused by visible collection of blood vessels beneath the skin and are typically red or purple in color and. Examples of vascular birthmarks include port-wine stains or salmon patches.  Pigmented birthmarks, such as moles, Cafe au lait and Mongolian spots are caused by an excess of melanin in a concentrated area. Pigmented and raised birthmarks or moles may be better treated by a shave, punch, or surgical excision. 

Vascular birthmark removal by laser resurfacing aims to improve and diminish the appearance of birthmarks. The laser used will always be a fractional laser which means the energy will be targeted to specific areas of the skin. Depending on the treatment recommended by your skincare professional either a fractional ablative laser or a fractional non-ablative laser will be used. Ablative lasers are more aggressive, penetrating deeper into the skin allowing the lasers to break up pigment and blood vessels, reducing the appearance of the birthmark. Ablative lasers typically require fewer treatments than non-ablative, however recovery time will be greater. The opposite is true with more gentle non-ablative lasers, which require more treatments however will be accompanied by a shorter recovery period.

Birthmark Removal by Laser Skin Resurfacing

Birthmark removal by laser skin resurfacing utilizes either an ablative or non ablative fractional laser therapy to vaporize old skin cells and promote new healthy cell growth.

Mole Removal

Birthmark Removal

Birthmarks & Moles

There are numerous variations of birth marks ranging in color, size, shape, and permanence. There are also a diverse array of cosmetic surgery procedures to lessen the appearance of or remove these skin lesions.

Diminishes the appearance of pigmented and vascular birthmarks through intense pulsed light therapy.

Light therapy can help reduce the appearance of pigmented and vascular birthmarks. Pigmented birthmarks are caused by irregularities in the melanin in the skin whereas vascular birthmarks are the result of blood vessel abnormalities. The resulting blemishes can effect one's confidence and self esteem when spots are large or ill-placed. If a pigmented birthmark is raised, your doctor may recommend excision via a shave, punch, or surgical method. 

Light therapy, intense pulsed light, or IPL, helps unwanted blemishes disappear by cutting off the blood supply to vascular birthmarks and breaking up the melanin in pigmented birthmarks. During an IPL treatment, a hand-held device delivers a visible pulse of broad spectrum light. This light targets the difference in color from the birthmark and the natural skin complexion. When the light is absorbed, the blood vessels and irregular pigments are heated and destroyed. Light therapy is not as targeted as a fractional laser resurfacing treatment for birthmark removal, meaning number and duration of treatments will vary considerably depending on the size and color of the treated area.

Birthmark Removal by Intense Pulsed Light (IPL)

It’s our moles, marks, and spots that make our skin unique, but sometimes these lesions need to go.

Birthmark, Mole, & Skin Growth Removal Solutions

birthmark light 1

- Keep skin moisturized and avoid sun exposure
- Stop smoking at least 4 weeks before and after treatment
- Avoid blood thinning medications
- An antiviral medication may be prescribed 

birthmark light 2

- Mild erythema and a stinging sensation for several hours
- Skin may feel sensitive, similar to the sensation of a sunburn, for up to 24 hours

birthmark light 3

Most patients will feel comfortable returning to work and social events 1 day after treatment. Significant changes may not be noticeable until several weeks after treatment 

1-4 Weeks After Treatment

birthmark light 4

It is common for patients to undergo a series of 3-8 sessions to achieve desired results from light therapy. Once the desired outcome is achieved, yearly maintenance treatments are typically necessary for continued results. 

Continued Treatment

Light therapy can be used to diminish the appearance of both pigmented and vascular birthmarks. While not as aggressive as laser resurfacing, intense pulsed light therapy, or IPL, can make birthmarks less noticeable. Here is a quick guide for what to expect before, during, and after birthmark removal by light therapy. 

