Dr. Levens' Parkland Life Magazine Articles

Procedures & Treatments to Give Eyes a Refreshed Look
By David J. Levens, MD, PA, FACS

Tired-looking eyes can add years to a person’s appearance and create an undesirable impression of stress and exhaustion.  That’s why eyelid surgery as well as non-invasive treatments to the skin around the eyes are so popular with both men and women.   
           
Let’s start with the least invasive approaches.
           
If the problem is “crow’s feet” at the corners of the eyes, several different treatments can be very effective.  Botox can be used to relax muscles which constantly contract when you smile or frown, thus reinforcing the wrinkles.  Restylane or other fillers can be used to fill in persistent wrinkles. Neither Botox nor fillers are permanent solutions and must be repeated after a number of months.  When the wrinkles are particularly stubborn or if a more lasting result is desired, peels and lasers can be used.  In rare cases, tiny muscles are cut to permanently relax the affected area.
           
If the problem is dark circles under the eyes, topical bleaching crèmes can sometimes minimize them sufficiently, but repeated treatments are needed to produce noticeable results.  If crèmes don’t do the job, vascular or pigment lasers can produce good results but again, multiple treatments are usually required.
           
If the problem is excess sagging skin between the eyebrow and the lashes, or sagging “bags” of fatty tissue beneath the eye, cosmetic surgery is the most appropriate approach.
           
There are two types of eyelid surgery—upper eyelid and lower eyelid.  Here’s a brief summary of how the procedures are done:
          
To reduce excess volume in the upper eyelids, incisions are made in the eyelid folds. The surgeon then removes fat and skin and closes the incisions with tiny sutures.  For the lower lids, incisions are placed immediately below the eyelashes where they are inconspicuous or inside the lower eyelids, depending upon the specific patient.  Fatty tissue which had caused a puffy look is removed and the incisions are closed.  A special laser is sometimes used on the skin of the lower eyelid to help minimize fine lines and wrinkles, and to shrink excess skin.  Often, Botox and/or fillers are also used to address crow’s feet and enhance the overall results of the eyelid surgery.
           
Careful and precise surgical planning is critical for eyelid surgery.  The goal is to  produce the most significant  improvement possible within the bounds of utmost safety.
Removing too much skin and fat can create a skeletal look later on and in rare cases, can make it difficult to close the eyes properly.
           
In many cases, browlift surgery is done at the same time as eyelid surgery.  A browlift is appropriate if the eyebrow has slipped below the orbital bone, producing a puffy look in the upper eyelid.  In fact, a browlift is sometimes done instead of upper eyelid surgery.
           
In the past, browlifts involved large incisions and often produced significant hair loss.  Today, they are done using endoscopes requiring only tiny incisions and producing almost no hair loss.  Typically, 3 tiny incisions are placed within the patient’s scalp and 2 incisions in the hair in the temple regions.  Tissues are then lifted and repositioned upward to provide the necessary lift to increase the distance between the brow and eyelashes. The brows are positioned to achieve the maximum improvement without creating an overly startled or unnatural look.  
           
Both eyelid surgery and browlift are done on an out-patient basis, discomfort is minimal and recovery is fairly rapid.  There is some bruising and swelling for the first week or so, but after 7-10 days, most patients return to work and social activities, though strenuous activity should be avoided for 3-4 weeks.  It is imperative to avoid sun exposure.
           
Unlike facelift surgery which often needs to be repeated after 10-12 years, eyelid and eyebrow surgeries typically do not. 

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David Levens, MD, PA, FACS has been practicing cosmetic surgery in Coral Springs since 1989.  In addition to his private practice at 1725 University Drive, Dr. Levens has served as Vice Chief of Staff and Chief of Surgery at the Coral Springs Medical Center. He is Certified by the American Board of Plastic Surgery and is a member of the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons.  Dr. Levens has been cited repeatedly in Miami Metro Magazine’s annual lists of “Best Doctors in South Florida”.  He earned his medical degree at Columbia University, New York, and served residencies in general surgery and plastic surgery at Montefiore Hospital & Medical Center, New York.  He lives in Coral Springs with his wife, Linda, and their two children, Danielle and Ben. He can be reached at 954-752-1020 or www.DrLevens.com