Dr. Kahana and the team at Kahana Oculoplastic Surgery specialize in facial rejuvenation procedures, with a focus on the eyelids, forehead and midface. Our team is committed to your care, with exceptional attention to detail. We offer both surgical and non-surgical treatments to achieve outstanding aesthetic results. An in-clinic evaluation is required to discuss treatment goals and customize an approach to each patient’s unique facial concerns and anatomy.

Surgical

Dr. Kahana offers the following cosmetic surgeries:

  • Upper Eyelid Cosmetic Blepharoplasty
  • Asian Eyelid Surgery
  • Eyelid Crease Revision
  • Lower Eyelid Blepharoplasty
  • Forehead Lift – Endoscopic or External
  • Bitemporal Brow Lift
  • Face lift

Upper & Lower Eyelid Cosmetic Blepharoplasty

Patient underwent bilateral upper and lower eyelid cosmetic blepharoplasty. Post op is at 6 months.

Forehead Lift

This is a woman presenting with complaint of eyelid skin folds. She actually has a normal amount of eyelid skin, and significant brow ptosis causing pseudo-dermatochalasis. She underwent a forehead lift. “After” photo is at 6 months.

Non-Surgical

Kahana Oculoplastic & Orbital Surgery also offers non-surgical procedures, including:

CO2 Laser Resurfacing

Leading up to your treatment:

  • No tanning for one month prior to treatment. Limit UV exposure. This treatment is more successful and has fewer risks on untanned skin.
  • Use SPF 50 sunscreen daily for the month leading up to treatment.
  • Use a vitamin C serum daily for one month leading up to treatment.
  • Stop use of your retinol/retinoid creams 2 weeks prior to treatment. I do recommend using a 0.25% retinol leading up to treatment, but this must be stopped one week prior at the latest before undergoing treatment. If you are new to retinols, start with a lower concentration and only use 2-3 times per week. These can make your skin very sensitive and dry and MUST be used along with sunscreen and moisturizers. Retinols should only be used before bed, and not in the morning. Don’t use retinols directly after application of vitamin C serum.
  • Stop use of oral tetracyclines (e.g. doxycycline) one week prior to treatment.
  • Tell your provider if you have a history of herpes virus infections.
  • Begin your antiviral medication as instructed prior to your treatment and continue as prescribed.
  • Begin your Z-Pak one day prior to treatment and continue as prescribed.
  • If you were prescribed valium, please bring your pills to treatment with you along with a beverage. If taking a valium, you MUST bring a driver with you.
  • If you take a blood thinner, please note that you may bruise more following treatment.

 

Shopping list prior to treatment:

  • Distilled white vinegar
  • Distilled water
  • Aquaphor large container
  • SPF 50 sunscreen
  • 1% Hydrocortisone cream (over the counter)
  • Vitamin C serum for before and after treatment
  • Topical antioxidant (eg. EltaMD Skin Recovery Serum, La Roche Posay antioxidant serum with SPF 50 or Paula’s Choice super antioxidant serum)

 

Recommendations listed by brand:

  • EltaMD AM and PM therapy (moisturizer) and EltaMD Skin Recovery Serum (antioxidant)
  • Paula’s Choice vitamin C serum (dupe for CE Ferulic acid from SkinCeuticals) and super antioxidant serum
  • Neutrogena and CeraVe brands for gentle cleansers, moisturizers, and sunscreens
  • La Roche Posay antioxidant serum with SPF 50, Toleraine double repair face moisturizer with SPF 30 for long term face lotion + SPF, vitamin C serum
  • Ole Henrikson Truth Serum Vitamin C Serum

 

What to expect during treatment:

  • You will experience mild pain with this procedure. A topical numbing cream will be applied beforehand once you arrive at our clinic.
  • You should plan to take your valium (if wanted) within 20 minutes of the treatment.
  • You will have shields placed over your eyes for protection from the light beams.
  • You should avoid plans for the 10 days after treatment.
  • Recovery time varies based on your skin type and adherence to post treatment guidelines.
  • Your skin will feel warm, like a sunburn, immediately after treatment. You will appear red and swollen, with possible oozing. These symptoms generally last for 24-48 hours, and ice packs and Tylenol will help. For excessive swelling, please sleep with the head of your bed elevated (extra pillows).

 

 

Post CO2 laser care instructions:

 

Day 0:

  • Your skin will look immediately red and irritated after your treatment. It will feel warm and similar to a sunburn.
  • You will have Aquaphor placed over treated areas immediately after your procedure. Continue to keep your skin covered with Aquaphor at all times for the rest of the day.
  • From now until day 10, do not use tap water on the treated skin.

 

Day 1-6:

  • Mix 1 tsp distilled white vinegar with 1 cup distilled water. Make a fresh solution every day to keep it clean, and store it in the refrigerator. Use a clean washcloth dipped in the vinegar solution to gently pat away the Aquaphor and debris from your skin. DO NOT RUB OR SCRUB your treated skin! DO NOT PICK AT FLAKING OR SCABBING SKIN! Reapply Aquaphor mixed with a small amount of 1% hydrocortisone cream after the vinegar wash. This should be done every 2-3 hours while awake.
  • Your skin may be itchy. This is a normal part of the healing process. DO NOT SCRATCH your treated skin!
  • The skin will be red and inflamed. It will become dry and flaky if you are not using Aquaphor adequately. Do not allow your skin to become too dry, and do not pick at any flakes or scabs if they form.