Birthmark Removal by Light Therapy

Intense pulsed light (IPL) is a minimally invasive birthmark removal procedure with less side effects than laser skin resurfacing.

birthmark laser 1

- Avoid overexposure to the sun and moisturize regularly
- Stop smoking at least 4 weeks before and after treatment 
- Avoid blood thinning medications 
- An antiviral medication may be prescribed

birthmark laser 2

Aftercare instructions will vary based on the type of laser used, however most patients will experience:
- Sensitive skin for 24 hours
- Mild swelling and redness
- More aggressive treatments will require protective bandages

birthmark laser 3

- Patients treated with a non-ablative laser will likely be healed and feel comfortable in public in as little as a few days to 1 week. 
- Patients treated with an ablative laser will have a longer healing processing, lasting 3-4 weeks with skin peeling and crusting. 

birthmark laser 4

The number of laser resurfacing treatments varies and depends on the needs of the patient and factors such as age, skin type, and type of birthmark. Annual treatments may be needed to maintain results.

Laser resurfacing can be used to lessen the appearance of both vascular and pigmented birthmarks. Although a fractional laser will be used during treatment, either an ablative or non-ablative laser can be used to treat unwanted birthmarks. Here is a quick guide for what to expect before, during, and after birthmark removal by laser resurfacing.

Birthmark Removal by Laser Resurfacing

Cryosurgery uses intensive cold therapy with liquid nitrogen to freeze and destroy unwanted soft tissues.

A cryosurgery procedure can cost anywhere from $100 to $500. The actual cost of a cryosurgery is dependent upon location, plastic surgeon, and length and involvement of the cosmetic procedure.

Cryosurgery, or cryoablation, is a non-surgical topical thermal treatment using extreme cold therapy to destroy unwanted tissues. Cryosurgery, like cryotherapy, uses liquid nitrogen to spot freeze tissues. Cryosurgery is highly effective in dermatology for removing most benign skin lesions, especially in patients with lighter skin looking to remove lesions on non hair bearing areas of the body. 

Actinic keratoses, molluscum contagiosum, skin tags, and numerous other skin conditions respond well to liquid nitrogen cryosurgery. Cryosurgery is also a first line technique for some cancer treatments including skin cancer and prostate cancer.

Cryosurgery

Considered the most effective and precise method of skin cancer removal with a high cure rate and aesthetic outcome.

A Mohs surgery procedure can cost anywhere from $1,000 to $2,000. The actual cost of a Mohs surgery is dependent upon insurance, location, plastic surgeon, and length and involvement of the surgical procedure.

A Mohs surgery (a.k.a. Mohs micrographic surgery) is the gold standard dermatology procedure performed by a specialized dermatologist for many types of skin cancers. The Mohs surgeon can precisely remove cancer cells while sparing healthy tissue in this effective treatment. 

A Mohs procedure involves removal of thin layers of tissue for review by a pathologist to determine margins of healthy tissue and cancer cells. The Mohs Surgeon can then repeat thin layers of tissue sample removal with a scalpel at the surgical site until the entire tumor is removed, and the patient is free of cancer cells. This is all done in the same visit with wait times in between each step. A Mohs dermatologic surgery is the gold standard for many common types of skin cancer as it has the highest cure rate with excellent cosmetic results.

There are alternative surgical techniques such as the shave excision technique which does not require stitches and creates a very small scar, the punch excision which can treat deeper lesions less than eight millimeters, and the surgical excision which treats lesions greater than eight millimeters.

Mohs Surgery

Mohs surgery is considered the most effective and precise method of skin cancer removal with a high cure rate and aesthetic outcome.

Aims to correct issues with the upper eyelid and under eye areas, such as under eye bags and droopy eyelids.

Also known as double eyelid surgery, this procedure creates a new natural looking eyelid crease.

An Asian blepharoplasty, sometimes also referred to as a double eyelid surgery, gives patients a new natural-looking eyelid crease. This crease is generated by dividing the upper eyelid. 

This procedure is performed using one of two techniques – suture ligation or external incision. Both are effective; however, your specific needs will determine which procedure your surgeon chooses. With a suture ligation technique, your eyelid tissues will be compressed and tied after the eyelid has been “crimped” and indented to form a new, appropriately positioned crease. Once positioned, the sutures are tied and buried underneath the skin. This technique creates a static crease, which simply means that it does not move or soften as you look down, and the results may fade over time. 

