Articles and Blogs

As we age, our face changes in predictable ways. The upper eyelids may droop, with fullness and heaviness. The lower eyelids develop “bags” and dark circles. And since the eyes are a window to our soul, it is natural to want your eyes to reflect your youthful soul. Fortunately, we can help restore that more youthful appearance. But it’s important to understand a few things in advance: First, surgical and non-surgical procedures can help you look younger, but if you’re 50, you will not suddenly look 20. In an effort to achieve the unachievable, some people undergo procedures that make [...]

Most people are familiar with the cosmetic applications of botulinum toxin (e.g. Botox, Dysport or Myobloc) - a neuromodulator that helps prevent and treat facial wrinkles. In the medical setting, however, botulinum toxin is also frequently used as a treatment for facial spasms, namely blepharospasm and hemifacial spasms. In fact, botulinum toxin was first used by ophthalmologists to treat strabismus and facial spasms, far before it was being used for cosmetic applications! Blepharospasm (full name is “benign essential blepharospasm” or BEB), is a disorder that causes uncontrollable eyelid twitching (spasms) or blinking, sometimes making it difficult to open the eyes [...]

Physiology of Protecting the Eye Surface Protection of the eye surface is a complex process. It includes preventing foreign matter from getting to the eye, lubricating the eye, hydrating the eye, and keeping it oxygenated. The eyelids protect the eye surface from foreign matter, and the tear system lubricates and hydrates the eye. Understanding the relationship between dry eyes, ocular surface inflammation, and blepharitis are crucial to treating and maintaining ocular surface health and overall comfort. There are 3 components to the “tear film”: Aqueous (water) from the lacrimal glands, which contains growth factors, nutrients, antibodies and immune cells that [...]

Have you ever gotten a painful little pimple on your eyelid margin? What about a big red lump on your eyelid? These are called styes (acute infectious process) and chalazia (inflammatory process), which result from blocked up oil glands within the eyelids. In normal healthy eyelids, oil is produced within these glands and contributes to your tear film. When the oil glands get blocked, this leads to decreased oil production and increased likelihood that you will develop an infection or inflammation (stye or chalazia) within the blocked off gland. It also leads to the nuisance of dry eyes! During the [...]

This month’s theme is “Listen.” Indeed, we would all do well to be better listeners. In medical practice, much of the diagnostic process relies on good listening skills. In my estimation, 75-90% of a diagnosis is made by listening to the patient, and the final 10-25% comes from a physical exam and various tests to assess and confirm the clinical suspicion. In a cosmetic plastic surgery practice, the first step of any evaluation is to listen to what the patient is aiming to accomplish, and what their priorities are. There is so much misinformation and so many false narratives in [...]

These are summer days in Michigan, and everyone is out and about, enjoying the sunshine. Michigan is a double peninsula, “upper” and “lower,” surrounded by water. As a result, our skies are often overcast, even in summer. And given our northern latitude, winters are long and sunny days are few. The result is that much of the year, we get little to no sun exposure. Unfortunately, this is associated with chronic vitamin D deficiency in much of Michigan’s population. In this month’s column, I’d like to share information about vitamin D and its role in our health. Vitamin D is [...]