Lower eyelid bags can make you look older and more tired than you actually are.  These bags and shadows are usually caused by lower eyelid fat pouches that are bulging in combination with hollowing of the upper cheek in an area called the "tear trough". 

There is a surgical option to correct these bags that removes and/or shifts the fat pouch.  The surgery may also involve fat injections and laser resurfacing to smooth the surrounding areas.  Surgery gives the most long-lasting benefit, but it also involves some downtime, usually a week (or a few) of swelling, bruising, and redness.

The non-surgical correction for eye bags involves filler injections to plump the hollow, sunken areas that create shadows under the eyes.  The fillers can last a year or more and have little downtime.  Most people can return to work after the treatment that takes about 15 minutes. 

The patient above (who generously allowed us to use his photos) had Juvederm Ultra placed by Dr. Brett Kotlus in the tear trough and upper cheek.  He was totally thrilled with the result.  Dr. Kotlus is one of the most experienced under-eye filler injectors in the state of Michigan and uses special techniques including blunt microcannula delivery systems to prevent bruising and reconstituted hyaluronic acid to ensure a smoother, more natural contour. He performs these treatments in the Macomb county office at Allure Medical Spa. 

This patient (who graciously allowed us to post her before and after photos) may be advanced in age but she is young at heart, and she wanted to express that to everyone around her. She had 2 simple non-surgical treatments to help her acheive that goal: Botox and filler.  These are injectable treatments that are performed in the office at Allure Medical Spa, with minimal to no downtime and dramatic results. 

Botox is used to relax the muscles that cause frown lines.  When used between the brows and around the crow's line wrinkles, the eyebrows are lifted and the wrinkles are softened at the same time.  This effect will last for 3-6 months after the treatment.  

Dermal filler (Juvederm Ultra Plus in this case) is a soft, biocompatible gel was injected underneath the eyebrows, in the grooves under the eyes, and in the sunken cheeks to lift and rejuvenate these areas.  Juvederm Ultra can last many months in these areas.

If you are looking to express your inner age with cosmetic treatments such as Botox or Juvederm, visit our main website or schedule a free consultation appointment at one of our Michigan locations, Shelby Township or Livonia. 

Everyone hates those wrinkles that radiate around the lips. And they only seem to get worse with age. What can be done? These simple steps will help to prevent these lines and can reduce their visibility.

1. Stay out of the sun.  It's well-know that sun damage causes wrinkles. Wear at least a 30 SPF sunblock and a hat when you're spending any time outside.

2. Don't smoke.  There are many good reasons to avoid smoke or to stop smoking.  Lip wrinkle prevention is another compelling argument to not smoke.

3. Use a medical-grade skin care regimen.  Ask your dermatologist or cosmetic surgeon about topical skin care products that can help with your particular skin type.  Tretinoin and L-ascorbic acid can both help with wrinkles by boosting collagen conent in your skin. 

4. Laser wrinkle treatments and chemical peels. These will create controlled injuries in the skin that stimulate new skin growth that tends to look smoother and more youthful. Lasers like Fraxel, ActiveFX, and DeepFX have been well established as excellent wrinkle treatments.  Traditional dermabrasion (not microdermabrasion) can also work well for lines around the lips, but it has a higher risk of hypopigmentation, when the skin loses it's color and looks porcelain white. 

5. Botox. A small amount of this popular muscle-relaxing protein can be injected into the muscles around the lips.  Just enough Botox or Dysport will reduce the lines that are caused by pursing your lips without changing the function of the lip muscles.  

6. Dermal fillers. The most popular injectable wrinkle fillers are made from hyaluronic acid gel, a substance naturally found in your body.  This gel can be used to fill under the wrinkles to lift them up and make them less noticable.  Juvederm, Restylane, and Perlane are among the most used HA fillers in the U.S. 

7. Combination treatments. Any or all of the above will help to reduce those pesky lip lines.  You can talk to one of the doctors at Allure Medical Spa in Michigan for a free consultation if you want to see what can be done for the lines around your lips. 

Unwanted scars can be a devastating result of cystic acne, leaving one with a dimpled, irregular skin surface.  Avoiding these scars before they occur is the most desirable course of action, but sometimes it is too late.  Treatments can alleviate the visibility of these irregularities.  The specific treatment options vary and should target the type of scar present.  Sometimes a combination of scar types are seen on an individual. 

A key point is to realize that acne scar treatments do not often eliminate acne scars, they can reduce their visibility.  Reduced shadowing and scar depth is the goal of treatment, but signs of the scars are often still seen.  In certain cases, the skin can look exceptionally smooth after treatment, but this is not true for all patients.  

Above is a diagram of acne scar types.  The deepest, ice-pick scars are the most difficult to treat.  Chemical peels (using the CROSS method with TCA) and laser resurfacing may be of the most benefit in ice-pick scars.  Other techniques for deep scars include skin punches and floating punch grafts.

Box-car and rolling scar types often respond better than ice-pick scars.  These are best treated with laser resurfacing and dermal fillers.  The Fraxel laser has an excellent track record when it comes to acne scarring.  Fraxel Restore uses fractional photothermolysis with an erbium laser to build collagen in the dermis.  Fractional CO2 lasers such as ActiveFX and DeepFX and Fraxel Repair are also excellent for these types of acne scars.  Fillers used to improve acne scars include hyaluronic acid (HA) products (Juvederm, Restylane, Perlane). In Michigan, HA fillers are the most popular form of wrinkle and injectable acne scar treatments, especially when performed in conjunction with laser resurfacing. 

An upper blepharoplasty or eyelid lift is a wonderful procedure that shapes the upper eyelid.  The result will frequently give you a more youthful, less tired appearance, brightening up the entire face.  The cosmetic upper eyelid lift does involve an incision, created with a laser, radiofrequency device, or scalpel.  But the scars almost completely disappear with time.  How does that occur?

The upper eyelid has a natural crease, usually 6-11 millimeters above the eyelashes, following a smooth arc.  The upper eyelid lift scar can be placed so that it coincides with your pre-existing crease.  In the photo below, the dotted red line shows the position of the eyelid crease, and the right side demonstrates an eyelid that already had a blepharoplasty, with a barely detectable scar.  

If you are considering aesthetic blepharoplasty, ask your surgeon if he or she plans to place the scar within the eyelid crease.  There are techniques that facilitate the scar/crease alignment.

Dr. Brett Kotlus is a cosmetic eyelid specialist that offers free consultations in the Detroit Metro area in Michigan. To learn more about cosmetic eyelid procedures, visit his website, EyeliftCenter.com.