 

Day 7-10:

  • Decrease the white vinegar soaks followed by fresh Aquaphor/hydrocortisone to 3-4 times daily.
  • Begin applying topical antioxidant daily.
  • Begin use of SPF 50 sunscreen every morning on clean skin.

 

 

 

Day 11:

  • Stop the white vinegar soaks.
  • You may now use tap water over treated areas.
  • If experiencing redness and hyperpigmentation, may continue with a very thin layer of hydrocortisone once daily for up to 6 weeks after treatment.
  • You may now use your normal facial cleansers and moisturizer (recommend CeraVe and Neutrogena).
  • Continue to use SPF 50 sunscreen every morning.
  • You may now use makeup.

 

Month 1 and on:

  • You may resume retinol products. Please be mindful that your skin is now more sun sensitive than before your treatment, and so use retinol more sparingly than before treatment. If skin becomes more irritated with use of retinol, stop or decrease the use of retinol.
  • You may now resume vitamin C serum.
  • Continue to use SPF 30+ sunscreen daily. Forever.

 

Other considerations:

  • Do not exercise for 7-10 days post treatment, or if you are still feeling burned and swollen. Sweating can increase the risk of infection.
  • You may take a “body shower” the day after treatment, however, be cautious not to allow hot water or steam to touch treated areas. Try to avoid tap water on treated areas for the first 10 days after treatment and use distilled water instead.
  • Do not undergo waxing, micro-dermabrasion, exfoliators, or light peels over the area for 3 months after treatment.
  • After CO2 laser, your skin is more sensitive and susceptible to UV light. For best results and to avoid hyperpigmentation, avoid sun exposure altogether for 4 weeks after your treatment. Wear coverings, a hat, sunscreen, or avoid completely. Sun exposure will increase the likelihood of hyperpigmentation of treated skin. Do not use sunscreen on treated areas for one week after treatment, and then use it daily going forward.
  • You will experience pinkness for weeks to months after the treatment. This is normal and is a sign of the body’s natural healing and collagen production.
  • A risk of skin resurfacing is post inflammatory hyperpigmentation (PIH). Following these post care guidelines will minimize PIH. Sun avoidance after treatment is critical for avoiding PIH. PIH typically fades over time, however you may require treatment for the hyperpigmentation if it is not subsiding.
  • Flare ups of acne or formation of milial cyst is possible after CO2 laser resurfacing. Please contact the office if cysts form.

CO2 Laser Resurfacing

Before laser resurfacing, revealing damaged cheek skin with hyperpigmentation, and the 3 and 9 days post resurfacing. The damaged hyperpigmented skin looks fresh and rejuvenated. And that’s just 9 days after 1 treatment. Typically, 3 treatments spread over several months provide an optimal result. Skin resurfacing using a fractionated CO2 laser is truly the gold standard, and we are fortunate to be able to offer this treatment to our patients, alone or in conjunction with other procedures.

Botox

Chemodenervation agents such as Botox® are commonly used to treat dynamic wrinkles of the forehead and around the eyes. Dynamic wrinkles are wrinkles that form when you move your muscles, as opposed to static wrinkles, which are present all the time. Chemodenervation works for dynamic wrinkles, but not for static wrinkles, which benefit from surface treatment such as lasers and peels.

In Dr. Kahana’s opinion, successful, natural results from Botox® treatment require nuance. Chronically “freezing” the face is not only unnatural, depriving you of facial expressiveness, but will eventually lead to atrophy and thinning of the muscles, which can lead to premature aging. Before initiating treatment, Dr. Kahana will perform a complete evaluation of your forehead and periocular dynamic wrinkles to develop a customized plan for your needs.

iLux and BlephEx

Schedule an iLUX appointment

You may think your dry eyes are caused by lack of tear production, but the most common cause of dry eyes is tears that are evaporating too quickly. This is caused by a condition called meibomian gland dysfunction (MGD). MGD occurs when the meibomian glands along the lid margin become inflamed and oil production (a natural healthy part of the tear film) is disrupted. The oil within the glands either get blocked, or comes out thick and crusty, further irritating the eye and leading to an unstable tear film and quickly evaporating tear film. Over time, the meibomian gland structure changes or dies off, leading to even worsening symptoms including dry eye disease.

An estimated 44 million Americans suffer from dry eye syndrome. Symptoms may include burning, stinging and fluctuating vision. Sara Turner, PA-C is specially trained to treat dry eye syndrome with a new device called iLux.

iLux starts at the source of the problem by delivering treatment directly to the blocked meibomian glands with the goal of clearing the blockages. This gentle, non-invasive, treatment delivers gentle warming and pressure directly to your eyelids to unblock meibomian glands. Treatment of both eyes only takes approximately 8-12 minutes.

iLux Dry Eye Treatment