Miami Residents Ask: Do Spider Veins Return After Treatment?

Spider veins are generally harmless condition, but the appearance of these red, blue or purple veins on the skin can be bothersome for some. In order to achieve clear skin, many people choose to pursue spider vein treatment. Below, we’ll examine spider vein treatment and the kinds of results that it can produce.

 What Are Spider Veins?

Spider veins are a type of abnormal vein condition that are smaller and closer to the surface of the skin. They may appear as red, blue, or purple tree branches or spider webs on the surface of the skin of the thighs, calves, ankles, face, and nose. Factors such as heredity, hormonal shifts, weight gain, pregnancy, or exposure to the sun can contribute to the development of spider veins. While they pose no threats to overall health, some people may feel uncomfortable with their spider veins and seek cosmetic treatment to lessen their appearance.

Treatment for Spider Veins

Spider vein treatment is a speedy procedure, usually lasting under 30 minutes, and is performed in the office. Additional sessions may be necessary to reach your final cosmetic goals, but you will be able to notice significant improvement after a single session. Recovery after treatment is relatively mild, as there are no restrictions on physical activity following the procedure. It is not uncommon for treated areas to appear slightly bruised or swollen within the first few weeks.

 Are Results Permanent?

Current treatments for spider veins have higher success rates compared to traditional treatments. Over a long period of time, however, spider veins may develop, especially if you frequently experience long periods of sitting or standing. This occurs because there is no cure for weak vein valves, despite successful treatment in the past. Although, any new spider veins that develop usually do so at a slower pace and typically not in the same spot they were successfully treated. One crucial step you can take to prevent new spider veins from forming is to wear graduated compression support stockings as much as possible throughout the day.
Contact Us to Get Started

As a leading oculofacial plastic surgeon, Dr. Gregory D. Lewen is uniquely qualified to treat spider veins on the face and nose. For more information or schedule a consultation, contact Lewen Cosmetic Surgery today. Dr. Lewen and his practice are proud to offer highly skilled services to the residents of Miami, Aventura, and the surrounding area.

Differences Between a Full Facelift and Mid Facelift in Miami, FL

Most people considering a procedure as drastic as a facelift do research before undergoing the procedure. It doesn’t take long to realize that there are many variations of the facelift procedure available, and you don’t always have to “go big or go home.” The full facelift is traditionally what comes to mind when we think about the procedure, but many cosmetic surgery practices now offer what is known as a mid facelift, a less extensive alternative. Below are three differences between the two procedures to help determine which is right for you.

 Areas Treated

The main detail that distinguishes a full facelift from a mid facelift is the area of the face that is treated in each procedure. The goal of a full facelift is to reverse sagging cheeks, excess skin at the lower jawline, and deepening folds of skin as a result of the natural aging process. While mid facelift procedures also aim to turn back the clock, they only target the middle third area of the face, such as the cheeks and the eyes, which is more likely to be seen in younger individuals.

 Recovery Time

One of the biggest reasons patients choose a mid facelift procedure over a full facelift is the lessened recovery time it allows. The mid facelift treats a smaller area of the face and therefore, Dr. Lewen is able to perform this procedure through very small incisions or even endoscopically. Since mid facelifts are less invasive than their more extensive counterparts, patients typically resume normal activities sooner.


Most patients that are considering a facelift procedure wonder how long their results are expected to last. This is yet another factor to consider when deciding between facelift procedures, as the answer changes, depending on the extent of the procedure. The mid facelift yields results that can last anywhere from 5 to 10 years. In contrast, the effects of a full facelift procedure are more dramatic and may still be seen for up to 15 years due to the extensiveness of the procedure.

Schedule Your Consultation

Lewen Cosmetic Center’s double board-certified plastic surgeon, Gregory D. Lewen, M.D., is South Florida’s leading plastic surgeon for mid-facelift procedures. If you live in Miami, Aventura, or the surrounding area, Dr. Lewen and his friendly team invite you to contact them with any questions regarding your mid facelift procedure.

