Skin Rejuvination

Skin Rejuvination


A radiant, smooth, youthful skin is the essence of beauty and trendy looks. Skin care routine highly contributes in the slowing down of rate of aging of the skin. Choosing the right skin care products for your skin type enhances your beauty keeping the skin cleansed, moisturized and well toned. Use of superficial skin resurfacing treatments to counter fine lines and wrinkles, acne scars and blemishes before they deepen ensures skin rejuvenation.

Types of superficial skin rejuvenation

  • Fillers
  • Facial masks
  • Chemical peels
  • Laser resurfacing
  • Microdermabrasion

Factors that contributes to a healthy skin
  • A well balanced diet with vitamins and essential elements
  • Avoid substances with high alcohol content
  • Intake of sufficient drinking water
  • Enough sleep and rest
  • Avoid smoking tobacco
  • Enough sleep and rest
  • Physical exercises
  • Avoid stress

Constant exposure to sun causes damage to the skin. It is fundamental to choose the right sun screen to protect your skin when going out on a sunny day or in summer. Use of sun screen and physical sun protection (use of hats and covering your body with clothing) safeguards your skin from aging and damages.
Choosing the right sun screen Choosing the right sunscreen for your skin is essential. The brand should be a known trusted brand of high quality. The SPF should be 30 or higher with a physical blocker such as titanium oxide or zinc which should not exceed 9%.

Skin rejuvenation begins with a change in lifestyle. Choosing the right food to eat, when to sleep, routine physical exercises and choice of habits goes a long way in the maintenance of a youthful smooth and radiant skin.




Wrinkles & Botulinum Toxin

Botulinum is a simple, nonsurgical, physician-administered treatment that can temporarily smooth moderate to severe frown lines between the brows in people from 18 to 65 years of age. It is the only treatment of its type approved by the Food and Drug Administration (FDA).


What creates wrinkles?
  • they are creases which result from making the same facial expression thousands of times
  • these lines are called lines of "facial expression"
  • they are typically located at the outer eyelid area (crow's feet) and in the forehead (frown lines)
  • Below, show the vertical wrinkles that often lead to an angry look

How can they be treated?
  • the muscle can be surgically damaged
  • the muscle can be temporally paralyzed with botulinum injections(area in red)

Does the injection hurt?
  • injections are done with the smallest possible needle
  • there can be initial sting, but it is less than having your blood drawn


Mechanism of Action of Botulinum

Toxin Botulinum Toxin acts by blocking neural transmission at four different sites in the body - the neuromuscular junction, autonomic ganglia, postganglionic parasympathetic nerve endings and postganglionic sympathetic nerve endings that release acetylcholine. It irreversibly blocks the release of acetylcholine, the principal neurotransmitter at the neuromuscular junction, without causing degeneration of the nerve terminals.

The botulinum-induced irreversible paralytic effect starts in 24 to 72 hours and is complete in four to seven days after injection. There is recovery of muscle function only with the formation of new nerve terminals and new synaptic contacts which takes about two to three months.

Hence, repeat injections should be given every three or four months based on individual response to therapy. It should be kept in mind that tolerance to the drug develops with repeated injections due to antibody formation. Therefore, it is advised that the lowest effective dose be given as infrequently as possible.


Technique of Administration

Botulinum toxin is administered by injecting an appropriate dose into the affected muscle or gland using a 30-gauge 1-inch needle. Lower doses are preferred in females and those with pre-existing weakness.

The injections are administered through hollow Teflon coated needles directly into affected or overactive muscles and are occasionally guided by electromyography.


Precautions after Botulinum toxin injection

A patient should go home immediately and take rest after receiving Botulinum toxin injection.

To prevent toxins from affecting neighbouring muscles, the patient should avoid any strenuous physical activity for one to two days, and refrain from laser/IPL treatments, facials and facial massage for one to two weeks after injections.

Patient selection and the proper choice of dose and administration site are the most important determinants for a favourable response to botulinum toxin injections.


Indications for Botulinum Toxin

Botulinum toxins have found veritable applications in the management of various medical, neurological, dermatological, ophthalmic and cosmetic conditions with good response to treatment.


