Dr. Flora Levin was featured in Zwivel discussing the risks of participating in clinical trials. To read the entire article click here.
The eyes are more than the windows to the soul, they are a central feature of the human face. We look at a person’s eyes to observe sincerity, trustworthiness, enthusiasm, and so much more. The prevalence of eyelid rejuvenating procedures is evidence that most people are very aware of what their eyes say about them. Usually, blepharoplasty is sought when the upper or lower eyelids become heavy with sagging, loose skin, bulging fat pads and loss of the youthful eyelid appearance.
However, it is critical to recognize the presence of ptosis, in addition to the aging eyelid skin. Ptosis is the true descent of the upper eyelid, with loss of the normal eyelid contour and the eye appearing smaller. Most patients are aware of the droopy eyelid but see it primarily as the excess eyelid skin.
What Causes Ptosis
It is commonly assumed that the eyelids are a compilation of tissue and tiny blood vessels and nerves. The upper eyelids also have two muscles that enable the eyelids to rise: the levator muscle and the Muller’s muscle. There are various reasons why ptosis develops. Most commonly, it is the result of the muscle stretching. Other causes include congenital where the muscle does not develop normally from birth, trauma, or a neurological condition that weakens the muscle. Various surgical techniques exist to correct ptosis. The underlying cause and degree of eyelid droop determine which surgery is best for the individual patient.
Ptosis Repair vs. Blepharoplasty
Blepharoplasty is the surgical technique that removes excess skin from the upper (or lower) eyelids. It is performed to correct the sagging that results from the loss of collagen and elastin in the skin.
It is very important to recognize when ptosis is present. Failure to do so may result in an unsatisfactory result in a patient who undergoes only blepharoplasty but needed ptosis surgery, or both. Often ptosis surgery is done together with blepharoplasty but this is determined based on each individual patient’s needs.
Drooping eyelids can alter your image and may also affect your field of vision. Learn more about the techniques used to correct ptosis. Call our Westport, CT office at 203-557-6464.
Dermal fillers have become the most popular means of facial rejuvenation. The products that have been developed in the last 15+ years have made it possible for more men and women to address their age-related cosmetic concerns without plastic surgery. While Dr. Levin is a recognized oculoplastic surgeon who understands the value of certain surgical procedures, she also realizes the benefits of dermal fillers and routinely performs non-surgical facial rejuvenation in our Westport, CT office.
How Dermal Fillers Fight the Signs of Aging
There are several signs of aging that we used to correct with facelift surgery but now are able to treat non-surgically. Some of the common uses of dermal fillers include:
- Lines around the mouth
- Lines from the nose to the mouth
- Lines from the mouth to the chin
- Loss of volume in the mid-face
- Undereye hollows and puffiness
- Hand rejuvenation
The Big Question
The question that most patients have when they begin their journey with dermal fillers is “how many syringes will I need?”
Did you know that each syringe of dermal filler (1.0 mL) product equates to about 1/5th or a teaspoon (5 mL) ?
When you look at it like that, you may imagine that you’d need numerous syringes of product to achieve your desired result. That may not be the case. Remember that products like Juvederm, which are based on hyaluronic acid, will expand exponentially due to the bond that occurs with water molecules. The function of filler product within tissue is one factor. Others include:
- Area being treated
- Patient’s individual needs
- Extent of volume loss
- Skin type
Whereas one syringe maybe enough for one patient or a certain area, someone else or other areas may need more. However, just as aging is a gradual process, the process of rejuvenation does not have to happen during a single appointment. On the contrary, it’s a gradual, continuous effort, and that creates the most natural, long-lasting results.
There is a good reason to obtain injectable treatments from a board-certified physician who also performs facial plastic surgery. Patients of Dr. Levin can expect professional care in a friendly environment. At all times, the focus is on the achievement of desired results in a manner that suits preferences related to timeline and cost.
Learn more about facial rejuvenation with dermal fillers. Call our Westport office at 203-557-6464.
Botox cosmetic has been one of the most recognized aesthetic treatments to date. It feels as though this original injectable led the charge in a new era of aging gracefully. Two decades ago, when Botox was first developed, approval was limited to frown lines. In time and through proven safety and efficacy, this particular injectable expanded its reach into the realm of crow’s feet reduction, neckline treatment, and even correction of a downturned mouth. We love to love Botox, that’s obvious. And yet, we also offer Dysport. Here, we want to discuss why the two can coexist, and how you may be able to choose which approach to wrinkle reduction is best for you.
