Jeffrey M. Kenkel, M.D., FACS
I'm a 36 year old of Asian decent. The last few years, I've been noticing that my upper eyelids are starting to droop. The crease that used to be visible is now covered with skin. Is it better to wait a few more years before having this surgery or do it sooner? I'm assuming that the skin will just get saggier. Is this surgery better if there is more skin to remove? I can't really tell if a brow lift is necessary, but every time I try to lift my brows a bit, I tend to have that startled look.
That is a very good question. How your eyes look is dependent not only on the skin of your upper eyelids but also your brow position. At 36, it would be unusual to have droopiness of your brows unless it is something that you were born with (which does happen). Either way, brows are very subjective and you have to fit your brow with your face. If you look in the fashion magazines you will see brows at various heights. I personally feel that you should address problematic areas earlier rather than later. The longer you wait the more accentuated your problem will be and the bigger change you and others will see. While that may not bother you, it does bother some that like to avoid drastic changes.
I noticed that you do not list laser spider vein treatment as one of the procedures on your website. What is the position of the Society on this procedure? Is it a viable option as opposed to scelerotherapy?
There have been some promising advances in the laser treatment of leg veins. I personally use the laser to treat vessels up to 3mm in size and then use a combination of injections and laser for larger vessels. Either way I tell patients they may need at least 2 sessions to eliminate the vessels of concern. Presently the 1064nm laser is the most exciting technology; doctors are seeing nice improvement in elimination of the vessels. You must remember that the treatment for leg veins may vary from physician to physician with regard to lasers versus injections. The important thing is that you go to a board-certified plastic surgeon who has experience in treating leg telangectasias.