Common Oculoplastic conditions
and many others
Botox is the trade name for botulinum toxin. In its pure form, botulinum toxin is a poisonous neurotoxic protein that is found in certain spoiled foods and causes muscle weakness. It acts as a nerve impulse blocker, preventing muscles from contracting. In an extremely dilute form, botulinum toxin has many medical applications.
Botulinum toxin is used to treat ocular conditions such as blepharospasm, an excessive contraction of the eyelid muscles that forces the eyelids closed, and hemifacial spasm, an excessive contraction of the facial muscles on one side of the face. When the toxin is injected directly into the muscles of the face or the eye, it causes the overactive muscles to relax. It usually takes a few days for the therapeutic effects to be noticeable, and the injections may need to be repeated every four to six months.
Botulinum toxin also is used to treat certain kinds of double vision. The toxin is injected directly into the eye muscle opposite the paralyzed muscle.
Botulinum toxin can also be used for cosmetic purposes to soften wrinkles around the eye. It can also weaken the brow muscles in order to diminish the deep furrows or frown lines that may appear in the middle of the forehead.
Side effects of the injections are temporary. They can include a droopy upper eyelid, double vision, and being unable to close the eyelids.
Eyelid surgery is a common method of treatment for entropion (inward turning of the eyelid), ectropion (outward turning of the eyelid), ptosis (drooping of the eyelid), and some eyelid tumors.
Eyelid surgery is usually an outpatient procedure performed under local anesthesia. Risks of surgery are rare but can include bleeding, infection, and eyelid asymmetry due to uneven wound healing. Differences in healing between the eyes may cause some unevenness after surgery.
After eyelid surgery, bruising or a black eye is common but resolves quickly. It may be difficult to close your eyelids completely, making the eyes feel dry. This irritation generally disappears as you heal. Serious complications are rare but can include vision loss, scarring, and infection. To most people, the improvement in vision, comfort, and appearance after eyelid surgery is very gratifying.
Sun, wind, and gravity affect the skin and muscles of the face over time. One of the most noticeable aspects of aging is a progressive drooping of the eyebrows. This can cause wrinkling of the forehead from raising one's eyebrows as well as vertical wrinkles or furrows between the eyebrows. Sometimes the eyebrows or excess eyelid tissue can obstruct vision.
A browlift (also called a forehead lift) elevates the brow, smooths forehead skin, and can remove vertical lines between the eyebrows. Incisions are made in inconspicuous places, either behind the hairline, in one of the forehead wrinkles, or immediately above the eyebrows. If an endoscope (a small tube with a fiber-optic light) is used, the incisions can be very small. After the muscles are tightened and excess skin is removed, the incision is closed with sutures. The operation is usually performed on an outpatient basis under either monitored anesthesia care (MAC) or general anesthesia.
Swelling and bruising, common after a brow- or forehead lift, begins to subside in seven to 14 days. Numbness and itching are common during the healing process. Sutures, staples, or clips are removed within seven to 14 days after the surgery. Incisions in the hairline may damage hair follicles and result in some hair loss.