Clinical Applications include:

  • Strabismus
  • Focal dystonias
  • Hemifacial spasms
  • pastic movement disorders
  • Headaches
  • Hypersalivation
  • Hyperhidrosis
  • Alternative to surgery in chronic anal fissures
  • Achalasia cardia
  • Ptyalism
  • Gustatory sweating after parotid gland surgery





Dermato-Cosmetological Applications include:

  • Glabellar lines
  • Correction of lines, creases and wrinkles all over the face, chin, neck, and chest
  • Depressor anguli oris, nasolabial folds, mentalis, medial and lateral brow lifts
  • Lessen shadows on one's face
  • Maintain a smooth outline of the jaw and cheeks from all directions
  • Localized axillary or palmar hyperhidrosis nonresponsive to conventional therapy

Adverse Effects of Botulinum Toxin

Botulinum toxin injections are generally well-tolerated and cause relatively few side-effects which are divided into two groups: paralysis of the wrong muscle group and allergic reaction.

Unwanted weakness or paralysis of the wrong muscle group: It is the most feared adverse effect but it is temporary and lasts from a few weeks to several months.

  • Upper lid or brow ptosis
  • Double vision
  • Uneven smile
  • Weakness of the lower eyelid or lateral rectus resulting in exposure keratitis
  • Dysphagia due to toxin reaching the oropharynx
  • Neck weakness due to weakening of the sternocleidomastoid muscles

Rare cases of generalized weakness

Allergic Reaction

Rare but can occur due to hypersensitivity towards any of the components of the injections such as egg albumin.

Systemic Side Effects

  • Headache
  • Flu-like syndromes
  • Immune-mediated plexopathy
  • Blurred vision
  • Dry mouth
  • Fatigue
  • Swelling and redness at injection site

Contraindications to Botulinum Toxin Injection

  • Preexisting motor neuron disease
  • Myasthenia gravis
  • Eaton-Lambert syndrome
  • Neuropathies
  • Psychological unstability
  • History of allergy to toxin or albumin
  • Pregnancy and lactating mothersnfection at the injection site
  • Aminoglycosides accentuate the effect of botulinum toxin
  • Penicillamine, quinine, chloroquine, and hydroxychloroquine reduce the effect of botulinum toxin
  • Calcium channel blockers and blood thinning agents such as warfarin and aspirin may cause bruising

Why does Botulinum Toxin Injection fail sometimes?

  • Photodamage and age-related changes which are not dynamic in origin
  • Improper injection technique
  • Denatured toxin used for injection
  • Neutralizing antibodies due to repeated exposure or individual variation

Future of Botulinum Toxin

The future of botulinum toxin is bright as it has revolutionized the treatment of various ophthalmic spastic disorders, facial dystonias and periocular wrinkles. As we gain more insight into the uses of various toxins for chemodenervation, there is hope for better uses of botulinum toxin.





Chemical Peels

Modern skin treatments have gained importance and popularity in the recent past. Trendy looks have taken people to scale higher heights due to increased confidence thus productivity. Chemical peel skin treatment has crossed from being a celebrity procedure of enhancing beauty but for all who want to maintain a youthful, radiant and smooth skin.


How a chemical peel procedure is carried out

  • Preparations
  • The doctor will advise you to Wear sunscreen and precondition your skin with preconditioning medication. You will also be advised on discontinuing of certain medications which can affect the procedure.
  • Chemical peel
  • A chemical peel procedure can be done by a doctor or dermatologist in a clinic, beauty spa or outpatient clinic. The skin is cleansed thoroughly to remove dirt and excess oils. The eyes and hair are covered properly and a chemical solution is administered on the desired area. The skin blisters and peels off leaving slight wound. The skin heals or regenerates into a new fresh skin.
  • How long does a chemical peel last?
  • There are three types of chemical peels depending on the depth of the treatment. Superficial, medium and deep peels procedure takes at least 40 minutes depending on the expertise of the doctor and the type of chemical peel.
  • Healing of the wound takes 7-10 days depending on the individual. The skin may take up to one year to completely heal the scabs and crusts which appear on the skin after the procedure.

Benefits of a chemical peel

A chemical peel has many benefits attached which range from psychological, social and mental benefits.