An external incision technique forms a dynamic crease that moves and adjusts as you look down. It is particularly helpful for those with heavy eyelids as this method has the capability to remove skin, underlying muscle and fat. The new crease line is marked prior to incision to ensure proper height and shape. Once excision is complete, the skin-muscle flap is repositioned and the crease and incision are closed to begin the healing process.

Asian Blepharoplasty

Asian blepharoplasty surgery creates a new eyelid crease using either a suture ligation or an external incision technique. With suture ligation, the eyelid crease is formed by the tying of a suture, whereas with external excision, a portion of the skin, underlying muscle, and fat are removed to create the desired results. Both techniques offer a natural looking crease and may also be referred to as double eyelid surgery.

A minimally invasive, partial incisional/suture technique used to create natural looking double eyelids.

For patients seeking a minimally invasive surgery to create an eyelid crease, an Asian blepharoplasty performed using the partial incisional/suture technique could be the ideal solution. Unlike the open approach to the Asian blepharoplasty, this approach does not require eyelid skin or muscle to be removed which can greatly reduce recovery time. Since there may be no incisions made, there is no visible scarring on the eyelid. 

Before the surgery begins, the patient's eye and eyelid will be anesthetized. Pre-operative markings will then be made to guide the surgeon during the procedure. The optional incisional portion involves making a 1cm incision along the outer corner of the upper lid marking. At this point, a very minimal amount of eye muscle and excess fat may be removed. For a completely incision-less procedure these steps would be skipped.

For a suture only procedure, a nylon stitch will be placed next to the lash line of the upper lid for retraction. The upper lid will be flipped to expose the inner surface of the eyelid and a 5mm bite of tissue using double-armed 5-0 nylon will be taken at the mid pupil along the upper border of the tarsal plate, a thick portion of dense connective tissue in the eyelid. The eyelid will be reentered through the same needle hole so that a full-thickness buried suture exits on the skin surface of the upper lid along the preoperative lid markings. A knot will be secured and retracted into the deep recesses of the eye muscle. Four sutures will be placed an equal distant apart. The candidate will open and close their eye to verify that the crease extends sufficiently across the eye, then the incision will be closed.

Asian Blepharoplasty Partial Incisional Suture technique

The partial incisional/suture technique for an Asian blepharoplasty is a minimally invasive method used to create natural looking double eyelids. This method achieves the natural appearance of the open incisional approach without creating a cut along the upper eyelid while using sutures instead to hold the tissues together.

Addresses complications that arise due to overcorrection of the skin during a lower eyelid procedure.

Massage and steroid injection therapy can correct the position of the lower eyelid when signs of abnormal healing and scar tissue related complications are present after a lower eyelid blepharoplasty. When a lower blepharoplasty includes skin removal, there is always a chance that the patient will experience a complication called ectropion, or an outward turning of the lower eyelid. This condition exposes the inner eyelid and can cause eye dryness, excessive tearing, and irritation. Steroid injection and massage therapy can be done preventatively to help decrease keratitis or ulceration after a lower blepharoplasty procedure.

Early identification of abnormal healing is key to fixing lower eyelid malposition after a lower blepharoplasty procedure. Steroid injection and massage can help to fix minor issues with eyelid malposition. More serious cases of ectropion will require surgical intervention with either a lateral canthal suspension canthopexy or lateral tarsal strip canthoplasty surgery.

Lower Eyelid Malposition - Massage and Steroid Injection

This procedure addresses concerns related to complications that arise due to over correction of the skin during a lower eyelid blepharoplasty. By using massage and steroid injection, this technique helps to correct ectropion, or an outward turning of the lower eyelid.

Reinforces the existing tendon of the lower eyelid by surgically stitching it to create extra support.

A lateral canthal suspension canthopexy is typically performed to correct complications from a lower eyelid blepharoplasty procedure. When a lower eyelid blepharoplasty is performed via a transcutaneous approach, a portion of skin will be removed to fix facial skin laxity. If too much skin is removed, the patient may experience ectropion which causes the eyelid to roll outwards and increase scleral show. This condition can cause the patient discomfort, dry eyes, and excessive tearing. If the ectropion cannot be corrected with steroid injection and massage therapy, a surgical approach will be necessary. 