How Neuromodulators Work
Botox and Dysport are both within the neuromodulator category of facial rejuvenation. This means that they affect the muscles that are responsible for various facial expressions. It is the frequent contraction of the muscles located across the upper face that leads first to what we call dynamic wrinkles (those that are only visible during facial expression) and then to permanent lines on the face. Clinical research has demonstrated that small doses of neurotoxin have a positive effect on these muscle contractions. Both Botox and Dysport are derived from a minute, purified form of botulinum toxin A. However, there are slight variances between the two.
How Dysport Differs from Botox
Ultimately, these two wrinkle-reducing treatments share more similarities than differences. Minor differences include:
- Slightly faster onset with Dysport; approximately 5 days versus 7.
- Potentially faster metabolism of the Dysport product, meaning retreatment may be needed sooner.
- Wider expansion from the injection site may occur with Dysport. This could be advantageous depending on the area of concern.
- Dysport treatment involves a greater amount of product, though costs are usually comparable between the two.
Botox and Dysport both have the capabilities to treat common areas of concern, including the forehead and brow, the outside of the eyes (crow’s feet), the mouth, the jawline, and frown lines, to name a few. Furthermore, both drugs can be safely combined with others, such as soft tissue fillers, to make a more dramatic impact on facial aging.
In the end, the choice between Botox and Dysport comes down to preference. During a consultation with Dr. Levin, you can consider the advantages and disadvantages of each choice and move forward in the way that best meets your needs.
Contact our Westport, CT office at 203-557-6464 for personal care that helps you reveal your best self.
The eyelids get a lot of suns. This makes them susceptible to developing skin cancer. Eyelid skin cancers account for up to 10 percent of all skin cancers. Fortunately, most of them are non-melanoma forms of skin cancer, basal cell, and squamous cell carcinomas.
Dr. Levin works with numerous dermatologists who diagnose the skin cancer and then send the patient to Dr. Leven to remove the tumor and reconstruct the eyelid.
Most common types of eyelid cancer
About 90% of all eyelid cancers are the basal cell skin cancer variety. Basal cell carcinomas, like squamous cell carcinomas, are the result of the amount of sun exposure over time. While not nearly as dangerous as melanoma, basil cell carcinomas still need to be removed as they continue to grow and begin to impact the function of the eyelid.
• Basal cell carcinoma— Under the squamous cells in the lower epidermis are round cells known as basal cells. Overall, around 80% of skin cancers come from this layer in the skin. Basal cell carcinomas usually appear in the lower lid and most often in people with fair skin.
• Squamous cell carcinoma— The top layer of the epidermis consists of mainly squamous cells, and up to one-third of skin cancers form in this part of the skin. Although less common than basal cell carcinoma, squamous cell carcinoma grows more aggressively and can spread more easily to nearby tissues. Squamous cell carcinomas are rare on the eyelids.
Surgery to remove eyelid cancer
Eyelid skin cancer usually occurs on the lower eyelid, but it can be found elsewhere. If possible, Dr. Levin prefers to use Mohs’ surgery to remove the tumor. This surgical method has the advantage of removing the least amount of tissue, a critical element in an area such as the eyelids.
In Mohs’ surgery, the visible tumor is removed along with a small area around the tumor. Then, with the patient still under anesthesia, the tissue taken is examined under a microscope, with particular attention paid to the margins. If the margins are clear of any cancer cells, the procedure is completed. If additional cancerous cells are found in the margins, additional tissue is removed until the margins are clear.
Mohs’ surgery for eyelid cancer has a very high success rate, with five-year cure rates of up to 99 percent. Plus, it has the advantage of taking only the smallest amount of skin beyond the tumor.
Reconstruction of the eyelid after removal of the skin cancer can be straightforward or very challenging, depending on the individual situation. Dr. Levin’s options are usually dictated by the size of the tumor is removed. The complexity of the reconstruction is unique to every procedure, but the main goal is to fully restore the function of the eyelid, brow, and corresponding facial tissue and muscle.
If your dermatologist has found a skin cancer on your eyelid, have the doctor refer you to Dr. Levin for the surgery and reconstruction. Her expertise in this area is second to none. Call 203-557-6464 if you have any questions about eyelid cancer, or if you need to make an appointment.
Eyelid surgery, or blepharoplasty, is performed to remove extra skin and fat deposits in the lower and upper lid. It is more common after the age of 35, but some elect to get the surgery earlier if they have a genetic disposition to drooping eyelids. Here are four factors to consider if you are exploring the idea of getting eyelid surgery.
Eyelid surgery can give you a more youthful appearance
Often, skin bulging or wrinkles on or near the eyelids make a face appear to droop. During eyelid surgery, delicate incisions are made to remove this excess fat and skin. The result is a more youthful and refined appearance.
