Procedures

Upper Blepharoplasty
Asian Blepharoplasty
Lower Blepharoplasty
Brow Lift / Forehead Lift
Eyelid Ptosis Repair
Eyelid Lesion Removal
BOTOX®
Fillers
Laser Skin Rejuvenation
Facials
Skin Care Products

Upper Blepharoplasty

Upper eyelid blepharoplasty, or eyelid lift, corrects droopy, baggy, wrinkly excess skin that has collected on the upper eyelids as a result of the aging process or heredity. Upper eyelid blepharoplasty is used to enhance the appearance of the face by restoring a youthful and refreshed look to the eye area. Dr. Erb's goal is to create a refreshed look while making sure that you still look like your natural self. She personally tailors your surgery to your own needs, desires, ethnicity, and individual anatomy. Contact Dr. Erb for more information on your blepharoplasty options and find out which are right for your needs.

 

For upper eyelid blepharoplasty in Irvine, Laguna Beach, and Newport Beach, contact Dr. Melanie Erb.

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Asian Blepharoplasty

Dr. Erb's goal is to create a double eyelid that is natural and non-surgical for an Asian face. 50% of Asians do not have an upper eyelid crease, while the other 50% have at least some form of crease. Eyelids without a lid crease are called a "single eyelid," while eyelids with a lid crease are called "double eyelids." The Asian patient usually wants to form a double eyelid from a single eyelid, partial creased eyelid, asymmetric eyelids, or shielded double eyelids. The Asian patient usually does not desire a "westernized," Caucasian eyelid, but prefers a double eyelid that "matches" the Asian face or is similar to the double eyelid that occurs naturally on other Asians.

 

For Asian Eyelid Surgery or Asian Blepharoplasty in Irvine, Anaheim, Fullerton, Westminster, Garden Grove, Laguna Beach, and Newport Beach, contact Dr. Melanie Erb.

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Lower Blepharoplasty

Do people tell you that you look tired? Lower eyelid blepharoplasty, or eyelid bag surgery, corrects puffy, baggy, dark circles, and wrinkly excess skin from the the lower eyelids that can make you appear tired. Lower eyelid blepharoplasty creates a more rehreshed and smooth look.

Rejuvenating the lower eyelid may include fat excision, fat repositioning, skin excision, and/or volume augmentation with fillers such as Restylane. The transconjunctival lower blepharoplasty is the procedure which will benefit many patients. This technique involves excising or repositioning the fatty compartments of the lower eyelid through a hidden incision inside the lid. This approach provides a natural, non-surgical look after surgery which preserves the structure and function of the orbicularis muscles in the lower eyelid.

Some patients have excess skin in the lower eyelid as well and benefit from a "pinch" skin excision. This can be performed alone or in conjunction with transconjunctival lower blepharoplasty. This technique also preserves the Orbicularis Oculi muscle and ensures preservation of the lower eyelid contour and position.

Some patients may need a lateral canthopexy to stabilize the lower eyelid position at the time of lower blepharoplasty. A canthopexy is a stitch which is placed near the outer corner of the lower eyelid inside the tissues. This stitch keeps the eyelid in position while healing. It dissolves in four to eight weeks.

For some other patients, non-surgical rejuventation with the placement of fillers is the best option. Fillers placed in the lower eyelid near the tear trough or placed in the apple of the cheek or on the cheekbone will smooth out the contour variations of the eyelid-cheek junction.

After a through consultation and evaluation, Dr. Erb can discuss which procedures can help you reach your cosmetic goals.

 

For Lower Blepharoplasty in Irvine, Laguna Beach, and Newport Beach, contact Dr. Melanie Erb.

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Brow Lift / Forehead Lift

Over time, one's eyebrows may descend due to force of gravity. A patient with eyebrow descent may give the impression that he/she is tired, angry, or sad. Brow ptosis may result in apparently redundant skin and hooding of the upper eyelids. Thus, patients may think that they need a blepharoplasty when they indeed need a brow lift. If the distance from the pupil to the top of the brow is less than 25 mm, then the patient may benefit from a brow lift. The proper combination of surgery can be better determined by manually elevating the brow to the proper anatomic position and reassessing the upper eyelid skin redundancy and fat herniation.

