Before and After Photos of eyelid surgery

Frequently Asked Questions's about eyelid surgery (blepharoplasty).

 Cosmetic eyelid surgery (technically called blepharoplasty) is a procedure to remove fat – usually along with excess skin and muscle – from the upper and lower eyelids. Eyelid surgery can correct dropping upper lids and puffy bags below your eyes – features that make you look older and more tired than you feel, and may even interfere with your vision. However, it won’t remove crow’s feet or other wrinkles (see Botox and Fillers) or lift sagging eyebrows (see endoscopic brow lift video in 3D Explanations section.). While it can add an upper eyelid crease to Asian eyes, it will not erase evidence of your ethnic or racial heritage. Blepharoplasty can be done alone, or in conjunction with other facial surgery procedures such as a facelift or browlift.

How eyelid surgery is done

As people age, the eyelid skin stretches, muscles weaken, and fat accumulates around the eyes, causing "bags" above and below.

 

Before surgery, Dr. Weiss marks the incision sites, following the natural lines and creases of the upper and lower eyelids.

 

Excess skin, muscle and/or underlying fat is then carefully removed, and the incisions are then closed with fine sutures, which will leave nearly invisible lines.

 

 

Removing the bags and dark circles (shadows) with no skin incision

In many cases, Dr. Weiss utilizes a procedure for improving the appearance of the lower eyelid that avoids a skin incision altogether, which he has been popularizing since 1986 when it was first introduced among oculoplastic surgeons. In a transconjunctival blepharoplasty (TCB), a tiny incision is made inside the lower eyelid and fat is removed from behind the eyelid without a skin incision. The incision is closed behind the eyelid with a single dissolving suture.

In appropriate patients this is absolutely the safest and most precise method for improving the appearance of the lower eyelids. Since there is no skin incision, the bruising is absent or minimal, with some patients able to return to work on the very first day without makeup (we recommend two days of cool compresses to decrease swelling no matter how good you look)! Dr. Weiss uses a special operating table for this procedure that briefly places the patient in an upright position during the procedure after the fat is removed. This allows him to account for the effect of gravity on the fat pads and adjust them accordingly which contributes to a high degree of surgical precision.

 

Before and After Photos 

Frequently Asked Questions about Botox

As an eye plastic surgery specialist, I have been using Botox since 1989 - well before it was used for cosmetic purposes. Ophthalmic plastic surgeons originally used it for its initial FDA indication - for the treatment of blepharospasm (uncontrollable blinking of the eyelids) and facial spasms.

Botox has since become the definitive non-surgical treatment for the wrinkles that are caused by contractions of the delicate underlying facial muscles every time you smile, laugh or frown. Over the years, I have refined strict dosage guidelines and procedural protocols to ensure that the Botox injection procedure is safe and effective for all of my patients.

Recognizing this experience, Allergan (manufacturer of Botox) has designated our office as one of their national training centers for cosmetic Botox treatments and appointed me to their National Educational Faculty. I have also attained Allergan's highest level of Botox injector, Platinum status.

Botox is easily administered during a routine office visit. The treatment procedure itself takes only 10 minutes. A simple injection, directly into localized regions of the facial muscles, weakens and reduces their pull on the skin, eliminating the ability to form deep expression lines on problem areas of the face.

Although not a permanent cure, with adequate dosages the effects of Botox can last from 3 to 6 months or even longer, making it today's most popular non-surgical cosmetic procedure. The treated areas not only have a more youthful and rested appearance, but patients have actually remarked about how much more relaxed they feel after their Botox treatments.

I can personally vouch for that (I get Botox between my own eyebrows). I definitely feel less tense and more relaxed from my treatments, especially when I am in the sun, which normally causes facial muscular contraction. It works much the way sunglasses relieve squinting.

Importance of realistic patient expectations

Botox injections are highly technique- and experience-dependant. This means that results can vary based on the doctor's knowledge of facial anatomy, particularly of the peri-orbital (area around the eyes) facial musculature and function. Although the actual injection is a relatively minor procedure, it still requires steady hands and a good injection technique to maximize results and decrease the risk of bruising.

Results can also vary between patients and even between same-dosage treatments in the same patient. This is because each patient has a unique sensitivity to the effects of Botox and also because between each treatment session there may be slight differences in the exact position of the needle tip that delivers the Botox. In some cases more than one session may be needed for optimal results. A Botox "Touch-up" may be administered 2 or more weeks after the initial injections if an additional improvement is desired.

From years of experience with Botox injections, I have found that it is one of the safest and most patient-pleasing treatments that I offer. I encourage my patients to consider Botox therapy if they would like to make a significant improvement in their appearance without surgery, with very little risk and in most cases, no 'down' time.