You need to be healthy to get eyelid surgery
If you are thinking about eyelid surgery, you need to be in general good health to be considered. The healthier you are, complications are less likely, and the healing process will proceed more smoothly. Eyelid surgery can give you a smoother and more energetic appearance. However, consider if your expectations are in line with what the eyelid surgery can realistically deliver. Schedule a consultation with your doctor to discuss your goals and voice your concerns.
You will see results soon
Within two to three weeks after surgery, you will see the dramatic difference that eyelid surgery makes to your look. Patience is important during those first few weeks as the incisions and bruising are allowed to heal.
Eyelid surgery is temporary (for the upper lid)
As we age, so do our eyelids. Even with eyelid surgery, your upper eyelid will eventually develop wrinkles and begin to sag again. This is completely normal and part of the aging process. Fortunately, the effects of eyelid surgery on the upper lid can last up to seven years. In contrast, surgery on the lower lids rarely needs any upkeep. Before your surgery, you will have a consultation with your doctor. During this time, be sure to discuss your goals with your physician. Be mindful of your expectations versus reality and if eyelid surgery is the best option for your needs.
To find out if eyelid surgery is right for your needs, schedule an appointment with Dr. Flora Levin. You can reach our office at 203-557-6464.
Every year, millions of Americans benefit from Botox treatments. Botox can temporarily remove fine wrinkles and deep creases, provide a smooth and even look. Here are four factors to consider as you contemplate getting Botox.
- Botox has side effects, but they are minimal: The most common side effect you will experience after a Botox treatment is bruising. Bruising is a normal and expected part of Botox and will disappear within a few weeks. Headaches are rare but sometimes happen, lasting 24-48 hours after the procedure. 1% of patients develop a drooping eyelid, but this will dissipate within a couple of weeks.
- Be mindful of your medications: During your Botox consultation, your doctor will discuss how to prepare for your treatment, and what substances to avoid will likely be part of that conversation. Certain medications alike aspirin, ibuprofen, and other anti-inflammatory medications can thin the blood, causing bruising. Be sure to stop taking these medications two weeks before you go in for your Botox treatment. Also, tell your doctor if you are on any herbal supplements as well. Vitamin E, fish oil, and gingko can also cause the blood to thin. Last of all, avoid alcohol one week before your treatment.
- Get Botox from a board certified physician: Botox “parties” and spas are trendy, but not the place for Botox injections. Dr. Flora Levin is a board certified Oculofacial Plastic Surgeon and specializes specifically in cosmetic eyelid surgery and non-surgical facial rejuvenation. Board certification is proof of your doctor’s outstanding knowledge and expertise in a particular medical specialty. With an area as visible and delicate as your face, be sure you choose the best to get the results you want. You can find out if your doctor is board certified by looking at their bio or contact page on their website. If you can’t find it there, call into the office and ask.
- Botox injections last 3-4 months: Botox treatments are temporary. Using a fine needle, Botox is injected into the muscles to block nerve signals. This creates a relaxed and smoother look. Within three months post treatment, you may notice the reappearance of some wrinkles. As you regularly get Botox, the muscles are trained to relax more, and the treatments may last longer.
Let us know if you have any additional questions about how Botox works. Call Dr. Flora Levin today at 203-557-6464. We look forward to helping you reach your facial cosmetic goals.
As aesthetic medicine has evolved, we have become increasingly aware of the nuanced problems that men and women face as they age. If we look at statistics and market research, we realize that, of all the changes that affect a person’s facial aesthetic, it is the eyes that stand out the most. This makes perfect sense because we tend to look one another in the eyes when we communicate and because our appearance does a lot of our communicating for us. Knowing this, we place a lot of value on what our appearance might be saying.
Undereye puffiness may give others the impression that you’re fatigued or older than you feel, but in reality, this cosmetic issue is related to the very structure of the mid-face. One of the most common reasons for the development of undereye bags is the loss of mid-face volume. When fatty tissue diminishes across the upper cheeks, the fat pads beneath the skin of the lower eyes appear more prominent. A second factor in the formation of undereye bags is the natural weakening of the orbital septum, the membrane that normally prevents fat pads from bulging. Whether alone or in combination, these two factors in undereye bag aging can be mitigated with proper care.
Two Pathways to Outstanding Results
There are two common methods of treating undereye bags: injection of dermal fillers and lower eyelid blepharoplasty. Each has its advantages and disadvantages and each has been successful in achieving patients’ desired outcomes.
