Newburgh Eyelid Surgery doctors

Eyelid surgery without sedation or anesthesia is possible but depends on a few factors:

1. Which eye lid is being treated. Generally, upper eyelid surgery can performed with local anesthesia i.e. numbing injections along with oral medication such as Valium to relax the patients. Lower eye lid surgery where fat is being removed requires some form of sedation anesthesia.
2. Fat vs skin removal: Again, if only skin is being removed from the upper and lower eye lids, sedation anesthesia is not required. This includes laser resurfacing of the eye lids.
3. Surgeons comfort without anesthesia as well as patients level of comfort with this approach. In general, using tiny needles for the Novocaine injections combined with an oral relaxing medicine such as Valium, background music and caring staff make all the difference in being able to perform surgery without sedation.

In order to answer this question, one has to know if the patients eye brows are

1. brows currently droopy?
2. patient male or female?
3. where the brows always heavy or is this change new?
4. In youth, did the patient like their eye brow position?
5. Does the patient have a problem with dry eyes

In order to answer many of these questions, my patients are instructed to bring in photos of themselves from their 20's and each decade up until the age at which they present. This helps me understand the evolution of their aging eye area.

Yes, heaviness in the eye brows contributes to heaviness in the upper eyelids as it tends to push down excess brow skin over the eye lids.

In male patients who always had heaviness in their eye brows, the most natural approach is simply an upper eye lift. This avoids an unnatural feminized appearance which can result from lifting the brows in men especially if overdone.

In female patients, if their eye brows are heavy but have not changed in position, I tend to not lift the brows if they liked where their brows were positioned in youth. An upper eye lift alone is sufficient to rejuvenate the eyes. If there is a significant change in their brows, then I will recommend an upper eye lift and brow lift.

Caution: I will try to avoid performing a brow lift and eye lift in someone who has a problem with dry eyes as this can accentuate the problem. Patients are certainly warned.

There are some patients who are not ready to go under the knife to rejuvenate their eyelids. Here are some options.

Excess eye lid skin: Rather than surgically removing this excess, the skin be smoothed out with Fraxel laser therapy or alternatively using Thermage radio wave technology. Droopy eye brows often contribute to the heaviness of the upper eye lids. The brows can be lifted by relaxing muscles that pull the brows downward with Botox injections as well as increase brow support using fillers i.e. Restylane , Juvederm, Radiesse or Sculptra.

Lower eye lid puffiness: This is caused by a combination of excess lower eye lid fat and a loss of facial volume just below the eye lid which accentuated the lower lid fat excess. Optimally, the fat is removed surgically and volume restored just below the eye lid with fat injections, Sculptra or other fillers. A dramatic improvement in the puffiness can be accomplished by simply camouflaging the lower lid with fillers and removing any of the fat. Results can be quite dramatic.

Crows feet: wrinkles around the eye lid both at rest and with smiling can be addressed non surgically by relaxing the underlying eye lid muscle which creates these lines by Botox injections. For lines that are present at rest and etched in, Fraxel laser resurfacing along with Botox injections goes a long way to smooth out the eye lid skin.

In summary: Most patients benefit from a combination of the above techniques.