Our eyes are the focal point of our face and express how we feel. This can explain why eyelids and brow surgeries are one of the most popular surgical procedures for the face.
As people age, there are a number of medical and cosmetic conditions that can negatively affect the eyelid and can cause one’s eyelids to droop, thus creating a tired appearance. There are effective methods to resolve this condition, some less invasive than others. Luckily, there is a small group of surgeons who specialize in this unique field of medicine, allowing patients a level of comfort and care that they deserve for a procedure so important to their appearance.
Known as oculoplastic surgeons, these physicians are ophthalmologists who complete an additional two years of intensive surgical fellowship that concentrates on cosmetic eyelids and brow lift surgeries, along with medical procedures to treat conditions such as ptosis (weakness of eyelids muscle), tear-duct obstructions, tumors and eyelid reconstruction after trauma and skin cancer removal around the eyes.
There are less than 600 oculoplastic surgeons in the United States, and among them is John J.W. Lee, M.D., FACS, who completed his fellowship at the renowned Wills Eye Hospital. Eyes are the most scrutinized part of the face.
Tolerances in this area are minimal, so even a very small change can have a big impact. The surgeon has to be accustomed to working in fine details every day. The eye is also very sensitive; only the brain has a higher density of nerves. The surgeon must not only know how to make the eye appear beautiful, but he also has to ensure that the function is preserved and protected.
“While general cosmetic surgeons learn to operate on the entire face and body, oculoplastic surgeons concentrate their training exclusively on eyelid and brow surgery,” says Dr. Lee, who has more than 10 years in practice, performing more than 1,000 upper/lower eyelids and brow procedures each year.
By their mid-30s, people begin to see signs of aging around the eyes. Eyelids begin to droop, causing a hooded appearance, and there is an increase in puffiness on the lower lids caused by herniated fat pads. “Women and a growing number of men want to look younger longer,” says Dr. Lee. “At the same time, they don’t want to look ‘different’ but refreshed.” The eyes are of particular concern because, he notes, “People always make eye contact when they are communicating, so it is the focus of our attention.”
One of the most cosmetically effective procedures is upper blepharoplasty surgery, or an eyelid lift. This is a simple procedure that will remove excess skin and fat on the upper eyelids. It can be performed in the office under local anesthesia in about 30 minutes. And recovery usually takes about a week.
In the course of the initial consultation, Dr. Lee will also discuss if a brow lift is appropriate for the patient. He goes over various surgical and nonsurgical methods of brow lifting by demonstrating directly on the patient’s face what can be achieved with various methods.
The 45-Minute Brow Lift
Many people understand the amazing results that can be achieved with eyelid lift surgery, but there are a lot of misconceptions and a general lack of education regarding the effectiveness and purpose of a brow lift. Many patients complain of droopy and sagging eyelids when the brow is actually the main culprit. Brow lifts are equally important as eyelid lifts in helping transform a tired and aged appearance into a more youthful and rejuvenated one. Unlike a typical eyelid lift, a traditional brow lift involves a far lengthier and extensive procedure.
The traditional brow lift is fairly invasive, time consuming and carries the risk of nerve damage and scarring. It can also leave recipients with an over-elevated forehead and a perpetual “surprised” look. Most people, in fact—with the exception of those with very heavy brows or a significant mid-forehead droop which is not the majority of patients who receive brow lift surgeries—do not require a traditional brow lift.
Being an oculoplastic surgeon who performs eyelid surgery on a daily basis, Dr. Lee has performed brow lift surgeries regularly but has been reluctant to recommend the procedure because of its invasive nature. “I would probably say that at least 30 to 40 percent of my eyelids lift surgery patients could have benefited from a brow lift procedure,” he says, “but I felt that the risk factors outweighed the benefits.”
To resolve this dilemma, he developed a method that is as effective as the traditional forehead lift but without the invasive dissection and arduous recovery. “By simplifying a complicated procedure, I am preventing excessive scarring, reducing patient risk and eliminating unnecessary steps, which can cause more complications and longer recovery,” Dr. Lee says. It also achieves a very natural look and avoids the “overdone or startled” appearance.
Similar techniques exist, but Dr. Lee has tailored this procedure and calls it “the ‘45-minute brow lift.” Dr. Lee performs this procedure in his office with local anesthesia and involves lifting only the lateral brow with tiny sutures that are placed under the forehead. Dr. Lee explains that “the sutures I use do not have any permanent cones or hooks that can slip and cause irritation, and the incision is entirely in the scalp and is less than an inch wide.”
The 45-minute brow lift is ideally suited for someone who desires mild to moderate lateral brow lifting, with minimal downtime and risk. The entire procedure takes less than one hour, and despite the recommended five- to seven-day recovery period, many patients resume work after a few days. The sutures can also be adjusted months or even years later to achieve the desired outcome and accommodate the natural changes of the aging face. It is a simpler way to obtain a natural and youthful appearance while providing long-lasting, if not permanent, results.
An Artist’s Touch
Of course, surgery is not the only option Dr. Lee offers his patients. The practice began to offer cosmetic injectables after patients of eyelid and brow lift surgery wanted Dr. Lee to do just a little more for them. He says it was a natural progression of the business. “We provide patients innovative uses of Botox/Dysport for slimming the jaws, fillers to sculpt noses, chins and foreheads, and to create a smooth appearance by filling in the deep sunken lower lids trough and transition to the cheek area. … A natural, more youthful facial contour is achieved.”
Few people understand that results achieved by the same product can vary a great degree. It is essentially a form of sculpting, and the artist needs to have the aesthetic sense and delicate hands to realize the potential that the product can deliver. Sculpting lips, noses, chins, foreheads and the lower lids or trough area should be performed only by very skilled and experienced injectors. An experienced injector knows there are special needles that should be used for certain areas and the vessels that they should avoid going near so a thorough knowledge of the anatomy is crucial to achieving the best results.
Dr. Lee performs all of his practices injections and procedures himself. He is conservative in his approach, believing any transformation should be gradual and ongoing. Dr. Lee is a firm believer in a more natural appearance and prides himself on results that don't appear to have been created by surgery, rather just a better and more youthful version of the patient. Dr. Lee states that “surgical results that are obvious are never a compliment to the patient or the surgeon.”
Dr. Lee believes in minimal sedation and often uses only local anesthesia or conscious sedation. With the use of a radio-wave scalpel, Dr. Lee maximizes precision and safety as well as reduces bleeding. Recovery times vary based upon the procedure, but most patients can return to work within one to two weeks.
“The combination of affordable pricing with optimal results, has kept our practice growing even through difficult economic times,” he says. “Our Botox pricing is $10 per unit, and we know it’s lower than most people expect for someone with my experience. However, I feel that it’s a fair price to charge in this economy and I want to make ongoing treatments affordable for my patients and, thus, achieve the best results. I believe our patients appreciate this. We know that injections can be expensive since it’s an ongoing commitment. I believe that our business model of providing the best quality care at an affordable price will keep our patients loyal and happy.
“In medical school, I chose to specialize in a very specific field where my surgical ability could really be honed and could provide the level of service to patients that I was comfortable with. We believe in doing just a few things to the best of our abilities. By repeating this every day we strive for the highest results in our services.”
John J.W. Lee, M.D., FACS
2050 West Chester Pike, Havertown
Phone: 610-789-6701
Web: www.drjohnleesurgery.com