  • Improved self esteem
  • Healing of the physical body
  • Smooth, radiant and youthful look
  • New look and fresh beauty increasing self confidence
  • Improved social relationships due to less attention on conditions like scars and wrinkles.

Limitations

Chemical peels have more benefits that limitations or negative effects. Possible complications vary from one individual to the next depending on medical history, prevailing medical conditions, genetic make-up and personal body reaction to different chemicals.

These includes;-

  • Takes time to heal.
  • Temporary or permanent loss of skin pigmentation.
  • You have to wear sunscreen as the new skin is sensitive to the sun.
  • Uneven skin tone depending on the severity of the condition being treated.
  • The patient may develop abnormal pigmentation or temporary skin color change.
  • Patients with herpes are at risk of cold sores reactivation though the doctor administers medication before the peel or after.

Most of the possible risks can be countered by the doctor by drug prescriptions.


Best candidate for a chemical peel

A chemical peel can be a cosmetic or medical procedure depending on individual needs. These needs includes:-

  • Acne scars treatment
  • Removal of fine lines on the face, neck and hands.
  • Reduce wrinkles resulting from ageing, damage from the sun and family genetic make-up
  • Mild scars treatment to improve appearance
  • Reduce dark patches, freckles and age spot resulting from birth control pills or pregnancy.
  • General desire for a new younger look




Fillers

In the world of cosmetic surgery, soft tissue fillers have become extremely popular. This is primarily due to the fact that they are minimally invasive; but additionally due to their excellent results and affordability. However, there are associated complications with this procedure, and here we shall take a look at these in a bit more detail.

Planning out procedures

Meticulous planning backed by a sound knowledge of human facial anatomy is what can prevent complications from occurring from soft tissue filler injections. There are a number of different aspects to consider in particular.

  • 1. Varying skin thickness in different parts of the face.
  • 2. Different density of blood vessels in different parts of the face
  • 3. The various fillers available. These can include hyaluronic acid, dalcium hydroxyapatite and poly-L-lactic acid.
  • 4. The expectations of the patient and their informed consent. They must be fully aware of the risks and side effects.
  • 5. A detailed clinical history to ascertain any underlying illnesses that may have an impact on the patient’s procedural outcome.


Early complications

Early complications are ones that are seen in the first 2 weeks following the procedure. They can broadly be divided into minor complications and major complications.

Minor complications

Mild bruising, bleeding and swelling at the site of injection are the most common minor complications that can occur in the hands of the most experienced practitioners. This is often prevented by injecting the fillers into the areas that are least populated by visible blood vessels, and following the injection by the application of an ice-pack on the area. There is no need for patients to stop taking their blood thinning medication prior to the procedure. If however bruising and ecchymosis does develop, then simple lasers can be used to treat this.

Swelling is a common phenomenon as well. It develops due to the filler being injected and also due to the development of inflammation within the tissues. Some dermal fillers are more predisposed to causing swelling due to their molecular structure and ability to retain water (for example Juvederm).

It is natural for patients to experience mild discomfort at the site of injection. This is expected with an injection, and any anxiety can be allayed by administration of a local anaesthetic at the site or giving the patients mild sedation. Sometimes, just simple reassurance is sufficient.

In the event of pain developing following the procedure, patients may be prescribed simple analgesics such as acetaminophen. Non steroidal anti-inflammatory drugs and aspirin must be avoided as this can worsen the bruising. This needs to be observed closely to ensure that it completely settles down.


Major complications

a. Undesired appearance

Patients expect an improvement in their appearance following dermal filler injections. However, if the appearance is significantly worse after soft tissue filler injections, then corrective treatments must be offered as this is widely regarded as a major complication. For example, if hyaluronic acid has been injected as a filler and needs changing, then injections of enzyme hyaluronidase can dissolve it. Just a small amount is sufficient to make the required change. Multiple injections may be required to get the desired result.
b. Nodule formation and infection

It is not uncommon for patients to be able to feel the fillers under their skin after it has been injected. However, sometimes these areas that can be felt become painful and tender, and can be felt as nodules under the skin. There is always a likelihood of infection developing within these nodules, and patients may require a course of antibiotics to manage it. This must be constantly reviewed.
c. Blockage of blood circulation