A lateral canthal suspension canthopexy procedure begins by first making two incisions – one on the upper eye just below the outer 2/3 of the eyelashes, and the other a skin-flap only incision on the lower lid. The upper incision exposes the orbital bone which facilitates passing the sutures directly next to the eye in the lining of the bone. These sutures are tied once the they have been adjusted to a desired tautness. If no skin is removed during surgery, the incision is much smaller. This method fully preserves the orbicularis muscle.

Lower Eyelid Malposition - Lateral Canthal Suspension Canthopexy

The lateral canthal suspension canthopexy focuses on reinforcing the existing tendon of the lower eyelid by surgically stitching it to create extra support. This helps to reduce the risk of complications related to a lower blepharoplasty, especially in patients who are already experiencing several age-related symptoms.

Addresses the appearance of bags and dark circles under the lower eyelids through re-sectioning of fat in the cheeks

This procedure addresses dark circles and bags under the eyes by re-sectioning or repositioning the orbital fat that has been affected by aging. During the natural aging process, the fat pads underneath the eyes can droop and sage, causing unsightly bags. These bags under the eyes can cause individuals to appear older and more tired. If only an adjustment to the fat pads is needed, a transconjunctival approach is ideal. However, if there is sagging skin present a more invasive transcutaneous approach may be needed to remove the excess skin. 

A lower eyelid blepharoplasty that is performed via a transconjunctival approach is done by creating incisions on the inside of the lower eyelid. These incisions allow for fat excision without causing damage to the eye muscle. Fat is re-sectioned within these incisions and can be redraped to a higher, more aesthetically pleasing position. No sutures are needed for this method. Tear trough deformities are addressed prior to completing the surgery by either redraping or repositioning the orbital fat to account for any present eye hollowing.

Lower Eyelid Blepharoplasty Transconjunctival Approach

A lower eyelid blepharoplasty with a transconjunctival approach addresses the appearance of bags and dark circles under the lower eyelids. This technique does not allow for skin excision, but it noticeably addresses concerns brought on by aging. It mostly focuses on re-sectioning the fat where the cheeks have begun to sag, causing eyelids to stretch and lengthen vertically.

Corrects many lid malpositions and works to elevate and tighten the eyelid.

A lateral tarsal strip canthoplasty can improve lower eyelid malposition by lifting the lower eyelid to improve aesthetic appearance and allow for better vision. An incision will be made in the outer corner of the eye, typically within a pre-existing wrinkle or crow's feet mark, between 8 to 10mm in length. The lateral canthal tendon is then excised between 6-12mm to effectively shorten the lower eyelid and improve eyelid laxity. Sutures are made within the tarsal strip and secured within a dense layer of vascular tissue around the eye.

Alternative procedures to help correct lower eyelid laxity include steroid injection and massage for a non-invasive technique, as well as a canthopexy procedure. The canthoplasty procedure is typically preferred to the cathopexy as it is longer lasting and has a lesser chance of reoccurence. The best way to decide which procedure will work best for your individual needs is to speak to a board certified surgeon during an in-person consultation.

Lower Eyelid Malposition - Lateral Tarsal Strip Canthoplasty

The lateral tarsal strip canthoplasty improves many lid malpositions. It is used to correct retraction (cicatricial or involutional) and ectropion. It is also a champion technique for elevation and tightening of the eyelid. It can be performed as a sole procedure or in conjunction with a midface lift. Although most canthoplasties can produce eyelid tightening, tarsal suspension allows elevation, retroplacement, and tightening even if the eyelid is under inferior-based tension.

Used to create a long lasting and natural looking skin crease in the upper eyelid that shows when the eyes are open.

An Asian blepharoplasty procedure is done to create an upper eyelid crease for patients of Asian decent. The surgery aims to create a natural appearing eyelid crease, but not look "Western" in appearance. There are two approaches to an Asian blepharoplasty: open/incisional or partial incisional/suture. The open/incisional approach allows for dynamic movement of the created eyelid crease and is the preferred method for patients who also need to address muscle and skin laxity.

