Oculofacial Restoration in San Diego, CA
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
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).
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 and a variety of cosmetic concerns including frown lines, crow’s feet, forehead lines, lip lines, lip shape (lip flip). Many patients with migraine headaches that are unresponsive to oral medications can benefit from Botox injections.
Botox is a purified protein that is synthesized from the naturally occurring bacterium, Clostridium botulinum. There are seven known forms, the most commonly 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.
Bruising is the most common unwanted side effect of Botox injection. In order to minimize bruising, there are a number of medications that patients 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.
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). Fillers are an excellent medical treatment for post-surgical or traumatic deficits of the eyelid and face. In addition, they can be used to augment the shape and contour of the eyelids, temporal fossa, nose, cheeks, perioral region and lips.
Bruising is the most common unwanted side effect of dermal filler injection. In order to minimize bruising, there are a number of medications that patients 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.
OPUS Skin Rejuvenation
The Opus Plasma, a combination of radiofrequency and microneedling, combats sagging skin, wrinkles and scars by stimulating new collagen production. It can be performed alone or in combination with Botox, filler and/or surgery.
Eyelid, Eyebrow, Eye Muscle, Tear Drainage System Surgery
As we age, the delicate skin around the eyes may begin to sag and wrinkle. Excess skin and fat under the eyes can cause puffiness and give you a tired, aged appearance. In more extreme cases, sagging upper eyelid skin can even impair vision. The eyebrows descend making the eyelid drooping even worse. The lower eyelid can also dislocate from their normal attachment and cause the lower eyelid to move inward, outward or fallen. As a board-certified, fellowship trained ophthalmologist with fellowship training and two decades of experience in oculofacial plastic surgery, Dr. Kimberly Cockerham has been performing cosmetic and functional eyelid surgery for over two decades. She customizes each treatment to reflect each patient’s unique anatomy, skin condition, aesthetic concerns and lifestyle— an approach that consistently delivers excellent results for her patients.
Dr. Cockerham performs functional oculofacial restoration surgery due to the following conditions:
- Weakened eyelid, eye muscle or facial muscle
- Eyelid rotation or eyelash abnormalities
- Excessive eyelid skin or fat
- Drooping eyelids, eyebrows or face
- Skin, eye or orbital (area behind the eye) cancer and other tumors
- Double vision
- Tear drainage blockage
- Floppy eyelids due to sleep apnea
- Blind painful eyes
Dr. Cockerham will discuss the non-surgical and surgical options that will provide your best possible outcome. Insurance may cover all or a portion of your oculofacial restoration medical and surgical needs. Call for a consultation today: (619) 810-1275.