A brow lift may be performed by many different surgical procedures and approaches such as endoscopic, coronal, pre-trichial, midforehead, suprabrow, and trans-eyelid. This surgery can be performed with upper and lower blepharoplasty, or by itself.

After a through consultation and evaluation, Dr. Erb can discuss which brow lift surgical approach would be best for you based on your anatomy and your cosmetic goals.

 

For a brow lift or forehead lift in Irvine, Laguna Beach, and Newport Beach, contact Dr. Melanie Erb.

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Eyelid Ptosis Repair

Eyelid blepharoptosis, often called "ptosis" for short, is when the upper eyelid drops from its normal position to approach or cover the pupil. Patients with ptosis may have a tired look as well as have difficulty reading or driving from the droopy eyelid. Ptosis may be congenital or acquired. Acquired ptosis occurs when the tendon of the muscle that opens the eyelid gets stretched with age. To repair it, Dr. Erb performs a tuck of the tendon/muscle on the inside of the eyelids with surgery. Bruising and swelling lasts for less than one week. For severe ptosis, Dr. Erb performs a larger tuck and bruising and swelling will last two weeks.

 

For Eyelid Ptosis repair in Irvine, Laguna Beach, and Newport Beach, contact Dr. Melanie Erb.

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Eyelid Lesion Removal

Dr. Erb performs surgery for all types of eyelid lesions, both large and small.

 

For Eyelid Lesion removal in Irvine, Laguna Beach, and Newport Beach, contact Dr. Melanie Erb.

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Botox

Facial wrinkles are caused by sun (UV) exposure, repetitive contraction of facial expression muscles, and loss of skin collagen and volume. As skin become less elastic, the muscles pull and force the skin above to form a wrinkle, which become etched in the skin. There are two types of wrinkles. Dynamic wrinkles form when the muscle is contracted. Static wrinkles are present even when the muscle is relaxed. Dynamic wrinkles progress to static wrinkles.

Botulinum Toxin (BOTOX) blocks the release of acetylcholine, the chemical that a nerve uses to tell the muscles to contract. Thus BOTOX weakens the muscle. With less muscle movement, the skin surface above it smoothes and wrinkles begin to soften. The effect is temporary and wears off in approximately 3 months.

Ophthalmologists have been longest users of BOTOX and have used it for two decades for treatment of benign essential blepharospasm, hemifacial spasm, and strabismus. Ophthalmologists began using BOTOX for facial wrinkles, and dermatology and others have followed. There have been an estimated 3.3 million treatments in 2005 alone.

BOTOX injections in the brow region have a high patient satisfaction rate. Dr Erb performs the injections herself. She injects above and between the eyebrows to smooth the wrinkles. The procedure takes 10 minutes. We can numb the area with anesthetic cream, cold pack, or no numbing is needed at all. She uses a tiny needle, so it just feels like getting your eyebrow plucked, and she places anywhere from 5 to 8 tiny injections. Risks include possible temporary bruising at the injection site which can be covered with makeup and temporary eyelid droop which is exceedingly rare. It takes about 3 days for the BOTOX to work, and lasts for about 3 months. She also can inject the forehead to smooth those wrinkles and can inject the "crow's feet" to soften them as well. We can even elevate the Brow with BOTOX. She customizes your treatment with BOTOX to help soften or eliminate facial wrinkles.

For BOTOX in Irvine, Laguna Beach, and Newport Beach, contact Dr. Melanie Erb.

