Learn what services we offer at the Johns Hopkins Wilmer Cosmetic Center.
The oculofacial plastic surgeons at the Johns Hopkins Wilmer Cosmetic Center specialize in cosmetic and reconstructive procedures designed to improve the appearance and function of the eyelids and face, allowing patients to look and feel natural again.
A facelift is a cosmetic procedure designed to tighten facial muscles and stretch facial skin for a smoother, younger appearance. A facelift may take place on the face, the neck, or both. It can include a browlift, blepharoplasty (eyelids), a cheek (mid-face) lift, a lower face lift, and a neck lift.
• Cheek (mid-face) lift: Over time, the cheeks start to deflate and descend, making the laugh lines (known as nasolabial folds) more pronounced. Sagging cheeks give the impression of sadness and older age, but a cheek (or mid-face) lift will provide a more plump, youthful appearance. Many patients also choose to receive fillers in addition to the cheek lift procedure, to add volume to the cheeks and further improve the nasolabial folds.
• Small incision (lower) facelift: A traditional face and neck lift is for patients who wish to reduce wrinkles across the entire face and neck. But for those patients with aging changes affecting the lower face in particular and only mild changes in the neck, a small incision (or mini) facelift is a better option. Also known as a “weekend lift” because of the short procedure and recovery time, the mini facelift is perfect for patients looking for substantial, long lasting improvement with minimal down time.
• Neck lift surgery: A full face/neck lift is reserved for those patients having severe sagging under the chin with prominent neckbands that would not be improved with a small incision facelift alone. An incision is made underneath the chin to tighten the superficial neck muscle, called the platysma. The removal of excess skin and tightening of the lower face and neck significantly contribute to a long-lasting rejuvenated appearance.
• The SMAS plication/resection Technique: Your skin is comprised of three basic layers. There is a layer of connective tissue between the outer skin and the muscles, known as the superficial musculoaponeurotic system (SMAS for short). The goal of the SMAS plication/resection facelift is to provide a long-lasting tightening of the SMAS and the skin, in order to remove the wrinkles in the face and eliminate the jowls. Our surgeons use this technique with both the small incision and the more extensive neck lift procedures in order to provide you with a sustained, longer lasting result. A deep-plane facelift elevates this layer and lifts it for the most powerful facelift.
• Recovery from Face and Neck Lift Surgery: Recovery from face or neck lift surgery greatly depends on which type of procedure you undergo. The more extensive the surgery, the longer the recovery. Generally, the physician will remove stitches 1-2 weeks following the procedure. Bruising and swelling typically subside after a couple of weeks. Speak with your doctor for more information.
As we age, our eyebrows begin to droop, which results in a sad, worried, or tired appearance. Brow elevation, also known as a browlift or forehead lift, is often performed at the same time as upper eyelid surgery. Functionally, this elevates and stabilizes droopy eyebrows to improve field of vision and brightness. Cosmetic versions of this surgery can smooth wrinkles, contour the eyebrow angle/shape, and rejuvenate a patient’s appearance.
Direct browlift: This is one of the most effective and long-lasting ways to raise droopy eyebrows. An incision is made just above the brow to hide beneath brow hair or hidden within a forehead wrinkle. A strip of excess forehead skin is removed to raise the brow upward. The drawback of approach is a potential visible scar, but this method of browlift if covered by insurance when the droopy brows are obstructing vision.
Browlifts are frequently performed simultaneously with eyelid surgery (blepharoplasty). Recovery is limited by the bruising and swelling that typically involves the eyelids and can last up to 3 weeks. However, we recommend our patients to take one week off work, since in the second and third week most bruising can be covered with makeup or glasses. The recovery for brow surgery alone is faster, since forehead swelling is minimal, but a week off is still recommended. Oftentimes, sutures used for browlift surgery other than internal browlift have to be removed at the 1-2 week mark.
Some patients will experience numbness in their forehead and scalp after browlift surgery. Numbness of the forehead will typically resolve itself in a few months. Patients will be able to shampoo their hair and wash their face with soap the day following surgery.
Eyelid surgery includes different procedures, which can remove excess eyelid skin with or without fat sculpting; tighten loose, sagging eyelids; and lift droopy upper eyelids. Functionally, this can improve a patient’s field of vision and/or brighten vision. Aesthetically, it rejuvenates patients by eliminating excess skin, lower eyelid wrinkles, and lower eyelid “bags.” The surgery leads to a more youthful, well-rested appearance.
