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These are some of the many procedures and products we feature. Click on a term for more details.
Belotero® is a filler that is used to fill vertical lip lines, also known as “smoker’s lines.” It can also be used to treat very deep glabellar frown lines, also known as “11 lines.” Dr. Johnson also occasionally uses Belotero® in an artistic fashion to fill wrinkles that don’t conform to a specific pattern. Belotero® is composed of hyaluronic acid which is a substance that we have in our bodies naturally. The filler lasts 6-9 months and leads to beautiful, natural results. Dr. Johnson applies numbing cream to the area to be treated in order to make the procedure as comfortable as possible. Many patients choose to have this filler done on their lunch break as there is no down time needed.
Upper eyelid blepharoplasty is a surgery that is used to remove excess skin and fat from the upper eyelids. This surgery is performed in the office under local anesthesia. Dr. Johnson makes an incision in the eyelid crease so that any scar that forms is hidden in the crease. He then removes the extra skin and fat and then stitches the skin closed. Most of the stitches come out in one week and the rest come out in two weeks. There is usually no pain after the procedure and the recovery period is two days. Dr. Johnson’s goal with this surgery is to produce natural-looking results that truly allow the patient to look, see, and feel their best. Dr. Johnson performs this surgery at all practice locations.
Lower eyelid blepharoplasty is a surgery that is used to remove extra skin and “bags” from the lower eyelids. Some of the fat in the lower eyelids is removed and the rest is “tucked in” to reduce the appearance of the bag. Dr. Johnson performs this procedure in the surgery center under sedation. It is same-day surgery and the patient rests at home for about three days before resuming most normal activities. The results that Dr. Johnson produces for his patients are natural, long-lasting, and elegant. He sees patients in consultation for this procedure at all practice locations.
Upper and lower eyelid blepharoplasty can also be performed on the same day at the surgery center under sedation.
Blepharospasm is a condition where the muscles around the eye are overactive. It can lead to constant spasms that can cause the patient to be unable to open their eyes. Botox® is used to relax these muscles and allow these patients to feel better and see better. The results take a few days to develop. After the first treatment session, Dr. Johnson likes to see his patients back a week later to make sure everything is perfect. This service is covered by most insurance plans.
The Blue Peel is a chemical peel that is used to remove the outer surface of the skin in order to allow new skin to grow. The new skin is brighter, lighter, and tighter than the old skin. The chemical peel is aggressive and requires about four days of down time. Patients who are very dedicated to keeping their skin looking as young and fresh as possible tend to have this peel done once a year. Dr. Johnson performs these peels from October through April and works around his patient’s schedules to allow them to “hibernate” for a few days should they choose to do so. The peel takes about 20 minutes to complete.
Botox® is the most commonly performed cosmetic procedure in the United States. It works by relaxing the muscles that cause wrinkles. The most common areas that patients treat with Botox® include horizontal forehead wrinkles, crow’s feet, and glabellar furrows (also known as “11 lines”). Botox® can also be used to lift the brow, reduce the appearance of “bunny nose” wrinkles, decrease the appearance of a “gummy smile,” and soften the vertical bands that can form in the neck. Dr. Johnson uses his Botox® needle like a paintbrush to produce results for his patients that are artistic, natural, and beautiful. The results take a few days to develop, but there is no down time and many patients choose to have this procedure done on their lunch breaks. Botox® is available at all practice locations.
As we age, the eyebrows can become droopy, leading to a tired or depressed appearance that is bothersome to many patients. Dr. Johnson uses one or more of three approaches, in the office under local anesthesia, in order to raise the brow. Depending on the patient’s facial anatomy, he selects these approaches to create the best results while camouflaging the scar in the eyelid crease, above the eyebrow, or in the hairline. The down time for this procedure is two days, after which time the patient can return to their normal life. Dr. Johnson performs this procedure at all practice locations.
A chalazion is another word for a stye. This condition is not serious, but can be painful, irritating, and unsightly. There are two treatment options available: a steroid injection or surgical excision. Many times a steroid injection can completely eliminate the chalazion. Other, more encapsulated chalazia require an office procedure to have it removed. There is about one day of down time before patients can return to their normal lives. Once the stye is removed, patients report feeling like themselves again. Dr. Johnson also reviews prevention measures to prevent future styes.
Dry eye syndrome can cause pain, tearing, and blurry vision, and can range from mild to moderate to severe. Mild dry eye can be treated with artificial tears such as Systane®, Refresh Plus®, and Optive®. Moderate dry eye requires artificial tears plus the addition of a gel such as Genteal® at bedtime. Dr. Johnson treats severe dry eye by using a heat treatment to shrink the tear duct and allow the patient’s own natural tears to remain in the eye longer. In extreme cases, he sews the outer corner of the eyelids together using a procedure called a tarsorrhaphy which allows the eye to dry out less slowly.
Dysport® is very similar to Botox®; in fact, the active portion in each medication is identical. For this reason, Dysport® can be used to treat the same exact areas that Botox® can: horizontal forehead wrinkles, crow’s feet, “11 lines,” droopy eyebrows, “bunny nose” wrinkles, “gummy smiles,” and vertical neck bands. The difference between Dysport® and Botox® lies in the fact that results usually develop one to two days earlier than they do with Botox®. Dr. Johnson tends to use this product when patients have an important event coming up within the next few days.
Ectropion occurs when the lower eyelid pulls down and away from the eye. This causes the eye to become exposed – leading to dryness, irritation, and blurry vision. Dr. Johnson treats mild cases in the office under local anesthesia using a technique called a lateral tarsal strip. He treats more severe cases in the operating room using a variety of graft procedures. After undergoing this treatment, patients report a greater overall sense of wellbeing. They tend to feel better, see better, and greatly appreciate having their eyelids restored to their normal, natural position.
