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Aging, the environment and your health can all affect the appearance of your eyelids and skin. Droopy eyelids and wrinkles can add years to your face and may even block your vision. The solution might be closer than you think. Baltimore Eye Physicians has long been recognized as one of the area’s premiere eye care centers, providing a full spectrum of high-quality medical and surgical eye care services. What many patients don’t know is that we’ve also helped thousands of people achieve the appearance they desire through eyelid and facial cosmetic treatments and surgery.

Botox injection

Botox injection is a revolutionary wrinkle reduction procedure that can reduce or eliminate wrinkles in the upper third of the face, including forehead lines, frown lines between the eyes and crow’s feet around the eyes. It is not surgery. There is no chance of scarring.

Before: Before Botox 
After:    After Botox

Botox is a protein that weakens and inactivates muscles that wrinkle the skin. When Botox is injected in extremely small doses directly into a specific muscle, it blocks the signals from the brain from reaching the muscle. As the muscle weakens, the skin overlying the muscle relaxes and the wrinkles caused by muscle contractions soften and often disappear. The effect can last from 4 to 5 months. Botox injection is for those who want to reduce or eliminate facial wrinkles.

Before Your Treatment

Ask your doctor to determine if you are a candidate for Botox injection. Together, you will determine the number and regularity of treatments best for you.

What To Expect On Procedure Day

Your treatment can be performed in an examination room environment. Since it isn’t a surgical procedure, it does not require a surgery center. Your doctor will inject an extremely small dose of Botox into designated facial muscles using a micro-needle. It will only take a few seconds. You might feel a stinging sensation that will subside quickly.

You won’t see the effects of the initial injections for three or four days, and improvements will continue for several days after that. If you experience any discomfort after the procedure, you can use ice compresses or over-the-counter pain medication. You may have a little bit of bruising.

Because this procedure is non-invasive and non-surgical, you may return to your normal activities immediately.

Realistic Expectations

Botox, when used in these extremely small doses, has a high level of safety. Since Botox proteins are only attracted to muscles, it has no effect on the central nervous system. It does not cause numbness in the area of the injections, and muscles related to other facial expressions are rarely affected. One or two patients in every hundred may experience a temporary drooping of the eyelid, but this usually goes away in a week or two.

Serious complications with Botox injection are extremely rare, but like any medical procedure, it does have some risks. Going to a specialist experienced in Botox injection can significantly minimize the risks. The vast majority of our patients are extremely happy with their appearance after Botox injection, however, we cannot guarantee you will have the results you desire.

If you decide that Botox injection is an option for you, you will be given additional information about the procedure that will allow you to make an informed decision about whether to proceed. Be sure you have all your questions answered to your satisfaction.
Alternatives to Botox injection:

Chemical peels and cosmetic surgery have been the primary means of reducing the undesirable effects of aging and wrinkles. If you would like more information about this exciting procedure, you may want to make an appointment, attend a seminar or request additional information from our practice.

Botox is a registered trademark of Allergan, Inc.

Intense Pulse Light (IPL)

Utilizing specific wavelengths to target various chromophores in the skin enables effective treatment of a variety of conditions, including vascular lesions, skin photoaging treatments and hair removal.

Broad spectrum pulsed light is transmitted through a continuously cooled applicator, gently placed over the skin. Cut-off filters in the handpiece change the range of wavelengths, optimizing it for different applications and skin types. The light penetrates the tissue and is absorbed by either the relevant chromophores and damages them (blood chromophores when treating vascular lesions and melanin chromophores when treating pigmented lesions).  The body’s natural processes then clear the lesion debris, giving the skin a more even and youthful appearance.

IPL Services

Dry Eye Therapy

Whether mild, moderate, or severe, dry eye syndrome can be disabling.  Feelings of “heavy” eyes, difficulty keeping the eyes open, and watery eyes are all common symptoms. Burning, stinging sensations while reading, or vision that becomes blurry while doing visual tasks are also symptoms related to dry eye syndrome. “Get the red out” eye drops should never be used for dry eye, as they can make things worse. Artificial tears can work temporarily to alleviate dry symptoms. A structured approach with a treatment tailored to an individual’s specific type of dry eye syndrome is the most effective means of therapy. Baltimore Eye Physicians has its own Dry Eye Clinic specifically designed to accurately diagnose and treat this prevalent condition.