This is a worrying complication and is usually seen when fillers are injected into the forehead area (glabella). The concern is one of blockage of the arteries or veins, and this should be kept an eye out for. If it does occur, patients may experience symptoms such as a change in the colour of their skin or pain. It should be treated straight away, and the area affected must be gently massaged. The filler needs to be aspirated out and hot fomentation must be applied to help dilate the blood vessels. 2% nitroglycerin paste may be beneficial. If needed, patients must be given oral steroids to reduce swelling. Patients must be closely monitored, and if needed a vascular surgical opinion must be sought.



Late complications

These are complications that are seen after 2 weeks of the procedure. They are once again classed as minor and major complications.

Minor complications

The presence of visible nodules or skin irregularities is the most common delayed complication. This is particularly common if the filler is not injected deep enough into the skin. They may cause a bluish colour due to a phenomenon called the Tyndall effect, and this is often clearly evident in the area just beneath the eyes. This discolouration can last for years.




Fillers

The skin loses fullness and youthfulness as we age. This is as a result of reduction in elasticity on the skin causing the skin to sag, droop, recede and becomes hollow/deep. This is a clear sign of aging which require treatment for a fuller youthful appearance.

Fillers can be used on different parts of the body including the eyes, mouth and lips, cheeks, chin and jaw line, on scared spots, wrinkles and fine lines.


Types of fillers

  • Skin filler
  • Soft tissue filler
  • Dermal filler
  • Anti-aging filler
  • Soft tissue augmentation

How fillers work

Filler treatment is carried out by injecting


How long it lasts

The procedure is carried out by a medical doctor and the time it takes depends on the area treated and the doctor. The procedure may take between 30-50 minutes or more depending on the surface area being treated. The patient can leave almost immediately and can resume to usual routine activities. The effect can be visible after 3-5days. Fillers injection has good results which can last for 6-9 months.


Benefits of fillers

  • Smoothens and softens the skin
  • Reduction in wrinkles and fine lines
  • Fuller youthful skin
  • Smooth and increase the volume of various body parts such as the chicks, chin, and jaw line among others.

Associated risks

  • Swollen reddened skin
  • Tissue hardening, bumps and lumps in rare cases
  • Allergic reaction to the treatment
  • Expensive procedure
  • Recurrence of cold sores

Who is best suited for fillers

All individuals with the following features on their bodies

  • Thinning lips
  • Receding chin
  • Fine lines and wrinkles
  • Hollowing of eyes beneath
  • Noticeable scars
  • Deep creases on the body
  • Hollow cheeks
  • Down turned mouth
  • Drooping brows



Laser Resurfacing

General Description Laser Skin Resurfacing of the Eyelids and Face

Aging of the skin is one of the most obvious and cosmetically apparent changes that happens as we grow older. The process of skin ageing is accelerated by excessive exposure to sunlight, hereditary and lifestyle factors such as nutrition, alcohol consumption and smoking. These, along with other conditions like pregnancy and birth control pills result in wrinkles or pigmentary lesions of the skin such as scars, blotches, brown spots or even precancerous skin lesions. Ageing of skin may be aptly dealt with Laser Skin Resurfacing, which is a very safe and effective technique to improve your skin by reducing the amount and severity of facial and eyelid wrinkles, while also correcting minor skin flaws with precision and surety.
Laser Skin Resurfacing is considered one of the finest developments in skin health and rejuvenation techniques. It has found many takers because of its safety, low risk profile, consistency, shorter recovery period and exceptional cosmetic results. It has been effectively used in treating wrinkles, blotchiness or age spots, and scars from pimples or precancerous lesions of the skin.
Laser Skin Resurfacing involves injuring layers of your skin using laser beams in such a way that subsequent healing of the microscopic burns produces scarring within underlying collagen tissues, thereby resulting in skin tightening, changes in skin colour and texture. It is usually done under anaesthesia.


Who are the best candidates for Laser Skin Resurfacing?