Miami Residents Ask: Is Non-Surgical Rhinoplasty Permanent?

Rhinoplasty is one of the most sought-after procedures in the plastic surgery world. The popularity of this procedure can be attributed to its versatility in solving both cosmetic and functional concerns. However, many people who would be excellent candidates for the procedure are fearful of going under the knife. Luckily, plastic surgeons have discovered a way to provide this demographic with non-surgical rhinoplasty procedures that are also effective. While this is a fantastic alternative, you may be wondering if the results of non-surgical rhinoplasty are just as permanent as its more extensive counterpart.

What Is Non-Surgical Rhinoplasty?

Traditional rhinoplasty is a surgical procedure that aims to correct any functional and cosmetic concerns of the nose. The procedure is performed by removing skin, cartilage, and other tissues to mold the nose to an ideal shape. However, many patients are reluctant to undergo such an invasive procedure, especially if their concerns are only minor. In cases such as these, a plastic surgeon may recommend for a patient to have a non-surgical rhinoplasty performed instead. During this procedure, Dr. Lewen will select a number of facial fillers that satisfy the patient’s goals and desires. Rather than make any incisions, he will instead inject these fillers in and along the contour of the nose. One benefit of this route is that the effects of some facial fillers can be seen immediately, instantly improving the shape of the nose.

Recovery Time

One of the biggest draws to non-surgical rhinoplasty over traditional rhinoplasty is the significant reduction in recovery time. After a traditional rhinoplasty is performed, a patient can expect a recovery period of at least six weeks before they are able to return to their normal obligations with their new nose. In contrast, patients can resume normal activities immediately after receiving their injections. Minor side effects such as tenderness and swelling around the injection sites within the first few days are normal but uncommon.

Are Results Permanent?

Non-surgical rhinoplasty is not performed with permanent facial fillers. Therefore, the results will not last forever. However, non-surgical rhinoplasty procedures still produce beautiful, long-lasting results that can be touched up as needed for a fraction of the cost of a traditional rhinoplasty procedure.

Contact Us to Get Started

Dr. Gregory D. Lewen and his team are proud to offer non-surgical rhinoplasty procedures to the people of the Miami area. To inquire for more information or to schedule a consult, contact our office today. Lewen Cosmetic Center is conveniently located near Miami, Aventura, and the surrounding areas of Florida.

Miami Residents Ask: How Can I Fix My Droopy Eyelid?

A droopy eyelid may be caused by ptosis, a condition that indicates damage or abnormalities with the muscles or nerves of the eyelid. In these cases, treatments that are intended specifically for anti-aging may not produce the desired improvement. If droopy eyelids contribute to your look of being tired or sad, Dr. Lewen may recommend droopy eyelid surgery.

Diagnosing Droopy Eyelids Caused by Ptosis

The first step in finding the right treatment for the tired look of your eyes is to determine what is causing the sagging of the eyelid. Stretching of the muscles that control the eyelid are the most common contributing factor and may be caused by:

  • Aging
  • Trauma to the eyelid or eye area
  • Excessively rubbing the eyes
  • Complications from previous eye surgeries
  • Chronic infections
  • Abnormal growths
  • Improper use of contact lenses

Droopy eyelids may also indicate a loss of soft tissue or bone that normally provides structure for the skin and eyelid. Dr. Lewen considers all of these factors before recommending the most appropriate treatment.

Treatment Recommendations for Droopy Eyelids

Whether your droopy eyelids are caused by changes to the muscles, loss of soft tissue and bone or congenital ptosis, Dr. Lewen may recommend surgery. In most cases, tightening the muscles that control eyelid movement and positioning is adequate. He may also remove any excess skin or soft tissue that lend to the sagging appearance of the eyelid. If he finds that you have an abnormal growth that is weighing down the eyelid, he will determine the nature of the growth and recommend complementary treatment.

