Facial Rejuvination F.A.Q.

Below is a list of Frequently Asked Questions answered by Dr Lipham, our facial rejuvination specialist:

What is your specialty?

I am an ophthalmic plastic and reconstructive or oculoplastic surgeon. That means that I am a board-certified ophthalmologist who then went on to perform an additional two-year fellowship in ophthalmic plastic and reconstructive surgery. The entire field encompasses eyelid reconstruction, surgical treatment of orbital tumors, and tear drainage disorders. In addition to these complex medical and surgical cases, I also was trained in and perform a variety of cosmetic procedures, including Botox and collagen injections, cosmetic eyelid surgery, endoscopic forehead lifts and laser skin resurfacing.

How does cosmetic or oculoplastic surgery relate to the practice of Minnesota Eye Consultants?

The physicians of Minnesota Eye Consultants are leaders in laser vision correction and cataract surgery. These procedures not only improve a person’s ability to see, but also decrease their dependency on glasses. Once patients have benefited from either cataract or refractive procedures, they are able to see better and are no longer dependent upon glasses. For the first time in many years, they are now able to look into the mirror and notice changes that have occurred in the tissue around their eyes. It is not surprising that many patients, following these types of procedures, ask whether or not something can be done to improve the appearance of the skin around their eyes and face. To provide a seamless approach to care and enhance these individuals' quality of life, the physicians of Minnesota Eye Consultants decided to bring me on board to evaluate and treat these patients.

For those aging "baby boomers," what are options for looking younger?

Facial rejuvenation is experiencing an exciting time. Never before has such a wide range of options been available. At the mildest end of this spectrum are cosmeceuticals, microdermabrasion, and Botox injections. Cosmeceuticals are cosmetics that contain pharmacologic agents and are prescribed by a physician. They produce much more dramatic results than over-the-counter cosmetics. Microdermabrasion reduces surface irregularities in the skin and evens pigmentation, while Botox injections to reduce the appearance of active wrinkles. For individuals looking for more dramatic results, laser skin resurfacing, cosmetic eyelid surgery or endoscopic forehead surgery can provide excellent results.

What is BOTOX? Is it safe?

Botox? is actually a purified protein derived from the organism Clostridium botulinum. The protein is manufactured by a benign organism that is grown in the laboratory. It is a very safe compound that has been in use since 1988 when the FDA first approved its use for the treatment of blepharospasm.

What about microdermabrasion? How does it work? What are the results?

Microdermabrasion is excellent at reducing surface irregularities and roughness in the skin, allowing make-up to be applied much more evenly. It also reduces pigmentary irregularities by evening out skin color. After multiple treatments it can also reduce the appearance of fine lines and wrinkles. Microdermabrasion works like a small sand blaster. A precision handpiece delivers a fine stream of crystals towards the surface of the skin to remove the outer dead layers of the skin and promote skin turnover. This exposes the underlying skin, which is smoother and healthier. Typically, six treatments are required to provide the desired results.

Are there other options for a more youthful appearance?

A number of new injectable substrates, such as Collagen and Cymetra, are becoming available to reduce the appearance of wrinkles. I think that Cymetra is a very interesting product since it lasts longer than conventional Collagen injections.

When should I consider cosmetic surgery?

My philosophy is not to radically alter or change an individual's appearance, but to rather turn back the effects of time and produce a more youthful appearance. For this reason, I regard my cosmetic surgical services as facial rejuvenation services.

I feel that once patients have tried some of the milder forms of therapy and feel that they are not able to reach an end point that they desire, it is reasonable to consider cosmetic surgery. Ultimately, this is a decision that is different for each individual and influenced by one’s own perceptions of where they want to be with regard to their appearance.

What's new in laser surgery?

One of the more exciting developments in laser skin resurfacing is a new generation of laser skin resurfacing lasers, namely the Contour laser by Sciton. Unlike conventional CO2 lasers, the new Sciton Contour laser allows the surgeon to independently adjust the amount of tissue to be removed, as well as the amount of thermal effect generated. This reduces recovery times and decreases the risk of scarring and complications compared to conventional CO2 lasers. The contour laser also allows the surgeon to individualize treatments, not only on a patient-by-patient basis, but to treat different areas of the face with different levels of thermal effect to obtain optimal results.

What's the recovery time?

The significant advantage with the Contour laser is the dramatic reduction in the amount of post-treatment redness or erythema. It is not uncommon for an individual's face to stay pink or red for at least 4-6 months following a CO2 laser skin resurfacing procedure. This new laser, however, reduces the amount of post-treatment redness to approximately 6-8 weeks, a significant reduction in recovery time.

How about cost? How does it compare to more traditional cosmetic surgery?

Full-face laser skin resurfacing with the Sciton Contour laser currently costs $5,000. This fee includes preoperative assessment and allows one to obtain a different type of result than is possible with a conventional incisional approach.

What can be done for droopy eyelids or puffiness under the eye?

In the upper eyelids, a blepharoplasty procedure is performed to remove excess eyelid skin and fat that contributes to the appearance of fullness over the upper eyelid. This is typically performed with an incision through the skin of the upper eyelid and can be carried out as a conventional incisional procedure or with the Sciton laser in incisional mode. The lower eyelids can be corrected by making an incision through the skin or alternatively, through the inside of the lower eyelid to remove the fat that is causing the puffiness in the lower lids. The decision as to which approach is best for an individual is based on the preoperative evaluation and how much excess lower eyelid skin is present.

Are these procedures covered by insurance?

Cosmetic procedures typically are not covered; however, some upper eyelid surgeries can be reimbursed through a third-party insurance company. In order to determine if an individual meets these criteria, photographs and visual fields need to be performed to document the amount of visual field loss. This type of testing would be performed at the time of the initial evaluation.

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