Laser Skin Resurfacing is not for everyone! Some of the best candidates for Laser Skin Resurfacing of the eyelids or face include those with:

  • Facial skin wrinkled due to age or other cause
  • Liver spots or age spots (solar lentigines)
  • Facial skin damaged by excessive exposure to sunlight
  • Awkwardly placed wrinkles around the mouth
  • "Crow's feet" lines around the eyes
  • Fine lines around the mouth or forehead
  • Laxity of skin around lower eyelids
  • Fine wrinkles around upper eyelids
  • Blemishes, brown spots or blotchiness of skin
  • Shallow pimple or chicken pox scars
  • Injury-induced superficial scars
  • Some precancerous skin lesions

Laser Skin Resurfacing is best avoided for treatment of stretch marks or if you are prone to acne, suffering from acne, or have a very dark skin.


Difference between Types of Lasers, Results and Ideal Patients

Laser Skin Resurfacing is usually done with a 2940 nm Er:YAG laser or a 10,600 nm CO2 laser, which vaporize skin cells causing it to heal by controlled scar formation.


CO2 Laser Resurfacing Laser Skin Resurfacing of the Eyelids and Face

The first complete laser resurfacing was done using CO2 laser in the 1990’s. Since then, it has been used to manage various skin conditions, such as wrinkles, scars, warts, enlarged sebaceous glands of the face and nose, lentigo simplex, seborrheic keratitis, small syringomas, epidermal melisma and dermatochalasis.

Fractional resurfacing using CO2 laser is the latest incarnation of this popular laser treatment technique and uses ultra-short laser beams in a scanning pattern that helps skin remodelling with very little damage. It has a short recovery period and shows excellent results within two to three weeks.


Er:YAG Laser Resurfacing Laser Skin Resurfacing of the Eyelids and Face

Erbium laser resurfacing helps in removing surface-level and moderately deep lines and wrinkles on the face, hands, neck, or chest. It is also associated with minimal burning of surrounding tissues. With fewer side effects and a quicker recovery period, it is preferred for those seeking faster results for superficial lesions. It can also be used for darker-skinned individuals.


Skin Anatomy

The skin offers protection to all the body organs making it prone to damage from the sun, dirt, chemicals in the atmosphere and strong wind.

Overtime, the skin changes and there is a reduction of collagen which then leads to formation of deep lines and wrinkles moderately around the eyes and mouth.

Laser resurfacing treatment takes advantage of the ability of the human skin to rejuvenate and grow new skin.


Realistic Expectations after Laser Skin Resurfacing

Laser resurfacing of the skin is not without risks! It is only rational to clarify the risks involved with your cosmetic surgeon or skin specialist before the procedure.


Resurfacing small, pin-pointed areas lasts about 30 to 45 minutes and might require just a local anaesthetic, while resurfacing larger areas of the face might require up to 2 hours under general anaesthesia. Although laser skin resurfacing is known to produce good results, it might be less than pleasant experience for some patients with itching, stinging, swelling, discoloured skin and the frequent application of gooey ointment or jelly for about 3 to 4 days. Redness of skin may even last for up to 6 months after the procedure.


It is mandatory to wear a sunscreen with at least SPF 30+ to prevent further damage to your skin after the procedure.


Risks involved in Laser Skin Resurfacing

A perfect skin might not be the goal of a person undergoing skin resurfacing, but disfigurement or scarring is not the end result that he or she seeks. Laser skin resurfacing carries the following risks:

  • Burns or other thermal injuries
  • Excessive scarring and disfigurement
  • Alterations in skin pigmentation rendering random areas of darker or lighter skin
  • Herpes cold sores may be reactivated
  • Bacterial infection is a potential risk that requires serious thought
  • Milia is commonly seen after laser treatment


Cost of Laser Skin Resurfacing of the Eyelids and Face

The cost of laser skin resurfacing varies widely depending on the type of procedure, the place of the surgery, and the surgeon handling the case.



Laser / Skin Resurfacing

Laser Skin Resurfacing

Human hairs are made up of three distinct parts: the bulb at the base of the hair follicle which produces hair, the shaft and the hair. The bulb and shaft are embedded within the skin, leaving only the hair visible to the naked eye. To remove unwanted hair on a long-term basis, it is necessary to destroy the hair follicle and its germinating centers that are in the bulb


Removal of unwanted body hair is of major importance to most women and to increasing numbers of men who spend tremendous sums of money and invest much time and energy in pursuit of this smooth look.