Before an open/incisional Asian blepharoplasty surgery begins, the eyes will be numbed with anesthetic drops and the surrounding eyelid will be administered a local anesthetic agent. The eyelid will be marked for the ideal location of the crease, the incision made, and between 1-2mm of excess skin removed if necessary. Fat and muscle will then be manipulated and excised. Internal closure is performed to create the eyelid crease, followed by skin closure.

Asian Blepharoplasty Open Incisional approach

The incisional "double eyelid" surgery or open Asian blepharoplasty technique is used to create a long lasting and natural looking skin crease in the upper eyelid that appears when the eyes are open. This technique is performed under local anesthesia and involves making a cut in the upper eyelid to remove excess skin, muscle, and fat. The incisional approach is the gold standard in Asian blepharoplasty.

Focuses on removing the excess fat pads and creating a centrally positioned eyelid without hooding or skin draping.

The upper eyelid blepharoplasty is a procedure that surgically removes excessive and droopy eyelid skin. This can be a result of loss of collagen and elastin during the natural aging process that can cause the eyebrows to fall, eyelid skin to lose tautness, and overall facial skin begin to droop. The excess skin can cause vision-related issues as well, making this both a procedure that corrects both form and function of the eyelids. This procedure is commonly combined with other facial rejuvenation surgeries such as a brow lift, lower eyelid blepharoplasty, or facelift. 

Although this procedure removes both excess skin and fat, special care will be taken to preserve as much as possible in order to retain a youthfulness in the eyelid. Your doctor will evaluate your eyelids by manually manipulating the area to determine how much skin removal is needed. Once the excision is planned and the lid is marked, a local anesthesia is applied and protective shields are placed over the eyes during the surgery. Once the excision is made fat and skin is then removed with either a cautery or laser device.  The eyelid will then be repositioned to its new, higher location and the incision will be closed.

Upper Eyelid Blepharoplasty

An upper eyelid blepharoplasty is one of the most commonly performed plastic surgeries in the United States and is often combined with a brow lift when performed for aesthetic reasons. It can also be done for functional purposes, though, such as for loose skin that inhibits vision. This eyelid lift focuses on removing the excess fat pads and creating a centrally positioned eyelid without hooding or skin draping, which refers to the way the skin hangs over the rim of the eye.

Addresses age-related dark circles and bags of the under-eye through an incision made beneath the eyelashes.

A lower eyelid blepharoplasty performed with a transcutaneous approach addresses age-related concerns such as skin laxity and fat protrusion that interfere with a smooth transition from the lower lash line to the cheek. Before the procedure, the surgeon will do an initial evaluation to determine lid strength and laxity by performing a snap test. During this test, the lower eyelid will be pulled down and observed for how long it takes for the lid to return to its normal position without the patient blinking. An abnormal result may require a lid-shortening procedure to ensure optimal results postoperatively. 

Once your doctor has performed the initial evaluation, an anesthesia will be injected to numb the area. Following preoperative marking, an incision will be made directly beneath the lash line to expose the eye muscle. The fat that easily flows into this incision is removed and, once complete, the skin-muscle flap is replace and the incision is closed with a running suture. Surgical glue may be used in some cases to provide extra reinforcement, and surgical tape suspends the lid laterally.

Lower Eyelid Blepharoplasty Transcutaneous Approach

The transcutaneous blepharoplasty approach addresses age-related dark circles and bags of the under-eye area through an incision made directly beneath the eyelashes. During surgery, an incision is made that allows the muscle of the lower eyelid to be tightened, while also creating space to trim and reposition excess skin and fat.

Aging & Tired Eyes

Sagging & Hooded Eyelids

Blepharoplasty

Face

Upper Eyelid

Blepharoplasty is a type of plastic surgery that corrects or repairs concerns of the upper eyelid (upper blepharoplasty) and under eye area (lower blepharoplasty). It can be performed for several reasons, including the removing dark under eye circles, under eye bags, and droopy upper eyelids. It also can be performed for creation of natural looking eyelids or simply for the aesthetic purpose of restoring the eyelids to a smoother, younger looking appearance.

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