HEALTH - JULY/AUGUST 2017

  • Print

0617healthmosaic

STRIPLVHEALTH - 0617

Eyelid Rejuvenation - Eyelid Lift Surgery is refreshing the way men look.

By Frank L. Stile, MD

Eyelid rejuvenation, also known as blepharoplasty or eyelid lift surgery, is one of the top two cosmetic surgical procedures requested by men in the United States, second only to body contouring via liposculpture or liposuction. One of the first things anyone notices about you, are your eyes. Inherited family traits or the natural aging process can result in eyelid wrinkles, deep lines, dark circles and puffiness. These elements contribute to a tired, sad or prematurely aged appearance. The surgical procedure removes excess skin from both the upper and lower eyelids. Underlying fatty tissue (fat pads) that herniate (protrude) can produce the appearance of puffiness or bagginess. These fat pads can be selectively removed or re-positioned for a more refreshed look. It can help improve vision in some patients who have “hooding” of their upper eyelids. Blepharoplasty can also add an upper eyelid crease to the Asian eyelid, giving patients a more westernized look.

A properly performed eyelid lift should leave you looking rested and very natural. The shape of your eyes should be symmetrical and not look different from one another. The result should make you look younger, more awake, more alert and refreshed. A blepharoplasty can be performed in conjunction with other cosmetic facial rejuvenation procedures such as a facelift. Cosmetic eyelid surgery is individualized for every patient. Upper and lower eyelid corrective rejuvenation procedures can be done separately, or the upper and lower lids may be addressed at the same time.

Eyelid surgery is an outpatient surgical procedure. I normally perform this procedure in my state-of-the-art fully licensed ambulatory surgery center, premium surgical services center. The procedure is performed while using general anesthesia (patients are fully “asleep”) for comfort control. General anesthesia, as well as pre and post-operative care, are provided by a board certified anesthesiologist.

Using high-magnification, eyelid surgery (blepharoplasty) procedure is carried out by creating incisions in the upper eyelid creases or just below the lash line of the lower eyelids. Using these incisions, excess skin is removed from both the upper and lower eyelids. Varying amounts of upper and lower eyelid muscle (orbicularis occuli) are also removed to reduce eyelid fullness.

Next, the underlying fatty tissue (fat pads) that herniate (protrude) producing the appearance of puffiness or bagginess are selectively removed or re-positioned. The eyelid skin is then tightened and the incisions are closed using a microsurgery suture. Cold compresses and antibiotic ointment are then applied. When healed these incisions will leave no visible scarring. The surgery generally takes about one to three hours depending on whether both upper and lower lids are corrected at the same time.

After a short stay in our post-anesthesia care unit, patients are discharged home. Patients are instructed to rest while keeping their head elevated. Patients report minor discomfort associated with eyelid surgery. This is well controlled with oral pain medication. Sutures are removed in the office seven days following surgery and patients may resume full activity fourteen days after their procedure.

Cosmetic improvements are evident immediately, but mature full results are appreciated at 3-5 months after surgery. The benefits of this procedure are long-lasting. Patients will have a more rested and youthful appearance. If your eyelids are sending the wrong message or are making you look older than you feel, an eyelid lift is probably right for you.

Want to find out how eyelid surgery can improve your look? A personal evaluation is the best place to start.  If you’re interested in scheduling a complimentary Eyelid Rejuvenation consultation, either in-person or via e-mail and phone, contact us via (725) 222-8644 or visit us on the web at drstile.com 

THE DOCTOR IS IN

Dr. John J. Pierce, DO ACOEP, ABAARM

VITAMIN D: NOW IS THE TIME

What is it?

Vitamin D is a fat-soluble vitamin that is naturally present in very few foods, added to others and is available as a dietary supplement. It is also produced naturally when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. Vitamin D promotes calcium absorption in the gut and maintains adequate serum calcium and phosphate concentrations to enable normal mineralization of bone and to prevent hypocalcemic tetany. It is also needed for bone growth and bone remodeling. Without sufficient vitamin D, bones can become thin, brittle or misshapen. Vitamin D has other roles in the body, including modulation of cell growth, neuromuscular and immune function, and reduction of inflammation.

How much is enough?