Over 80 million women use depilatories, epilators, waxing or shaving kits on a regular basis spending an estimated $500-600 million annually.


Most unwanted hair, however, is an aesthetic concern rather than medical condition


In the past few years, lasers and intense pulsed light systems have gained widespread acceptance as the most convenient long-term hair removal method. Intense light is converted into heat when it is absorbed in chromophores such as melanin. When light is absorbed in the follicle, shaft or bulb, it raises their temperature. Once the temperature reaches a high enough level in a hair follicle during its active phase, the targeted hair structures are critically damaged, hindering hair regrowth.



How does it work?

When a pulse of light or a laser beam is delivered to the skin, you may experience a mild sting or pinch similar to the snap of a rubber band. No local anesthesia or pain medication is required.

In contrast, shaving, waxing, and depilatory creams are all temporary methods that must be repeated on a regular basis.

Electrolysis is a tedious, invasive, and painful process that involves inserting a needle into each hair follicle and delivering an electrical charge to destroy them one at a time.

Electrolysis often requires years of treatments at regular intervals. So, in a few minutes, the doctor can effectively treat an area that would take over an hour with electrolysis.



How many treatments are required?

This varies depending upon the hair color and location on the body. Several treatments may be needed, with each session lasting 10-30 minutes.



What are the side effects?

Short-term side effects may include slight reddening of the skin or local swelling which may last a few days. In rare instances there may be some blistering.



After treatment, what are the restrictions on my activity after treatment?

You can return to work the same day and resume all regular activities. You should limit sun exposure, which is always a good idea.



Who are candidates for treatment?

Most people may be treated; however, check with your doctor. This may require a consultation visit



Benefits of Laser Hair Removal

Lasers are useful for removing unwanted hair from the face, leg, arm, underarm, bikini line, and other areas.

Benefits of laser hair removal include:

Precision. Lasers can selectively target dark, coarse hairs while leaving the surrounding skin undamaged.

Speed. Each pulse of the laser takes a fraction of a second and can treat many hairs at the same time. The laser can treat an area approximately the size of a quarter every second. Small areas such as the upper lip can be treated in less than a minute, and large areas, such as the back or legs, may take up to an hour.

Predictability. Ninety percent of patients have permanent hair loss after an average of three to five sessions.



How to Prepare for Laser Hair Removal

Laser hair removal is more than just ''zapping'' unwanted hair. It is a medical procedure that requires training to perform and carries potential risks. Before getting laser hair removal, you should thoroughly check the credentials of the doctor or technician performing the procedure.

If you are planning on undergoing laser hair removal, you should limit plucking, waxing, and electrolysis for six weeks before treatment. That's because the laser targets the hairs' roots, which are temporarily removed by waxing or plucking.

You should also avoid sun exposure for six weeks before and after treatment. Sun exposure makes laser hair removal less effective and makes complications after treatment more likely.



What to Expect During Laser Hair Removal

Just before the procedure, your hair that will be undergoing treatment will be trimmed to a few millimeters above the skin surface. The laser equipment will be adjusted according to the color, thickness, and location of your hair being treated as well as your skin color.

Depending on the laser or light source used, you and the technician will need to wear appropriate eye protection. It will also be necessary to protect the outer layers of your skin with a cold gel or special cooling device. This will help the laser light penetrate the skin.

Next, the technician will give a pulse of light to the treatment area and watch the area for several minutes to make sure the best settings were used and to check for bad reactions.

When the procedure is completed, you may be given ice packs, anti-inflammatory creams or lotions, or cold water to ease any discomfort. You may schedule your next treatment four to six weeks later. You'll get treatments until hair stops growing.

Recovery and Risks

For a day or two afterward, the treated area of your skin will look and feel like it's sunburned. Cool compresses and moisturizers may help. If your face was treated, you can wear makeup the next day unless your skin is blistering.

Over the next month, your treated hair will fall out. Wear sunscreen for the following month to help prevent temporary changes in the color of the treated skin.

