Do’s and Don’ts of Cheek Fillers in Miami, FL

The cheek area is an important part of an attractive appearance because the bone and skin structure create highlights and shadows. The cheeks also work to anchor facial balance of all features. Dr. Lewen prefers cheek fillers rather than cheek implants because the technique gives him exceptional control when sculpting the cheek and mid-face area. Here are some of his recommendations for best practices when using dermal fillers for the cheeks.

Do Remain Cognizant of Anatomical Considerations

First and foremost, the individual patient’s anatomy must be considered when administering cheek fillers. This may require injecting the fillers in areas around the cheekbone rather than using more traditional injection patterns. In the end, crafting an injection pattern that is unique to the patient creates a more natural and appealing overall improvement to the face.

Do Use Cheek Fillers for Dual Benefits When Possible

Whenever possible and necessary, Dr. Lewen identifies ways to use cheek fillers for dual purposes, such as to add volume to the under eye area, soften wrinkles around the mouth and nose or address sagging along the jowls. This ensures that the patient benefits from the injections in unexpected ways. In following this methodology, Dr. Lewen often recommends cheek fillers to patients who have lower eyelid surgery and other procedures in the eye area.

Don’t Assume You Know a Patient’s Goals

Not every patient wants to turn back the clock necessarily. Some patients, including those in their 40s and beyond, may want to create an entirely new look with cheek fillers. Dr. Lewen takes the time to understand each patient’s vision for cheek fillers and other procedures, and he discusses the options with their specific goals in mind.

Don’t Overdo It with Cheek Fillers

Some practitioners use techniques that involve injecting a more than adequate amount of dermal filler directly into the cheeks, typically around the cheekbone. This may produce an unnatural shape to the apple of the cheeks and make patients more uncomfortable with their appearance. The justification is typically a “more is better” reasoning, but this is never the case when it comes to dermal fillers. Instead, dermal fillers should be injected in smaller amounts at several injection sites, including points outside the cheek area.

Are You Considering Cheek Fillers? Contact Lewen Cosmetic Surgery

If you are considering cheek fillers, or even cheek implants, contact Lewen Cosmetic Surgery to schedule a consultation. Dr. Lewen understands the nuances of cheek fillers and the techniques to use to create the most appealing proportions for your face.

Thyroid Conditions that Cause Dry Eyes in Miami, FL

The thyroid is part of the endocrine system that regulates the hormones in your body that are needed for sleep, libido, metabolism, emotions and many other aspects of your physical health and overall well-being. Thyroid disorders cause an imbalance of hormones, and your body does not function as well as it should. Dr. Lewen works with men and women who have thyroid conditions that cause dry eyes to help them find solutions.

What is Thyroid Eye Disease?

Dry eyes and other issues may be symptoms of a thyroid condition that causes you to have too many or too few hormones in your body. Some of the patients that Dr. Lewen works with do not realize that they have a thyroid disorder until he determines the root cause of their dry eyes. Thyroid eye disease can be difficult to diagnose because it not only causes dry eyes, but may also cause double vision, difficulty opening and closing the eyes, redness, watery eyes and bulging eyes. Although the exact cause of thyroid eye disease is not known, it is believed to be an autoimmune disorder.

How are Thyroid-Related Dry Eyes Diagnosed?

As an oculofacial plastic surgeon, Dr. Lewen has the expertise to examine the inner structures of your eyes and look for signs of thyroid eye disease, such as inflammation and irritation. Bags under the eyes may be another indication of the disorder. Lab tests may be recommended to check your thyroid hormone levels.

What is the Treatment for Thyroid Conditions that Cause Dry Eyes?

Dr. Lewen takes a comprehensive approach to treating dry eyes that are caused by thyroid disorders. Inflammation and pressure in the eye may be treated with ointment or eyedrops. In some cases, surgery is required to address bulging eyes and disorders of the eyelids. The most common type of surgery is orbital decompression. By removing fat and bone from the area where the eyeball sits in the socket (orbit), Dr. Lewen decreases the pressure on the eyeball and improves the way it rests within the orbit. You should also work with an endocrinologist to manage your thyroid condition and prevent future complications with your eyes and other organs.

Learn More About Thyroid Conditions That Cause Dry Eyes. Contact Lewen Cosmetic Surgery.

Dry eyes can be caused by several conditions, so you should be diagnosed by an oculofacial plastic surgeon who understands thyroid conditions and other conditions that affect the eyes. Contact Lewen Cosmetic Surgery to schedule a consultation.


Miami Residesnts ask: Can You Combine a non-surgical brow lift with fillers?

Combining non surgical brow lift with fillers.
When the skin of the forehead area thins with age, the resultant sagging lowers the eyebrows and hinders how open your eyes look. The overall effect is that you look tired and angry. Brow lift surgery is often recommended to rejuvenate the forehead area by removing excess skin and fat, but this may be more extensive than what is needed in some cases. A nonsurgical brow lift relies on dermal fillers to add volume to the skin and reduce sagging.

Advantages of a Nonsurgical Brow Lift

Brow lift surgery may take several hours, and you will have at least two weeks of healing. After the surgery, you may experience tenderness, bruising and swelling, and you will have a permanent scar. A nonsurgical brow lift takes less than one hour and there is no downtime or scarring.

What Dermal Fillers are Used for a Nonsurgical Brow Lift?

Dr. Lewen uses a combination of neuromodulators and facial fillers for his unique nonsurgical brow lift procedure. Neuromodulators, such as Botox®, Dysport® and Xeomin® help with dynamic wrinkles that are caused by facial expressions. The lifting of the brow is achieved with dermal fillers, such as Restylane®, Juvéderm®, Radiesse® and Juvéderm® Voluma. The hyaluronic acid in Restylane®, Juvéderm® and Juvéderm® Voluma brings more water to the skin to provide hydration and volume. Radiesse® works by introducing microspheres that provide lift and increase the amount of collagen in the skin.

How Does a Nonsurgical Brow Lift Work?

Dr. Lewen recommends the nonsurgical brow lift for patients who have mild to moderate sagging in the brow and forehead area. You may notice these types of changes on your own, but we recommend that you be evaluated by Dr. Lewen to determine if you do have a sagging brow. If you are a good candidate, Dr. Lewen considers your anatomy and patterns of aging to select the combination of neuromodulators and dermal fillers that will rejuvenate the upper portion of your face. His treatment plan is based on using multiple injections of the appropriate products to carefully sculpt and lift the brow and forehead.

After Your Nonsurgical Brow Lift

You will see an immediate improvement in the area after the procedure. Gradually over the next four to six weeks, the area continues to improve. The results will last several months or longer, depending on the dermal fillers that are used. A nonsurgical brow lift will not stop the aging process, but it may delay the need for brow lift surgery.

Learn More About the Nonsurgical Brow Lift at Lewen Cosmetic Surgery

To learn more about Dr. Lewen’s innovative nonsurgical brow lift procedure, contact us to schedule a consultation.

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.