After Surgery for Droopy Eyelids

After your surgery for droopy eyelids, you see an immediate improvement. You may have some swelling, but your eye is more open than prior to the procedure. Dr. Lewen provides detailed instructions on how to ensure that your eye heals properly, and he will schedule follow-up appointments to monitor your progress.

Some steps that you can take to minimize sagging in your eyelids are:

  • Use proper sunscreen, even on cloudy days
  • Use high-quality professional skin care products that are designed specifically for the delicate skin of the eye area
  • Do not rub your eyes
  • Have any infections or unusual bumps evaluated as soon as you discover the issue

Learn More About Droopy Eyelid Surgery at Lewen Cosmetic Surgery

If you have drooping or sagging eyelids, or if you always look tired even when you feel rested, contact Lewen Cosmetic Surgery to schedule a consultation to learn more about droopy eyelid surgery.

Rid Dark Eye Circles with Tear Trough Fillers in Miami, FL

If you have ever had a bout of poor sleep or been out too late at night, you know that dark circles are a sign of being exhausted. In these cases, though, dark circles typically resolve with some hydration, food and good sleep. If you always have dark circles under your eyes, lifestyle changes may not do the trick. Discuss your concerns with Dr. Lewen, and he may recommend tear trough fillers for dark circles.

What Causes Chronic Dark Circles Under the Eyes?

The dark coloration under your eye is caused by thinning skin that allows the blood vessels and underlying tissues to show through the skin. The tear trough area between the top of your cheek and lower eyelid is highly vascular, meaning that there are a multitude of small vessels that carry blood to the face and eyes. The skin in this area is also very delicate, so the tear trough is more susceptible to revealing these vessels than other areas of your face.

How Do Facial Fillers Help with Dark Circles?

Facial fillers contain ingredients that add volume to the skin, either by stimulating collagen or increasing the amount of water with hyaluronic acid. This additional volume creates a deeper space between the surface of the skin and the network of blood vessels to hide the anatomical structures that cause dark circles. The fillers also help with any sunken appearance to the tear trough and bags under the eyes.

Who Can Perform Fillers for the Tear Trough?

Although dermal fillers are commonplace, few practitioners have the knowledge and expertise that is needed to appropriately perform tear trough fillers. Choosing an inexperienced injector to perform the procedure may result in damage to the nerves, delicate muscles and tiny blood vessels. As an oculofacial plastic surgeon, Dr. Lewen has an in-depth understanding of these structures, and performs the injections in the safest and most effective way possible. You may have some minor swelling, tenderness, tightness and minor bleeding, but these symptoms are common with any injectable dermal filler.

What to Expect After Tear Trough Fillers for Dark Circles

The benefits of tear trough fillers last at least several months before you need a follow-up treatment. Protecting your eye area from sun damage and using high-quality skin care designed for the delicate skin of the eyes may extend the longevity of your results. Dr. Lewen may recommend complementary treatments to further improve the skin around your eye area to give you a refreshed and rejuvenated look.

Are You Tired of Looking Tired? Contact Lewen Cosmetic Surgery.

If you are tired of always looking tired, we can help. Contact Lewen Cosmetic Surgery to learn about Dr. Lewen’s unique tear trough filler treatment for chronic dark circles under the eyes.


Miami Residents Ask: Is Facial Fat Grafting Permanent?

Fat grafting is a technique that has been used in cosmetic applications to add volume to the skin. Although the technique is more intensive than dermal fillers, it does offer unique benefits for men and women who want to reduce wrinkles or enhance facial features, such as a greater longevity.

The Fat Grafting Procedure

The fat grafting procedure is a three-step process.

  1. Fat is removed from an area of the body, such as the thighs, abdomen flank, or buttocks, using a limited liposuction technique.
  2. The fat is processed to remove any impurities and isolate the fat cells.
  3. The fat cells are loaded into a syringe and injected into the treatment area of the face, such as nasolabial folds, cheeks, under the eyes, forehead and other areas.

With fat grafting, you do have some downtime, typically one to two days.

