Cosmetic Surgery

This procedure involves the removal of excess upper lid (or less commonly lower lid excess) skin. Excess muscle and fat can also be removed. Generally the results of an upper eyelid blepharoplasty are more predictable and more dramatic. Blepharoplasty can be performed for both functional and cosmetic reasons.

Botulinum toxin A can be used as a very effective treatment for various conditions around the eyes and face. It is injected using a very small needle. It is injected into overacting muscles around the face, which can cause deep lines and wrinkles around the eyes and forehead area. It can also be used to treat debilitating conditions such as blepharospasm (involuntary severe spasms of the eyelids) and hemifacial spasms.

Common sites for injection are the vertical frown lines between the eyebrows (glabella lines), horizontal forehead lines, and crow’s feet around the eyes. The onset of effect is within 3-5 days and the effect can last between 3-4 months. With continued use the results can last even longer.

A filler is an inert substance (commonly hyaluronic acid) which is injected into depressions and wrinkles around the eyelids and face. It can also be used to enhance and to fill the lips. Common areas treated by Dr. Pakrou include the lips, tear trough area below the eyes, and the lines between the nose and the mouth (nasolabial folds). Other areas that often benefit from fillers are the midface (to plump up and lift the midface) and the cheekbones. There are many fillers on the market and Dr. Pakrou will discuss the best options based on the desired outcomes.

Some fillers are enhanced with rejuvenating compounds and factors, which over time can improve the quality and radiance of the skin. Most fillers are temporary and results last between 6-12 months based on the product used, and the area being treated. Most of the fillers used can also be dissolved if the desired outcome is not achieved.

Dr. Pakrou performs all procedures. As an eye and eyelid surgeon, Dr. Pakrou has extensive knowledge of the facial and eyelid anatomy. Although all procedures do carry a very small risk, Dr. Pakrou has the expertise to minimise any potential risks.

Patients are advised to avoid lying supine following treatment for four hours. They are also advised to avoid massaging or applying heat to the treatment area, and to avoid activities that cause flushing (such as exercising heavily, consuming alcohol, and hot tub use) on the day of treatment. These aftercare practices are used to reduce potential spread of the botulinum toxin and/or filler, however; they are not supported by randomized controlled trials.

Onset of effect and duration

Partial results following botox injection can be seen within 3-5 days with maximal reduction at two weeks following injection. Return of muscle function and wrinkles is gradual and generally after three to four months after treatment. Further treatment can be performed when muscle contraction is visible in the treatment area and before facial lines return to their pre-treatment appearance. Following multiple treatments, the effects of botox may be prolonged and, in most cases, treatment intervals can be extended.

The results following facial and lip fillers are almost instant. However initially there can be bruising, redness and swelling which can mask the ultimate result. These effects can be noticed very soon after injections, and can worsen over 24-48 hours before improving. Using cold packs can help minimise bruising and swelling. Most fillers are temporary and results last between 6-12 months based on the product used, and the area being treated. Most of the fillers used can also be dissolved if the desired outcome is not achieved.