Tuesday, July 6, 2010

A Doctor With an Eye 4 Beauty

One of the main complaints from men and women as they hit the 40's and beyond is that they look tired no matter how much sleep they manage to get. Many times it's the lines, wrinkles and gravity that contribute to this feeling that we don't look as young or energetic as we might feel.

And one of the first areas to show age can be the eyes either on the upper lid,the lower lid or both.

A friend showed up at a restaurant recently and although we couldn't put our finger on what was different about her she seemed to look refreshed and like she had just come back from a vacation. As it turns out she had just gotten her eyes "done," the simple way of saying she just had an Upper Blepharoplasty.

One of the premiere cosmetic surgeons in our area for performing eye surgery is Dr. Soheila Rostami of Oculo Facial Plastics Consultants in Reston, VA. Dr. Rostami is a board -certified surgeon specializing in lacrimal, orbital and reconstructive eyelid surgery.

Dr. Rostami was gracious enough to share her expertise with BeautyInDC.com readers and answer our questions on eyelid rejuvenation.

Q: Dr. Rostami it seems that one of the first places that shows our age is our eyes. What are the most popular procedures you perform to rejuvenate them?

A: Upper blepharoplasty (or eyelid surgery) is one of those procedures that can help us appear more youthful, because the excess skin and fat are removed from the upper eyelids, which helps to restore the look we had when we were younger.

Also popular are (1) lower blepharoplasty (under eye surgery) to reduce sagging skin and puffiness caused by herniated fat under the eyes; (2) brow lifts to pull-up the forehead muscle and put the eyebrows back in the position you had when younger; and (3) sometimes ptosis (droopy eyelid) repair with a technique called a levator advancement, where the eyelid muscles are tightened with sutures.

Q: Who is a good candidate for one of these procedures?

A: Anyone, male or female, who has excess upper or lower eyelid skin or bagginess. Sometimes, this skin hangs down on the eyelids and interferes with one’s peripheral vision. We often hear from patients that their eyelids are too heavy, and they must use their forehead muscles to hold their eyelids up. By the end of the day, they use their fingers to hold open their eyelids and let their forehead muscles relax. When they do this, they feel a great sense of relief.

Q: Could you describe what you do during an Upper Blepharoplasty?

A: This is a procedure that is easily performed in-office using a local anesthetic. This is an over-simplified explanation, but here are the basic steps. First, the excess eyelid skin that needs to be removed is carefully measured and marked. This is an important step, because if not enough skin is removed, you won’t be happy, and if too much skin is removed, it can cause functional eyelid problems. The eyelid area is numbed with a local injection and then swabbed with an antiseptic. An incision is made with a surgical blade along your natural eyelid crease, and then the excess skin and fat are removed. The incision is then closed with sutures. An ointment is applied to the suture line for the next few days. Ice packs are also encouraged to be used off and on for at least a day. Sutures are removed 7 days later.

Q: What about a Lower Blepharoplasty?

A: Because there is more discomfort associated with the lower blepharoplasty, I recommend that this procedure be done in an outpatient surgery center under IV sedation. There are two ways of doing lower blepharoplasty, and it all depends on whether or not there is a lot of excess skin. If there is puffiness from herniated fat, an incision is made from the inside of the bottom eyelid and the fat is removed. If there is sagging excess skin as well as herniated fat, an incision is made along the lower lash line, the fat and excess skin is removed, and then the area is sutured back together.

Q: Is there a long recovery time from these procedures?

A: The eye area is very vascular, meaning that there are many blood vessels in the area, so it is normal to experience bruising and swelling after surgery. Healing is very individualized – how fast you heal depends on your general health and how your body usually heals. Generally, you can expect to resume light activities in about 1-2 weeks after surgery, which means no heavy lifting and no vigorous exercise during the recovery time.

Q: Are there any risks involved?

A: All surgical procedures involve risk. As my patient, I want you to fully understand all the risks associated with these procedures, so that you can make an informed decision. There are healing symptoms like swelling and bruising, discomfort and pain, and itching and scar redness which are normal to experience. Other risks include bleeding, inflammation, infection, wound separation, etc., which are dealt with quickly to resolve. Some of the most serious complications are also extremely rare. These include allergic reactions, blindness and loss of life. I discuss these risks with my patients in detail during their consultation.

Q: Are your patients usually pleased with the results?

A: My patients and I both are usually pleased with the surgical results, as I have been doing these procedures for several years and consider myself skilled in what I do. I receive letters from them, telling me how much their appearance has improved and their outlook has changed. For some, the surgery is more about function – their peripheral vision is improved, their eyes are no longer tired and irritated, and they no longer have to hold up their eyelids with their forehead muscles. Others tell me they receive many compliments on the color of their eyes, which haven’t changed, but are now much more noticeable to others!

Q: What is the cost involved and does insurance cover any of these procedures?

A: On my website, www.Beauty4Eye.com, I have posted costs under the “Services” tab – the last item in the left hand column, called “Pricing/Menu.” For my self-pay patients, I try to be fair and make my fees reasonable, especially when combining procedures.

Upper blepharoplasty, levator advancement for ptosis repair, and/or eyebrow lifts are sometimes covered by insurance companies. In order for these procedures to be covered by your insurance plan, medical necessity must be proven through clinical notes, photographs, and visual field tests (which shows how badly your upper eyelids are affecting your field of vision). These items are sent in advance to your insurance provider to see if they will cover the procedures. Lower blepharoplasty is not a covered procedure by insurance; it is strictly cosmetic.

Dr. Soheila Rostami
1860 Town Center Drive, Suite 250

Reston, VA 20190



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