Blisters are rare but are more likely in people with darker complexions. Other potential side effects are swelling, redness, and scarring. Permanent scarring or changes in skin color are rare.



Costs of Laser Hair Removal According to the American Society of Plastic Surgeons, the average cost for laser hair removal is $235 per session. The cost varies widely, depending on factors that include:

  • Size of the area being treated and time required for treatment
  • Number of treatments required
  • Whether a doctor or someone else is performing the procedure
  • The part of the country where you are having the procedure
Procedures
Anophthalmos
- Anophthalmia is a medical term used to describe the absence of the globe and ocular tissue from the orbit. - This was first reported more than 400 years ago, yet it is only recently that significant reconstructive options became available. - There are many reasons why one might lose an eye. - Surgeries which result in anophthalmos
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Blepharoplasty
What is Blepharoplasty?
- Your eyes including your eyelids, are perhaps one of the first things people notice in you. This makes your eyes and eyelids one of the most important components for an appealing facial expression and aesthetic appearance. Any visible change in the shape or size of the orbital or periorbital region can spoil the look of your face.
- As you age and grow older, your eyelids may become ‘droopy’ or ‘baggy’ due to the stretching of your eyelid skin and gradually decreasing tone of your eyelid muscles. Your droopy eyelids and brow together cut a sorry figure for your face making you look tired, sleepy and haggard, further leading to eyelid or brow straining or both. In extreme cases, your saggy, baggy eyelids can even obstruct your vision, particularly peripheral vision causing difficulty in reading or driving.
- Blepharoplasty ensures cosmetic or functional corrections to the area around your eyes to enhance your look or to correct any abnormalities in function.
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Blepharospasm
- Blepharospasm is defined as an abnormal, involuntary, sustained and forceful closure or twitching of the eyelids. It is derived from the Greek word ‘blepharon’ which means eyelid, and ‘spasm’ which is an uncontrolled muscle contraction. Blepharospasm is usually associated with headache, eyebrow strain and occasionally loss of vision.
- Isolated blepharospasm is rare and represents a minority of patients presenting with blepharospasm. Blepharospasm is commonly associated with lower facial spasms as part of a syndrome or disease complex. Some examples are:
   - Meige Syndrome: Characterized by spasm of the eyelids and midface.
    - Brueghel’s Syndrome: Presents with blepharospasm and marked spasms in the lower face and neck.
    - Segmental Cranial Dystonia: In addition to the usual spasms of the eyelids and facial muscles it is associated with spasms along distribution of various cranial nerves, most frequently involving the Facial Nerve.
    - Generalized Dystonia: Presents with spasms across various body parts in addition to blepharospasm and facial spasms.
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Brow Lift
A forehead lift, also known as a browlift or browplasty, is a cosmetic surgery procedure used to elevate a drooping eyebrow that may obstruct vision and/or to remove the deep worry lines that run across the forehead and may portray to others anger, sternness, hostility, fatigue or other unintended emotions
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Congenital
Congenital anomolies include :
- Eyelid Disorders
- Orbital Disorders
- Congenital Ptosis
- Congenital Nasolacrimal Duct Obstruction

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Dry Eye
What is Dry Eye?
- Dry eye is a reduction in your eye’s ability to produce sufficient natural tears.
- Insufficient tear production can lead to irritation and pain, and even scarring of the cornea (the transparent part of the eye that covers the pupil and iris).
- Many people will experience dry eye symptoms at some point in their lives.
- Often due to environmental factors such as indoor heating or air conditioning, it can also be caused by occupational factors such as prolonged computer use.
- Dry eye symptoms can affect anyone.
- Some of the symptoms of dry eye include a burning sensation or gritty feeling in the eyes. You may also experience decreased tolerance to contact lens wear or sensitivity to light.
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Eyelid Laxity
- Eyelids protect your eyes from any foreign bodies while keeping them lubricated throughout. Any alteration in the shape, position or function of your eyelids can predispose your eyes to a plethora of ailments or interfere with our vision.
Our eyelid is a complex structure consisting of three theoretical layers:
   - Anterior Layer contains the skin and orbicularis muscle
   - Middle Layer contains the orbital septum and eyelid retractors
   - Posterior Layer contains tarsus and conjunctiva.