Frequently Asked Questions about Botox

See Juvéderm before and after photos.

Introducing Juvéderm

Juvéderm gel is the 'Next Generation' of FDA approved hyaluronic acid dermal fillers. Because of advanced manufacturing methods, Juvéderm provides a smooth, soft long-lasting correction of facial wrinkles and folds.

Beauty, Without Restriction.

Over the years your tissues sag and your lips lose their substance, retracting, and giving a sad, tired appearance. You look at yourself one morning in the mirror and lipstick runs from once full lips. What were once smile lines become hollowed-out nasal furrows, giving a tired look. Age is catching up to you - but it doesn’t have to!

Juvéderm is a long-lasting gel injected under the skin with an ultra-fine needle which lifts and adds volume to the areas being treated. With a simple injection of Juvéderm, minor imperfections and signs of aging are softened. The smooth consistency of Juvéderm may also help to minimize the minor discomfort that can sometimes occur during the injections.

Acting naturally but not irreversibly, your lips regain their sensuality and your face its smooth curves.

Dr. Weiss and Facial Aesthetic Injectables

Dr. Weiss has been injecting dermal fillers since 1986 and Botox since 1989.

He has taught an official Botox instruction course at American Academy of Ophthalmology from 2004 through 2006 and is on the National Education Faculty for Botox Cosmetic.

Because of his expertise in facial aesthetics, Dr. Weiss was one of a select group of physicians to participate in the Juvederm Experience Trial, in advance of national product availability in January 2007.

Juvéderm vs Restylane

Let your skin lie about your age!

Before and After Photos

Frequently Asked Questions about Laser Skin Rejuvenation.

When we were young, our skin was soft, clear and radiant. Over the years, the effects of sun, wind, cold and pollution take their toll. Fine lines appear near the eyes and eye brows, on and around the lips, and even across the cheeks. Laser Skin Rejuvenation can help!

If your skin looks older than you feel, perhaps it’s time to consider looking years younger with laser skin rejuvenation. Removing your wrinkles with laser skin resurfacing is the next generation in wrinkle removal, offering the most advanced technology for the safe and effective treatment of age- and sun-damaged skin.

The laser is used like an artist’s brush, gently painting away wrinkles - even those stubborn ones in delicate areas around the lips and eyes. Deep laugh and frown creases can be softened. Some acne and surgical scars can be minimized. The new laser method 'irons' wrinkles away so precisely and safely that it replaces most chemical skin peels and dermabrasion.

 

Fraxel SR1500 Laser Treatment: Repairing aging and sun-damaged skin: pixel by pixel, spot by spot

Before and After Photos

With today’s emphasis on active, healthy lifestyles, most people feel a lot younger than they look. Aging and sun-damaged skin, wrinkles, fine lines, and brown spots often mask your inner beauty. Fortunately, there is a new aesthetic laser solution that provides a fresh chance to turn back the clock on aging.

Richard A. Weiss is pleased to be one of the first physicians in Orange County to offer Fraxel Laser Treatment. This new science was developed at Harvard University’s Wellman Laboratories in connection with breakthrough technology from Reliant. Fraxel Laser Treatment improves both the top layers of skin by reducing wrinkles and pigmented lesions such as sun spots and age spots, as well as affecting the deeper skin layers by giving the supporting tissue a boost to help the skin feel softer, smoother and tighter.

To appreciate the benefits of Fraxel Laser Treatment, think of a family portrait or digital photograph in need of high-quality restoration or touch-up. Just as a damaged painting is delicately restored one area at a time, or a photographic image is altered, pixel by pixel, the Reliant Fraxel Laser improves your appearance by affecting only a fraction of your skin at a time with thousands of microscopic laser spots. It’s like PhotoShop digital software for your skin!

The unique “fractional” approach is a huge step forward in providing significant cosmetic results with practically no downtime. This advanced treatment is the first cosmetic laser to provide an effective, gradual procedure that creates new healthy tissue by stimulating the body to naturally repair aging and photo-damaged skin without significant risks or recovery time.

The Reliant Fraxel Laser is FDA-cleared to treat wrinkles around the eye and improve pigmented lesions, including age spots and sun spots. The procedure can be performed in our office using topical anesthesia. Treatment takes about 45-60 minutes, depending on the size of the area(s) being treated. Because the procedure does not ablate or remove the outer skin layer, patients can resume routine activities right after treatment. The skin may have a reddish tone for 1-5 days. Swelling is minimal and generally resolves in about 2 days.

For more information or to schedule appointments please call our office at 949-720-1400.