If the eyelids affect your line of sight, corrective procedures may be covered by insurance. Request an appointment with our surgeons to learn more.
The most frequently performed eyelid procedures are:
Many people opt to have ptosis correction surgery in conjunction with upper blepharoplasty as the same upper eyelid crease incision is used for both procedures and there is no increase in recovery time.
Both upper and lower eyelid blepharoplasty are performed on an outpatient basis. It is generally recommended that patients plan on staying home for 2-3 days after the procedure, and apply ice to the eyelids to reduce bruising and swelling. It typically takes about 3 weeks for the bruising to disappear completely, although this can be effectively covered with makeup or sunglasses. Patients should refrain from heavy lifting (over 10 pounds), bending over, and straining in the first week after surgery. Stitches are either dissolvable or removed at the 1-2 week mark after surgery.
As we age, wrinkles can become deeper and more noticeable. Oculofacial plastic surgeons at the Wilmer Eye Institute have a thorough understanding of facial anatomy and undergo extensive training to administer neurotoxins and facial filler safely and effectively. These injections provide a non-surgical option for wrinkle prevention and/or treatment, facial appearance modification, and overall facial rejuvenation.
Wrinkles most commonly prevented or treated with neurotoxins are in the forehead, glabella (brow frown lines), and crows’ feet. Neurotoxin injection can also provide a chemical brow lift, fix mild brow asymmetry, and smooth out strong jaw lines (square-shaped faces). Fillers can be used to add volume in the cheek area, soften the nasolabial folds and marionette lines (area in between mouth and chin), and reduce the appearance of hollow lower eyelids. Neurotoxin and filler injections can be combined to lift the corners of down-turned mouths, augment lip volume, and change lip shape.
When used regularly, both neurotoxins and fillers can decrease fine line and wrinkle formation, although both offer temporary results that can last several months up to a year or more. Consistent treatments are recommended for long-term results.
Filler and neurotoxin injections require no to very little recovery time. Some patients may experience tempoaray bruising and/or swelling at the injection site that clears within several days. The face could develop small bumps near the injection site, but these typically subside within a few hours.
Prior to getting injections, patients should disscontinue the use of over the counter anti-inflammatory drugs (NSAIDS), as well as supplements and vitamins for 10 days prior to treatment to reduce the risk of bruising. Over-the-counter Arnica Montana can be used to help with bruising.
Chemical peels are a cosmetic treatment used to reduce fine wrinkles and eliminate discoloration by gently removing the outer (damaged) layers of the skin and stimulating the formation of new, healthy skin. Highly effective cosmetic procedures, chemical peels involve less risk and recovery time than laser skin resurfacing and provide equivalent or better results. The depth of peel is tailored to the patient’s needs and individual preferences to achieve the desired effect.
Chemical peels typically fall into one of two categories:
Prior to your TCA peel your provider may give you instructions to prep your skin in the weeks prior to the chemical peel. It is recommended that you stop using any products containing retinoids in the three (3) days prior to the TCA peel. Retinol ingredients can thin the skin and possibly cause damage from chemical exposure.
Microneedling is a cosmetic procedure that involves perforating the skin with tiny sterilized needles, creating small wounds causing your body to create more collagen and elastin. It is also known as “Collagen Induction Therapy”.
The procedure can take upwards of one to two hours. During that time your skin is prepped, numbing is applied and the face is treated. Most people require 4-6 treatments for optimal results.
The goal of the procedure is to trigger your body’s natural defenses by sending collagen and elastin to “patch” up the tiny, controlled injuries. Collagen assists with smoothing out wrinkles and adds volume to your skin, naturally.
What to expect after Microneedling
Wilmer offers products to treat your cosmetic goals. These products may include:
Products are prescribed or provided in office to treat:
Together, with the doctor, we will review your cosmetic goals and medical history and determine the best products and treatment plan to help you reach them. Some products may be available in office. Other products may require a prescription.
When you choose the oculofacial plastic surgeons at Johns Hopkins, you benefit from fellowship-trained specialists with vast experience conducting cosmetic procedures and services.
We offer each patient a thorough and comprehensive approach that encompasses medical, surgical and behavioral treatments to improve your quality of life.
Johns Hopkins Wilmer Cosmetic Center is one of the most robust centers for cosmetic procedure research in the country.
Get to know our aesthetic professionals, who bring unsurpassed skill and experience to help patients reach their goals
Appointments are available in Baltimore and Bel Air, Maryland.