Serum concentration of 25(OH)D is the best indicator of vitamin D status. It reflects vitamin D produced by the skin and that obtained from food and supplements. Practically all people are sufficient at levels between 50-120 ng/ml. The USRDA (U.S. Recommended Daily Allowance) for vitamin D is currently set at 400 IU for adults and children age 4 and older. I feel that, in general, this recommendation is much too low. Approximately 90% of the patients I see in my clinic are deficient in vitamin D. I generally recommend between 4,000 to 10,000 IU’s of vitamin D3 a day. We do follow these levels with lab work to ensure that toxic levels are not reached. 

Where can I get it?

Most people meet at least some of their vitamin D needs through exposure to sunlight. Season, time of day, length of day, cloud cover, smog, skin melanin content and sunscreen are among the factors that affect UV radiation exposure and vitamin D synthesis. Complete cloud cover reduces UV energy by 50%; shade (including that produced by severe pollution) reduces it by 60%. UVB radiation does not penetrate glass, so exposure to sunshine indoors through a window does not produce vitamin D. Sunscreens with a sun protection factor (SPF) of 8 or more appear to block vitamin D-producing UV rays, although in practice, people generally do not apply sufficient amounts, cover all sun-exposed skin, or reapply sunscreen regularly. Therefore, skin likely synthesizes some vitamin D, even when it is protected by sunscreen as typically applied. The factors that affect UV radiation exposure and research to date on the amount of sun exposure needed to maintain adequate vitamin D levels make it difficult to provide general guidelines. It has been suggested by some vitamin D researchers, for example, that approximately 5–30 minutes of sun exposure between 10 a.m. and 3 p.m. at least twice a week to the face, arms, legs, or back without sunscreen usually lead to sufficient vitamin D synthesis, and that the moderate use of commercial tanning beds that emit 2%–6% UVB radiation is also effective. Very few foods in nature contain vitamin D. The flesh of fatty fish (such as salmon, tuna, and mackerel) and fish liver oils are among the best sources. Small amounts of vitamin D are found in beef liver, cheese, and egg yolks. Fortified foods provide most of the vitamin D in the American diet. For example, almost all of the U.S. milk supply is voluntarily fortified with 100 IU/cup. The best source of vitamin D is through supplementation with vitamin D3. Some of the higher quality multi-vitamins provide 2,000 IU’s of vitamin D3. Again, I generally recommend 5,000- 10,000 IU’s of vitamin D3 daily to my patients, so there is generally an additional supplement needed to achieve that recommendation. I also recommend taking vitamin D3, 8-12 hours after your multivitamin, as D3 competes with Vitamin A for the same receptors. If you take your multi twice a day, then take the D3 with the smaller portion of your daily multi. 

What are the benefits?

Vitamin D helps to improve bone strength. This means lower risk for development of osteoporosis and osteopenia.  Research has found that men with low levels of vitamin D in the blood were at increased risk for heart attack compared to those with sufficient levels, even after adjusting for other risk factors and physical activity. The same association was not seen among women; the reason for this is unclear, but one possible explanation given is that women may need higher intake of vitamin D because they tend to have a higher percentage of body fat than men, and vitamin D is fat soluble. Higher levels of vitamin D have been associated with reduction of colds and the flu. Influenza A (seasonal flu) incidence was reduced by 42% in one study. There was no effect on influenza B, which is less common than influenza A, and is not seasonal. On a personal note, I do not take the flu shot and I have not gotten the flu, even when I worked in the emergency room, since I started regular supplementation with vitamin D. My 90-year-old mother also takes vitamin D, and she rarely gets ill, even though she lives in an assisted living facility with approximately 200 other older folks. She does not get the flu shot either. 

Other studies show correlations with diseases such as depression, Seasonal Affective Disorder (SAD), Parkinson’s disease, certain types of cancer, rheumatoid arthritis, multiple sclerosis and type 2 diabetes (DMII), with low serum 25(OH) vitamin D levels. 

Dr. John J. Pierce, D.O. • Ageless Forever Anti-Aging and Longevity Clinic is located at

6020 S. Rainbow Blvd. Suite C  Las Vegas, NV 89118 • 702-838-1994 • AgelessForever.net