At Idaho Eyelid & Facial Plastic Surgery, PLLC, Mark Boerner M.D. and Chad Jackson M.D. perform all cosmetic and reconstructive eyelid and facial surgeries. Their focus is to provide a comprehensive approach to achieve natural results. Their area of expertise includes eyelid surgery (blepharoplasty) along with many other types of reconstructive medical procedures. These surgeries can be combined with other procedures to maximize aesthetic results, such as wrinkle prevention techniques, laser skin resurfacing, chemical peels, neck liposuction, and fat transfer to the face. These surgeries and procedures are further described below.
Cosmetic and Reconstructive Eyelid and Facial Surgery
Blepharoplasty – As we age, eyelid skin stretches and muscle tone weakens. Our upper eyelids often begin to droop and lower eyelid bags begin to fill in. The aging process of the eyelids can make us appear tired or unfriendly. In advanced cases, our field of vision may be impaired. Blepharoplasty is the term used to describe the surgical procedure to remove excess skin and fat from the eyelids. Sometimes one may hear the terms “functional” and “cosmetic” applied to blepharoplasty. In reality, the main components of the surgery are the exact same. What differs is the amount of excess skin before the surgery is performed. Those patients with extensive extra skin, termed dermatochalasis, may notice that their eyelid skin is reducing their visual field because it is obstructing light entering the eye. If the visual obstruction is significant enough then medical insurance will pay to have the skin removed to improve eyesight. This “functional” blepharoplasty is performed when an insurance company pays for the surgery. Each insurance company has their own strict requirements that must be met for them to pay for the surgery. Some elements considered may include:
- External photographs (most insurers require photographs showing that the pupil is least partially covered by the eyelid as demonstrated in the examples of functional blepharoplasty provided below)
- Measurement from the pupil to the upper eyelid
- Visual field test
Some insurances may also require pre-authorization and supporting documentation from the clinic visit for their approval, and also expect that activities of daily living are impacted by droopy lids. When the amount of excess skin does not meet the strict criteria set by the insurance companies, the blepharoplasty is “cosmetic”. Sometimes, misunderstandings arise when a referring provider thinks a patient should qualify for a functional blepharoplasty, without first consulting and determining whether strict insurance requirements are met. Therefore, an in-person consultation with one of our physicians is required.
Examples of functional blepharoplasty covered by insurance:
Examples of cosmetic blepharoplasty (not covered by insurance):
Idaho Eyelid and Facial Plastic Surgery has conducted thousands of blepharoplasty over the years and uses an aesthetic eye to achieve the best results for you. Photos in our Before and After Gallery show the difference blepharoplasty can make after surgery…Facebook and Instagram posts provide additional images to show you great results.
Short Incision Facelift – The short incision facelift is a cosmetic facial surgery for men and women who are starting to see some laxity in their lower face around the jaw. It is a procedure best suited for those in their 30s through 50s who generally have good skin tone. Before/after photos show reduction of jowls, sharpening of the jaw line, and tightening of the neck that results from this cosmetic surgery. Also called a mini-facelift, it enhances key facial areas with less risk, less stress, and shorter recovery time than standard facelift surgery. Our surgeons are available for consultation to determine whether you might be a good candidate for this type of cosmetic facial surgery. The photo on the right shows a nearly imperceptible scar at 6 months.
Forehead Lift – The forehead lift is a cosmetic facial surgery designed to smooth the forehead, raise the brows, and minimize frown lines. The impacts of time and gravity are visibly reduced through the brow lift. Before and after photos below show results of a brow lift.
Fat Transfers – Another procedure used to rejuvenate the mid-face is transfer of a patient’s own fat to areas that have lost volume due to the aging process. Our surgeons use this cosmetic facial surgery to smooth and repair wrinkles and creases on the face, and to elevate depressions which can exacerbate the appearance of lower eyelid bags. The combination of fat transfer and blepharoplasty can produce extraordinary results. For example, the before/after image directly below combines lower lid blepharoplasties, fat transfer, and upper eyelid fat pad removal.
Wrinkle Prevention/Reversal Procedures
Botulinum toxin injectables help restore a more youthful look without requiring any surgery or downtime, making them very convenient. They work well on crows feet, laugh lines, lip lines, forehead wrinkles — as shown in the before/after photos. We like to emphasize that our injections are performed by physicians, or by nurses after delegation by one of the physicians. All patients are seen first by the doctors (as required by the state medical board) to establish a treatment plan. This process helps us deliver the best possible outcomes for our patients, as our injectors have a thorough knowledge of facial anatomy and vasculature. On staff we have an Idaho member of the Botox National Advisors Board, with the experience and know-how to get great results. We offer the following botulinum toxins:
• Dysport (dysport.com) – Dysport is an injectable treatment used to resolve a number of age lines and wrinkles. This procedure is so convenient and effective that it can be performed during a patient’s lunch break
• Botox (botox.com) – Botox Cosmetic is a natural purified protein that functions by relaxing overactive muscles that cause wrinkles to form. When properly used, Botox Cosmetic can make a dramatic change in appearance.
Filler Injections – Fillers are used to smooth out folds and fill in wrinkles. They can also be used to enhance lips and other areas by adding volume. Fillers such as Restylane (restylaneusa.com), Juvederm (juvederm.com), Radiesse (radiesse.com), and Artefill (artefill.com) can result in smoother, younger looking skin. Artefill (artefill.com) is another option that is different from temporary injectable wrinkle fillers. The unique microspheres in Artefill are not absorbed by the body and provide the support your skin needs for natural, long lasting results. Ask our surgeons which filler is right for you.
Ablative CO2 Laser Resurfacing – In terms of reversal procedures, ablated resurfacing is a type of cosmetic facial surgery that reduces medium and deep wrinkles associated with aging/sun-damaged skin. It also reduces the appearance of acne scars. This involves removing the epidermidis and injuring the dermis in a controlled fashion. After a two week healing process, marked reduction in even the deepest wrinkles is apparent. Certain types of skin are better than others for this laser and our surgeons can help you determine whether your skin type is suitable for this cosmetic facial procedure.
Skin Care Products
Epionce – Skincare line that delivers powerful therapy with botanical ingredients, patent pending formulas, and a multiphase system. This line enhances the lipid barrier of the skin and quells inflation caused by the environment. Very well tolerated by sensitive, dry skin.
Obagi Prescription-strength skincare line designed to improve skin function and transform skin so that it looks and acts younger and healthier. Especially ideal for evening skin tone and improving skin texture.
Latisse – A prescription treatment used to grow thicker, longer, darker lashes.
Procedures for Eye Socket/Tear Duct Disorders
In addition to cosmetic surgery, our surgeons are also trained in reconstructive oculoplastics. They deal with surgical management of tumors, trauma, and disorders of the face and eyelid. A variety of these surgeries involve skin grafting and precise stitching. Below is an example of a patient who had basal cell carcinoma removed and required eyelid reconstruction. The younger patient received a dog bite to the lower lid.