Photorejuvenation

Photorejuvenation uses lasers, intense pulsed light, or photodynamic therapy to treat skin conditions and effects of photoaging such as wrinkles, spots, and textures.

Sunspot Removal

Sunspots are discolorations on the skin related to aging and UV exposure from. They vary in color and are located in areas most often exposed to the sun.

Upper Eyelid Blepharoplasty

Complete eye health includes healthy eyes and healthy eyelids. Common eyelid problems include excessive eyelid skin and droopy eyelids (ptosis). Ptosis can cause eye discomfort, limit vision, and affect appearance. Fortunately, it can be identified and corrected appropriately.  This is often covered by medical insurance if the symptoms are affecting your lifestyle. Surgery to improve the appearance of the eyelids is called blepharoplasty. The goal of the procedure is to remove extra skin, muscle, and fat to achieve a more youthful appearance. Early in Dr. Doxanas’ career he recognized the role of the eyebrows which accentuates upper eyelid abnormalities. Failure to recognize eyebrow changes compromised surgical results. As such, the eyebrows and the eyelids are considered as a functional unit.  Anatomic studies have identified the eyebrow fat pad in the lateral 2/3 of the brow as an important factor in brow contour and fullness. Patients with prominent low-set brows generally have a more pronounced brow fat pad. As such, the transeyelid brow elevation procedure was developed. In conjunction with a standard blepharoplasty, and through the same eyelid crease incision, the brow is addressed. Dissection is carried above to the eyebrow allowing debulking or sculpting of the brow fat pad and elevation. A second or separate procedure for brow elevation are therefore avoided. This combined procedure is a much more efficient means of brow elevation, much less expensive, and less invasive than the standard option.  Attention to the eyebrow position will result in a more youthful and permanent result.

Before: Before Blepharoplasty

After:    After Blepharoplasty

Before: Before Blepharoplasty

After:    After Blepharoplasty

Dr. Doxanas is a Board certified ophthalmologist with a special interest in eyelid surgery.  Fellowship trained in eyelid surgery, he is also certified by the American Society of Ophthalmic Plastic and Reconstructive Surgery. Practicing for over thirty years, he specializes not only in the functional, but cosmetic anomalies of the eyelids. Pioneering new approaches to eyelid surgery, he wrote a book, Clinical Orbital Anatomy and contributed approximately 40 additional scientific articles and chapters, most of which are related to eyelid abnormalities.

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Lower Lid Blepharoplasty

Approaches to lower eyelid surgery are now tailored to the patient’s concerns. Previously all lower eyelid surgery was addressed through a standard incision under the lashes extending all the way across the lower eyelid. However, closer evaluation of patient’s requesting eyelid rejuvenation has a combination of issues: fat herniation, redundant skin or eyelid laxity. The traditional approach is not indicated for fat herniation and may aggravate those patients with lower eyelid elasticity. As such, separate procedures were created for each specific problem.

Dr. Doxanas uses a different approach for fat removal. Herniation or prominent lower lid fat is familial tendency aggravated by aging. Without creating a skin incision, these fat pockets are approached through a small button hole incision in the inside of the eyelid. As such, eyelid edema and puffiness can be eliminated without external scarring. If redundant skin is more of a problem, then a traditional transcutaneous approach is used. This generally requires a minimal skin removal but can be more extensive based on the doctor’s determination. If redundant skin or festoons are of primary concern, these can be removed directly. Excessive skin removal may result in eyelid contour or eyelid malpositions and is such avoided.

It is important to have an ophthalmologist trained in eyelid surgery perform these techniques. Dr. Doxanas is a certified by the American Society of Ophthalmic and Reconstructive Surgery. He has received the prestigious Lester T. Jones award for significant contributions to the understanding of ophthalmic plastic surgery. This extra training allows a greater level of understanding of anatomic concept which will maximize success and enhance patient satisfaction with all eyelid abnormalities.

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