How Fat Grafting Works to Reduce Wrinkles and Add Volume

The transferred fat cells absorb nutrients and oxygen from surrounding tissues until a process known as “neovascularization” occurs by which the body develops new blood vessels to deliver nutrients and oxygen to the fat cells directly. Neovascularization is the most important facet of fat grafting. Once the blood vessels are developed by the body, the fat grafts become an integrated part of the subcutaneous tissues and work much like the native fat cells. Recent studies have also revealed that the fat cells contain growth factors that help the body heal naturally. This mechanism enhances the anti-aging benefits of fat grafts.

How Long Do Fat Grafts Last?

The key distinction between dermal fillers and fat grafts is that transplanted fat cells are integrated into the tissues, whereas dermal fillers contribute to the presence of certain proteins, such as collagen and hyaluronic acid. While every fat cell may not survive the grafting procedure, for all practical purposes, fat grafting is considered a permanent solution. We do advise our patients that some fat cells may not survive the harvesting, purification and implantation, so a follow-up fat grafting procedure may be required to achieve the desired results.

Can You Extend the Results of Your Fat Grafting?

Because fat grafts become part of your subcutaneous tissues and are subject to changes that affect native fat cells, many people want to know how they can extend the longevity of their fat grafts. The surgical technique that is used and the experience of the surgeon is of utmost importance. Dr. Lewen specializes in facial fat grafting, and his skills provides his patients with the best possible outcomes for the procedure.

Learn More About Facial Fat Grafting at Lewen Cosmetic Surgery

Dr. Lewen can discuss fat grafting and the results that he achieves with his patients during a consultation. To learn more about fat grafting at Lewen Cosmetic Surgery, contact us to schedule your personal consultation.

Miami Residents Ask: Is Mohs Surgery Covered by Insurance?

Skin cancer is the most common type of cancer, and it affects millions of people in the United States. The Miami area sees a high number of skin cancer cases due to the outdoor lifestyle that makes Florida a popular place to live. If you are diagnosed with skin cancer, Dr. Lewen may recommend Mohs surgery.

What is Mohs Surgery and When Is It Recommended?

Although Dr. Lewen does not perform Mohs surgery himself, he is able to provide patients with highly recommended colleagues who are able to perform the surgery instead. Skin cancer that has not spread to surrounding tissues can be treated through a surgical incision of the abnormal tissues or Mohs surgery. Mohs surgery is highly recommended in most cases because it ensures that only the cancerous cells are removed. Often, this minimizes scarring and ensures patients of positive prognosis in the cancer treatments. The technique that is used for Mohs surgery is referred to as micrographic surgery. The surgeon removes thin layers of tissues from the lesion and studies it under a microscope. If the surgeon detects cancer cells in the tissues, another layer is removed and evaluated for the presence of cancer cells. This process continues until the surgeon removes a thin layer of tissue that is free of any cancerous cells. The wound that is left on the skin is treated with techniques that minimize scarring and preserve the aesthetics as much as possible.

Once this is done, Dr. Lewen will perform any reconstruction procedures that are necessary to areas of the eyes or face that have been affected by Mohs surgery. Dr. Lewen and his staff will continue to closely monitor your healing progress following the Mohs surgery and skin reconstruction.

Considerations for Insurance Coverage of Mohs Surgery

The cost of Mohs surgery can be expensive, so insurance coverage is an important consideration. Fortunately, Mohs surgery is a medical procedure, and it is not considered an elective even though it does provide some cosmetic benefits. Micrographic surgery has become a standard procedure under insurance policies, so it is covered in most cases. We do advise our patients that they should check with their insurance carriers directly, and we are happy to provide any details that will help you explain the medical necessity of the procedure. Even if your Mohs surgery is covered, you may have some out-of-pocket expenses to consider before having the procedure.

What If Insurance Doesn’t Cover Mohs Surgery?

If your insurance does cover any or all the cost for your Mohs surgery, we may have some options to help you afford the cost. We work with CareCredit® to offer our patient’s financing options that fit their budgets.