A large percentage of cosmetic patients prefer to first take a non-surgical approach to the correction of undereye bags and other signs of aging. Dermal fillers have made it possible to significantly reduce the appearance of undereye bags with no down time and none of the risks of surgery. Products such as those in the Juvéderm or Restylane families are formulated with organic substances that the body naturally metabolizes over time. When introduced to the tissue where the upper cheek meets the undereye skin, a filler smooths the transition between the two areas, which rejuvenates the eye.
Lower Eyelid Blepharoplasty
The value of eye rejuvenating surgery may be realized after one or two non-surgical treatments as it is more long-lasting with more definitive results. Surgery can address the bags but trimming and re-positioning the excess fat that is bulging toward the surface as well as the crepey eyelid skin to tighten it. The transconjunctival approach (inside of the eyelid) to access the lower eyelid fat is the safest way to avoid undesirable results or complications. Surgery can be combined with laser skin resurfacing to further tighten the lower eyelid skin and improve the appearance of fine lines and wrinkles.
Board certified oculofacial plastic surgeon Dr. Flora Levin specializes exclusively in cosmetic eyelid surgery and non-surgical facial rejuvenation. To discuss potential treatment options for undereye puffiness, call our Westport, CT office at 203-557-6464.
Most of us have a history of at least some bad behavior when it comes to the sun, and we’ve got the skin damage to prove it: brown spots, uneven texture, and wrinkles. But there’s a bright side to this story, and it comes in the form of laser skin resurfacing.
Using light energy to treat sun damaged skin
The light energy of lasers can be used to resurface the skin, and treatments can do a lot to make up for a time in the sun without sunscreen. And there are many different types of lasers and procedure options, depending on your skin, the area you want to treat and your goals. So here’s a brief look at the main categories of lasers – and then our favorite laser for treating sun damage:
Ablative or non-ablative? Here’s what you need to know
- Treats the skin on a more superficial level
- Doesn’t remove skin.
- Penetrates deeper into the skin
- Removes a thin layer of skin surface
Discover The Pearl
This is a new FDA-approved, state-of-the-art laser used for treating skin problems caused by sun damage, as well as uneven texture, discoloration, spots, enlarged pores, fine lines, and wrinkles—regardless of the cause. The Pearl’s advanced technology can provide cosmetic benefits in only one to two treatments, restoring your skin with minimal downtime. During a 15-minute procedure, pulses of laser light and heat are delivered to help reduce and even eliminate signs of sun damage and aging, along with stimulating your collagen growth. The technology is also available in two additional forms:
- The Pearl Fractional
It can be used on the entire face and is especially effective in the eye and mouth areas. Many patients notice improvements after only one treatment. Over time, continued effects include increased volume and firmness.
- The Pearl Fusion
Using two lasers, the treatment addresses surface problems (brown spots) as well as deeper issues (creases). The approach can result in immediate improvements and increased firmness over time.
Learn more about The Pearl and what it can do for you
Call for your Pearl treatment today: 203-557-6464
A natural sign or aging is often sagging upper eyelids. It happens to everyone to one degree or another and can be even more pronounced if droopy eyelids show up earlier in life because they run in your family.
Sun damage and smoking can also contribute to skin that ages prematurely, especially around the eyes where it’s thinner and more delicate. But there’s another condition that can cause your upper eyelids to droop. And to treat the condition properly, it must be diagnosed correctly.
Ptosis causes upper eyelid drooping
Stretching or weakness of the levator muscle responsible for raising your eyelid is a reason your eyelids may be drooping. Ptosis can also be the result of damage to the nerves that control the muscle, as well as:
- Congenital condition
When it comes to treating droopy eyelids, it’s important to identify the correct cause to help ensure you achieve the proper treatment and the most desirable outcome.
Ptosis can affect one or both eyelids
Just as with typical eyelid sagging, ptosis doesn’t always affect both eyelids equally. However, it shouldn’t be confused with the excess eyelid skin or fat that is the cause of most eyelid drooping. While some patients with ptosis also have excess eyelid skin and fat, an eyelid lift, or blepharoplasty, isn’t the only treatment needed to achieve the best aesthetic results for ptosis.
Specific surgical techniques are used to correct ptosis
Most of the methods involve tightening the levator muscle that lifts the eyelid. This can be accomplished through:
- An incision in the crease of the eyelid
- An incision on the inside of the eyelid
The surgical approach we use is based on your individual exams, testing, and needs. Many patients combine their ptosis surgery with an eyelid lift.
If drooping eyelids obscure your vision
We can work with you to photographically document your condition, along with providing visual field test results to illustrate that your eyelid surgery may be functionally or medically necessary. That means the procedure is often covered by many insurance plans.
Call for an eyelid consultation appointment today: 203-557-6464