Cosmetic Enhancements & Oculofacial Restoration
Dr. Kimberly Cockerham will help you restore and enhance your eyelid, eye muscle and facial function and form. The face- including the eyelids- can be altered by neurologic conditions, autoimmune disorders, surgery, trauma and aging. As a decorated US Army veteran who served at Walter Reed Army Medical Center, Dr. Cockerham is committed to working with you to create a personal plan to help you achieve your goals and optimize your outcome.
Botox, Eyelid/Facial Spasms, Double Vision, Eyelid Retraction, Ptosis, Entropion & Cosmetic Concerns
Botox was initially FDA approved for patients with double vision and then was found to be helpful in patients with a variety of medical problems and cosmetic concerns.
Botox injections are an excellent medical treatment for eyelid/facial spasms but are also effective at combatting double vision following eye stroke, drifting eyes, eyelids that won’t close or close too much, eyelids that role in (entropion).
But Botox is best known for its use for a variety of cosmetic concerns including frown lines, crow’s feet, forehead lines, lip lines, lip shape (lip flip).
Botox is a purified protein that is synthesized from the naturally occurring bacterium, Clostridium botulinum. There are seven known forms, the most used are Botox, Dysport, and Xeomin. All are botulinum type A. The effects of Botox typically lasts 12 – 15 weeks before it wears off. Over time the nerves that are affected by Botox recover and form new nerve endings. Multiple injections are more effective than increasing the volume of the injection.
Blepharospasm and hemifacial spasm are typically aggravated by voluntary facial movements. They are increased with fatigue and emotional stress, and may be suppressed with sleep, relaxation and hypnosis. These spasms begin with twitches and increases in frequency and severity over time. Women are affected 3-4 times more often than men. These spasms may be localized to a single muscle (eyelid) or involve multiple muscles of the face. The cause of blepharospasm is poorly understood; rarely the spasm is due to a brain stroke or multiple sclerosis. Spasms located on one side of the face can be due to dysfunction of the facial nerve (called hemifacial spasm) or can follow Bell’s palsy (aberrant regeneration of the facial nerve). Many patients with migraine headaches that are unresponsive to oral medications can benefit from Botox injections.
Informed Consent: Bruising is the most common unwanted side effect of Botox injection. To minimize bruising, there are several medications that you should avoid two weeks prior to injection. These include aspirin, Motrin (and other pain relievers other than acetaminophen), fish oil, flaxseed, Vitamin C and E and garlic tablets. Additionally, there is an herbal supplement called Arnica, which can decrease bruising. This is taken by mouth and should be started two days prior to injection. Other less common risks of Botox include numbness, double vision, drooping eyelids, headaches, flu-like symptoms, muscle weakness and death (in children given very high doses).
Dermal Fillers for Treatment of Scars, Post-surgical or Traumatic Deficits & Facial Augmentation
Dermal filler comprised of varying molecular sizes of hyaluronic acid molecules are the most popular. Brand names include Restylane (Refyne, Defyne, L and Lyft) and Juvederm (XC and Voluma). While the fillers were initially FDA approved for cosmetic augmentation of wrinkles, lips, cheeks, tear troughs, temporal fossa and other concerns, they are also helpful for some medical concerns. Fillers are an excellent medical treatment for post-surgical or traumatic deficits of the eyelid and face.
A youthful midface is characterized by high, strong cheekbones that defines and balances out well with the lower eyelids. Also, the midface is where many patients start losing facial volume.
As our face ages, the skin, underlying muscles and soft tissue descend, and with the loss of fat volume, the resulting deep lines and hollows can create a sunken or tired look. Today’s dermal fillers can quickly and easily address these conditions.
Issues Dermal Fillers Can Address
- Deep lines around the sides of the nose to the mouth (nasolabial folds)
- Loss of volume and fine lines on or around the lips
- Hollowing below the eyes or along the eyebrows
- Loss of cheek volume cheek augmentation
- Lip, nose or chin augmentation and shaping
- Facial deformities or scarring
Dermal fillers result in immediate visible effects. Fillers are injected in the office following topical anesthetic, and they result in immediate visible effects. Bruising or swelling is possible, so icing is recommended immediately following the procedure. Dermal fillers can stimulate collagen production and provide long-lasting enhancements that can last from months to years, depending on the product used and the site of injection.
Informed Consent: Bruising is the most common unwanted side effect of dermal filler injection. To minimize bruising, there are a number of medications that you should avoid two weeks prior to injection. These include aspirin, Motrin (and other pain relievers other than acetaminophen), fish oil, flaxseed, Vitamin C and E and garlic tablets. Additionally, there is an herbal supplement called Arnica, which can decrease bruising. This is taken by mouth and should be started two days prior to injection. Other less common risks of dermal fillers include persistent swelling, blue discoloration, granuloma formation, migration and visual loss due to embolization.
For more information about dermal facial fillers or to schedule your personalized consultation with Dr. Cockerham, use secure chat on this site.
Laser Resurfacing
Skin Restoration
Facial Laser Resurfacing — Reversing the Effects of Aging with Lasers
Over time, the effects of sun exposure take their toll. You start noticing the fine lines, wrinkles and sagging, all of which can make you look tired, sad and older than you feel. In the past, the role of sun exposure in aging was underestimated and sunscreens didn’t protect against the aging/cancer (UVA) rays that cause premature winkles, poor texture and tone dyschromia (redness, brown and white spots). Using laser technology, Dr. Cockerham can reverse the effects of sun damage and provide you with a fresher, more youthful appearance.
Issues Laser Surfacing Can Address
The laser can be used to resurface your face, eyelids or other areas where skin texture and tone are a problem.
- Wrinkles, jowls and descent
- Fine and deeper lines
- Acne and other scars
- Sunspots and melasma
- Sun damage
- Skin discoloration
- Poor tone and texture
The rejuvenating effects of laser facial resurfacing will reset your appearance and will slow the aging process as long as proper skin fitness is maintained with medical-grade topical products (KCMD) and daily sunblock.
OPUS Skin Rejuvenation
The Opus Plasma, a combination of radiofrequency and microneedling to combat sagging skin, wrinkles and scars by stimulating new collagen production. It can be performed alone or in combination with Botox, filler and/or surgery.
Informed Consent: After the procedure, you will be red and puffy and have a burning sensation that resolves with cool compresses, The redness and swelling typically resolve in 3-5 days. If scabbing occurs, the scabs will take a week or more to resolve. It is important to avoid retinol, Retin A and other acids for two weeks and to use sunblock frequently when driving or outside.
Microneedling
Microneedling is one of the most effective ways to improve skin texture, treat scars, fine lines and wrinkles, with minimal downtime:
- Effective for all skin types, light to dark
- Comfortable experience
- Short procedure time
- Ideal any time of the year
- Real results from a safe, natural and minimally invasive procedure
To reduce visible redness, we recommend healing camouflage, peptides or hyaluronic acid after the procedure, and to protect the skin with physical block based sunscreen—all available through Dr. Cockerham’s office.