Learn More About Mohs Surgery at Lewen Cosmetic Surgery

If you have been diagnosed with skin cancer or have an unusual lesion that you need to have evaluated for skin cancer, contact Lewen Cosmetic Surgery to schedule a consultation. Dr. Lewen will determine if your skin cancer can be treated with Mohs surgery, and we can assist you with finding out if the procedure is covered by insurance.

Why Mohs Surgery is Ideal for Treating Facial Skin Cancers in Ft. Lauderdale, FL

Skin cancer is a common problem among Miami residents because the Florida lifestyle means spending a lot of time outdoors. Sometimes, despite your best efforts, skin cancer develops in areas that are most often exposed to sunlight, such as the face. There are several options for treating skin cancer, yet Mohs surgery is considered the gold standard for treating skin cancer on the face. Although Dr. Lewen does not perform Mohs surgery himself, he does Mohs reconstruction surgery if necessary after a dermatologist has removed the skin cancer with Mohs surgery.

What is Skin Cancer?

Skin cancer describes a condition in which abnormal cells develop in multiple organs of the body, such as the skin. There are several types of skin cancer, including:

  • Basal cell carcinoma
  • Squamous cell carcinoma
  • Melanoma

Of these, melanoma presents the most serious type of skin cancer because it can infiltrate the surrounding tissues and organs. Most cases of skin cancer involve basal cell carcinoma.

Skin Cancer Treatment Options

Treatment for skin cancer does vary slightly based on the type of cancer, but treatments may include:

  • Excising the cancerous cells to include a margin of healthy tissue
  • Radiation therapy
  • Topical immunotherapy and radiation
  • Cryosurgery
  • Curettage and electrodesiccation
  • Mohs micrographic surgery

While each of these options may successfully remove or destroy the cancerous cells, there are disadvantages to most, such as scarring and side effects. Mohs micrographic surgery produces no side effects, and the technique involves removing the smallest amount of tissue necessary to remove the cancerous cells.

Mohs Surgery for Facial Skin Cancer

Dr. Lewen does not perform Mohs surgery, but he is happy to provide recommendations for patients and to perform any facial reconstruction surgery once the skin cancer has been removed. Mohs surgery offers exceptional precision when removing cancerous cells from the face. Rather than removing a large section of tissue with traditional excision, the doctor removes very thin layers of skin cells. Each layer is studied under a microscope to detect the presence of cancerous cells. If cancer is detected, the surgeon removes another thin layer of skin from the lesion and studies it under the microscope. This process is repeated until no cancer cells are detected. Depending on the size of the resultant wound, the surgeon may:

  • Allow the wound to heal naturally
  • Suture the wound closed
  • Use skin grafts or flaps to cover the wound

Following the removal of any facial skin cancer, Dr. Lewen may perform facial reconstruction surgery afterward. He will choose a technique to help minimize scarring as well as preserve your vision and the delicate tissues around the eyes and cheeks. He may even recommend scar revision surgery at a future date to further camouflage the scar with the surrounding skin.

Interested in Mohs Surgery for Facial Skin Cancer? Contact Lewen Cosmetic Surgery.

If you have been diagnosed with or suspect that you have skin cancer on your face, contact Lewen Cosmetic Surgery to schedule a consultation. Dr. Lewen will determine if Mohs surgery and facial reconstruction is your best option, or recommend alternative treatments for the lesion.

Miami Residents Ask: How Many Treatments are Required for Laser Hair Removal?

Shaving, waxing, and plucking are an unpleasant part of your hygiene routine, but having unwanted hair is even more troublesome. With laser hair removal, you can manage that unwanted hair quickly and easily. Best of all, the results may be permanent. The most common question we receive about laser hair removal is, “How many treatments are required for laser hair removal?”

How Does Laser Hair Removal Work?

Shaving cuts the hair at the surface and plucking or waxing yanks the hair out of the follicle. None of these techniques affect the way the hair grows, so soon after you treat your unwanted hair, it comes right back. Laser hair removal is unique because it changes the follicle so that it does not grow hair as well as before treatment. With repeat treatments, the follicle may stop producing hair altogether.