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Fillers: Juvederm, Restylane, Belatero, Voluma

The appearance of facial aging is also due to drooping and deflation. Drooping occurs from the effects of gravity over a lifetime, drawing the facial features such as skin, subcutaneous tissue, and fat inferiorly. Deflation occurs from volume loss as collagen is decreased, fat becomes atrophied, and fluid turgor is decreased. Drooping and deflation leads to signs of facial aging such as prominent nasolabial folds (folds from the side of the nose to the corner of the mouth), marionette lines (vertical lines below the mouth corners to the chin), nasojugal grooves (groove from the inner corner of the eye to the cheek, now more commonly known as tear troughs), among others.

Fillers are gels that are injected into the facial tissue to smooth deeper, static wrinkles, folds, and grooves. Fillers add volume back to the deflated face which give the face a smoother look and restore youthful contours to the skin. There are many fillers on the market, but Dr. Erb prefers fillers which are made of hyaluronic acid (HA), which occurs naturally in the human body particularly in skin and cartilage. Natural HA provides volume and fullness to the skin, acts as a cushioning agent, and delivers nutrients.

Fillers work well on the lips, cheeks, brows, and temple hollows. Fillers also work well in the tear trough. Due to her training in ophthalmology and oculoplastic surgery, Dr. Erb has considerable expertise in filling and smoothing this particular area. These fillers also work well on deep, static wrinkles that Botox alone may not fully soften. Botox smoothes the dynamic component of a wrinkle while Fillers smoothes out the static component of a wrinkle.

Dr Erb performs the injections herself. The procedure takes 15 minutes. We numb the area with ice, anesthetic cream, or injection of anesthesia. A tiny needle is used. Risks include swelling and bruising. The effects of Juvederm or Restylane last for about 12 months.

Fillers fill the grooves and wrinkles and add volume back to the deflated face which give the face a smoother look and restore youthful contours to the eyelids, lips and face. These fillers can also be used to fill in the sunken appearance after over-corrected blepharoplasty surgery.

For Juvederm, Restylane, Belatero, or Voluma treatments in Irvine, Laguna Beach, and Newport Beach, contact Dr. Melanie Erb.

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Laser Skin Rejuvenation

Over the years our skin begins to show signs of the natural aging process. Overexposure to the sun, alcohol use, smoking, smiling and laughing are all well known to accelerate the development of wrinkles, lines and dark aging spots. Laser Skin rejuvenation is a procedure specially designed to dramatically soften, reduce, and very often erase the superficial and moderately deep lines, wrinkles, aging spots and acne scars. As an added benefit, skin tightening usually occurs, providing a nonsurgical mini-facelift, pores are smaller, and the new skin is rich in collagen, rejuvenating the face and literally making the patient look years younger.

Dr. Erb can use her lasers to

  • Transform dull, lifeless, aged, and damaged skin to radiant, luminous, clear, youthful skin.
  • Remove 5 to 15 years from your appearance with one procedure.
  • Soften wrinkles
  • Lighten brown spots
  • Vaporize sun damage

Laser skin rejuvenation is most commonly used on the face, neck, chest, scalp, arms, and hands.

For laser skin rejuvenation in Irvine, Laguna Beach, Coto De Caza, Rancho Santa Margarita, and Newport Beach, contact Dr. Melanie Erb.

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Facials

We offer facials which are both relaxing, rejuvenating, and refreshing. Michelle will provide skin analysis, exfoliate, clear out impurities, hydrate, improve circulation to encourage a glow, and massage. We are here to pamper you.

For facials in Irvine, Laguna Beach, Lake Forest, Laguna Woods, Laguna Hills, Aliso Viejo, Mission Viejo, Costa Mesa, Santa Ana, Tustin, and Newport Beach, contact Dr. Melanie Erb.

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Skin Care Products

We offer a full line of skin care products to help nourish, protect, and show off your new smoother and radiant skin. Michelle will expertly customize a skin regimine for you based on skin type and personal needs.

For skin care products in Irvine, Laguna Beach, Lake Forest, Laguna Woods, Laguna Hills, Aliso Viejo, Mission Viejo, Costa Mesa, Santa Ana, Tustin, and Newport Beach, contact Dr. Melanie Erb.

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