Ancillary Procedures

Neigel Center for Cosmetic and Laser Surgery

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Autologen

Your own collagen made from the skin removed during surgery to be used after surgery to fill in wrinkle lines or defects.

Botox (Botulinum) Injections

Injection of a derivative of botulism (the food poisoning toxin) directly into wrinkles can often make them disappear. Results usually last three to six months. These injections are completely safe and have been used fo more than 15 years in patients with blepharospasm (constant spasms causing closure of the eyelids or twitching). In smaller doses they dissolve wrinkles between the eyebrows (glabellar region) and crow's feet. Any side effects such as double vision, droopy eyelid and bruising wear off in one to three months.

Brow Lifts - Surgery to raise droopy eyebrows, often resulting in less eyelid skin, opening of the eyes and loss of forehead wrinkles.

Lid crease incision - sutures placed to raise the brow through a blepharoplasty incision.

Direct - incision just above the eyebrow.

Forehead - incision in one of the wrinkle lines of the forehead.

Coronal - incision across the top of the head from ear to ear either at the hairline or 1-2 inches behind the hair line (partial face lift).

Endoscopic - tiny incisions in the scalp through which light pipe is used to raise the forehead, now the preferred method for correcting droopy eyebrows.

Chemical Peels

Glycolic Acid Peels - mild exfoliative, needs to be repeated every several months (see below).

TCA - trichloracetic acid peels - may need to be repeated every 1-2 years. Effective for mild wrinkling, difficult to control the depth of the peel.

Phenol Peel - a very deep and high-risk peel, should never be used around the eyelids. Can be toxic and cause heart problems. May produce a white, shiny look to the skin.

Glycolic Acids

One of a number of alphahydroxy acids (AHA) which are naturally occuring substances found in fruits, sugarcane and sour milk, as well as in our bodies. These substances have a beneficial effect by gently loosening the bonds that hold dead skin cells together.

Preparation of the skin with alphahydroxy acids, preoperatively as well as post-operatively, should help improve the skin's tone and texture. These products can minimize fine wrinkles, refine large pores, and even out pigmentation and other irregularities such as dry, rough and thickened skin. They are also good for oily skin and acne.

Glycolic acids, also known as alphahydroxy acids or fruit acids, work best in prescription strength (5-15 percent). Over-the-counter products found in pharmacies or department stores usually are 2-3 percent and are often buffered, which can deactivate the main ingredient. These products can help reverse some of the effects of sun exposure, but because they make the skin more susceptible to sun damage, it is extremely important to also use sunscreen daily with these products. Sun damage will reverse the effects that you are trying to achieve.

Special products with glycolic acids are designed for the delicate skin of the eye area. These products contain sunscreen as well as glycolic acid, glycocerimide, liposomes and microencapsulated betacarotene (Vitamin A), along with other vitamins, giving valuable moisture protection to the skin while reducing the appearance of fine lines and wrinkles.

If glycolic acids cause drying, flaking, redness, and peeling of the skin, your dosage should be adjusted. Makeup can be worn over these products: a water-based, low pH foundation is recommended. A moisturizer with a low pH will prevent dry skin and will enhance the effect of the glycolic acid. Once your skin has been primed with these products, chemical peels can be performed (see Chemical Peels).

Laser Eyelid Surgery - with the Ultrapulse CO2 Laser

This laser can be used to perform eyelid surgery resulting in less bleeding, bruising and swelling with a faster recovery time. It acts as a cutting beam of light.

Laser Skin Resurfacing - with the Ultrapulse CO2 Laser

Used to resurface facial and eyelid skin by smoothing and softening fine wrinkles to crows' feet. Minimizes scars and is a controlled method for skin rejuvenation. The focused laser beam moves rapidly in a computer generated pattern to gently vaporize wrinkles and scars so swiftly that other layers of skin are not harmed.

Midface Lift

The midportion of the face (cheek) sometimes can be tightened through a lower lid incision and lifted at the same time, decreasing the line or bag at the side of the nostril.

Permaliner

Tattooing a line of dark pigment between the eyelashes, most often performed by an aesthetician. This can be used after trauma or burns to camoflauge loss of lashes.

Ultrapulse CO2 Laser

The latest technology is lasers. This laser is used for surgery and also resurfacing of skin (wrinkle erasing).