Why Do I Still Have Hair After Laser Hair Removal?

Every hair on your body follows a set growth cycle that has four stages. In the first stage (anagen), the hair is growing. Most of the hair that you have right now is in this stage. Next comes catagen, or the transition stage. Over two to three weeks, hair growth stops, and the connection to the blood supply is disconnected. In stage three or telogen, the hair rests inside the follicle, yet receives no nutrients from the bloodstream. This is when a new hair starts to form under the old hair shaft. In the fourth and final stage, the hair falls out of the follicle. If you see hair after your laser hair treatment, chances are that those hairs are in different stages of growth and will fall out in the days or weeks after your laser hair treatment.

How Many Treatments Do I Need to Eliminate All the Hair?

The number of treatments to remove all the hair varies by person, hair type and treatment area. Dr. Lewen uses the LightSheer® Duet™ system for laser hair removal. This system is proven to reduce treatment times by up to 75% compared to other laser hair removal systems. Most of the hair will be gone with the first treatment, but you may need some spot treatments over the following weeks. Each treatment takes 20 minutes or less, and typically we can achieve total hair removal with two to three treatments.

Find Out More About Laser Hair Removal at Lewen Cosmetic Surgery

If you are interested in laser hair removal, contact Lewen Cosmetic Surgery to schedule a consultation. Dr. Lewen uses the LightSheer® Duet™, considered the “Gold Standard” of laser hair treatments.

How to Fix Chronic Puffy Lower Eyelids in Miami, FL

Having occasional puffiness under your eyes is normal. You may not be getting enough sleep or drinking enough water. Chronic puffiness, though, may be a sign of other issues that are developing in your under eye area. While these concerns do not necessarily require attention from your physician, puffiness certainly does affect the way you look and feel. Dr. Lewen offers lower eyelid surgery to remedy chronic puffiness under your eyes.

What Causes Puffiness Under the Eyes?

Chronic bags under the eyes and puffiness may indicate age-related changes that are occurring to the tissues. The muscles in the area may be weaker than when you were younger, and this allows the tissues to sag. As you age, the fat in your face sags, and this causes folds in various areas, including under your eyes. Poor skin elasticity is another reason that you may have chronic puffiness, and the condition can also be related to excess fluid in the tissues.

Start with Lifestyle Changes

Before you consider surgery for the bothersome bags under your eyes, Dr. Lewen recommends that you make some lifestyle changes to see if you can remedy the problem on your own. His recommendations include:

  • Getting better quality sleep, both in the amount of time you sleep and how deeply you sleep.
  • Increase your activity level.
  • Stop smoking.
  • Speak with your physician about any allergies that may be causing puffy eyes.
  • Drink more water throughout the day.
  • Reduce the amount of salty foods you eat.

If these techniques do not help with your chronic puffy eyelids, you may be a good candidate for lower eyelid surgery.

How Does Lower Eyelid Surgery Help with Puffiness and Bags Under the Eyes?

Like other cosmetic concerns, chronic puffiness under the eyes can be hereditary. Dr. Lewen uses a surgical technique to address the most common causes of chronic puffiness. An incision is made along the lower eyelashes to access the deep tissues. He may reposition the fat or remove any excess fat. The muscles are tightened with sutures, and any extra skin is trimmed. This approach rejuvenates the under eye area and helps reduce puffiness and bags.

Can Dermal Fillers Be Used for Bags Under the Eyes?

Dr. Lewen may recommend a non-surgical lower eyelid lift to help with your puffiness. This may be a standalone procedure or performed in conjunction with surgery to refine the results.

Is Lower Eyelid Surgery Right for You? Contact Lewen Cosmetic Surgery.

If you have tried every technique possible to eliminate the bags under your eyes and now find yourself using concealer to look refreshed and younger, you may be a good candidate for lower eyelid surgery. Contact Lewen Cosmetic Surgery to schedule a consultation and discuss your options with Dr. Lewen.