- Eyelid malpositions include any unnatural or incorrect positioning and orientation of eyelids due to various factors that influence any of the three layers of the eyelids. They may be caused due to ageing, trauma, scarring, birth defects or medical disease involving any or all of the three layers.
- The most common forms of eyelid malposition are eyelid retraction, ptosis, entropion and ectropion.
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Face
The world of cosmetic surgery has advanced tremendously over the last two decades. New procedures have emerged that can make an individual look and feel younger in a matter of a few minutes. Amongst the vast number of cosmetic procedures currently available, the face lift is a commonly performed one that is sought after by both men and women. Here we shall take a look at this procedure in a little more detail.

- What is a face lift?    - A face lift is called a rhytidectomy in the world of medicine. It involves tightening the muscles of the face and smoothening of the skin so that the face appears younger.    - However, it must be remembered that a face-lift is not an anti ageing solution.
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Lacrimal System
- The lacrimal gland produces tears which enter into the "duct" that drain the tears from the eye into the nose. The most common symptoms are If one has a plugged up "tear duct," not only will tears spill over the eyelids and run down the face, but the stagnant tears within the system can become infected.    (1) excess tearing (tears may run down the face) and    (2) mucous discharge - This may lead to recurrent red eyes and infections. - The excessive tearing can also produce secondary skin changes on the lower eyelids.
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Lagophthalmos
Patients with lagophthalmos have an inability to close eyelids. This may occur, for instance, in patients with Thyroid eye disease.
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Latisse
LATISSE® makes lash growth possible because of its active ingredient: bimatoprost. Although the precise mechanism of action is not known, research suggests that the growth of eyelashes occurs by increasing the percent of hairs in, and the duration of, the anagen (or growth) phase. Lashes can grow longer, thicker and darker because bimatoprost can also prolong this growth phase.
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Orbital Tumors
- Orbital Tumor is any tumor that occurs within the orbit of the eye. The orbit is a bony housing in the skull about 2 inches deep that provides protection to the entire eyeball except the front surface. It is lined by the orbital bones and contains the eyeball, its muscles, blood supply, nerve supply, and fat.
- Tumors may develop in any of the tissues surrounding the eyeball and may also invade the orbit from the sinuses, brain, or nasal cavity, or it may metastasize (spread) from other areas of the body. Orbital tumors can affect adults and children. Fortunately, most are benign.
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Ptosis
- Ptosis is an abnormally low position (drooping) of the upper eyelid
- Ptosis occurs when the muscles that raise the eyelid (levator and Müller's muscles) are not strong enough to do so properly.
- It can affect one eye or both eyes and is more common in the elderly, as muscles in the eyelids may begin to deteriorate.
- Compare with dermatochalsis (extra skin and fat)
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Skin Rejuvination
A radiant, smooth, youthful skin is the essence of beauty and trendy looks. Skin care routine highly contributes in the slowing down of rate of aging of the skin. Choosing the right skin care products for your skin type enhances your beauty keeping the skin cleansed, moisturized and well toned. Use of superficial skin resurfacing treatments to counter fine lines and wrinkles, acne scars and blemishes before they deepen ensures skin rejuvenation.
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Skin Tumors
Cancer of the eyelid, like any other cancer, can be a worrying thing. Treatments are variable and depend on the type of cancer. In this article, we shall take a brief look at the different kinds of eyelid tumors.
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Symblepharon
A symblepharon is a fibrous tract that connects bulbar conjunctiva to conjunctiva on the eyelid.
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Thyroid
Graves' disease is an autoimmune disease.
It most commonly affects the thyroid, causing it to grow to twice its size or more (goiter), be overactive, with related hyperthyroid symptoms such as increased heartbeat, muscle weakness, disturbed sleep, and irritability. It can also affect the eyes, causing bulging eyes (exophthalmos).
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Trauma
Eye injuries are extremely common with over 2 million cases reported every year that require medical treatment. Blindness in one eye is most commonly due to cataract and this is followed closely by eye injuries. In addition, in children, injury to the eye is a recognized as the most common cause of blindness in one eye that is not due to a birth defect.
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