Entropion occurs when the lower eyelids turn inward and the eyelashes rub against the eye. This can be extremely painful as the eyelashes are constantly scratching the ocular surface. Dr. Johnson usually treats this condition in the office under local anesthesia combining eyelid tightening procedures and strategically placed stitches. Patients often feel better immediately after the procedure and are excited to return to their day-to-day activities with a renewed sense of confidence and wellbeing.
Dr. Johnson is sometimes called upon to remove an eye. This occurs when an eye has been severely traumatized, if it contains a tumor, or if it has become blind and painful. Depending on the unique characteristics of each specific case, these conditions can be treated by removing the intraocular contents only in a procedure called evisceration. At times, however, the entire eye needs to be removed using a procedure called enucleation. Dr. Johnson performs this procedure under general anesthesia. Once the eye is removed, he places an orbital implant in the eye socket to replace the volume that is lost. Once the patient has healed, Dr. Johnson works very closely with an artist known as an ocularist who fits the patient with a prosthesis. Dr. Johnson’s goal is to have the artificial eye look as natural as possible so that patients can get back to their full range of activities. He also works closely with therapists to help patients cope with the loss.
Excessive tearing occurs when tears run down the patient’s face on a regular basis. This condition can lead to social anxiety as patients feel they cannot have a proper conversation without having to constantly wipe their eyes. There are four main causes of excessive tearing: (1) an obstruction of the tear duct, (2) a droopy lower eyelid (see Ectropion), (3) ocular surface disease such as dry eyes, and (4) oversecretion. In the office, Dr. Johnson determines the cause of the tearing in order to select the best therapeutic option. By eliminating this problem, patients report feeling an increased sense of confidence and overall wellbeing.
Bumps on the eyelid can range from skin tags to life-threatening skin cancers. When Dr. Johnson sees a patient in consultation for an eyelid lesion, he performs a biopsy of that lesion on the same day. Small lesions can be removed, in their entirety, right in the office. For larger lesions, a piece of it is removed and sent to the pathologist to obtain a tissue diagnosis. This is then followed by a formal excision in the surgery center. Once these lesions are removed and fully-healed, many patients report that they look, see, and feel their best again.
The delicate skin around the eyelid is where the first signs of aging present themselves. Fine lines and wrinkles in the upper and lower eyelids can cause the patient to look tired or sad when they feel otherwise refreshed and happy. A chemical peel using trichloroacetic acid can be used to soften the appearance of these fine lines and wrinkles and restore a more youthful appearance. This treatment can be used in conjunction with Botox®, fillers, and blepharoplasty to provide a result that is natural, long-lasting, and youthful.
Floppy eyelid syndrome occurs when the eyelids turn inside out when the patient is sleeping. They can then rub against the pillow and cause significant irritation. This condition has a high association with sleep apnea. Therefore, Dr. Johnson refers all his patients with this condition to have a sleep study performed. He then performs a procedure that tightens the eyelids in the office. There is usually no pain associated with the procedure and the recovery period involved two days of downtime. Many of the patients who have floppy eyelids also have ptosis (droopy eyelids) that can be corrected as a subsequent procedure called ptosis repair (See below) in conjunction with blepharoplasty (See above). Once the floppiness, droopiness, and excessive eyelid skin have been corrected, these patients truly feel that they look, see, and feel their best again.
IPL or Intense Pulsed Light is a technology that uses light energy to treat several conditions. This therapeutic option can be used to treat dark spots on the face. It can also be used to decrease the redness that occurs with rosacea. IPL can also be used for overall skin rejuvenation. In the world of ophthalmology, this treatment can also be used to treat dry eyes. IPL has minimal downtime and can be performed on the patient’s lunch break.
Juvederm® is a filler that is used to fill the nasolabial folds which are the deep lines that run from the corner of the nose to the corner of the mouth. It can also be used to treat the marionette lines that run downward from the outer corners of the mouth. Juvederm® is composed of hyaluronic acid which is a substance that we have in our bodies naturally. The filler lasts 9-12 months and leads to beautiful, natural results. Dr. Johnson applies numbing cream to the area to be treated in order to make the procedure as comfortable as possible. Many patients choose to have this filler done on their lunch break as there is no down time needed. Juvederm® is available at all practice locations.
Kybella® is a revolutionary new treatment used to treat the double chin. It is injected into the area of fatty tissue that forms in the neck area. This treatment usually requires two to three treatment sessions to see dramatic, long-lasting, natural results. Dr. Johnson applies ice to the area to be treated prior to injecting the medication. Once Kybella® is injected, it kills the fat cells, and the body removes them over the next few weeks. This treatment is ideal for patients who may have inherited this “double chin” from their family members and do not want to undergo surgery.
Latisse® is a prescription-strength medication used to increase the length of the eyelashes. The patient applies this treatment at home by brushing it along the top eyelashes. When the patient closes their eyes, the Latisse® will coat the bottom lashes. Results can be seen after a period of one to three months, at which point the frequency of treatments can be reduced. This treatment is perfect for the patient who wants longer, natural eyelashes and does not want to resort to eyelash extensions.
Obagi® is a medical-grade skincare line created by Dr. Suzan Obagi, a dermatologist in Beverly Hills. This revolutionary line represents the strongest skin treatments that can be obtained without a chemical peel. Tretinoin is a topical medication that increases cell turnover by shedding the outer dead layer of skin and allowing new cells to grow; Dr. Johnson describes it as a “workout for your skin.” Obagi® also features the NuDerm System which is ideal for overall rejuvenation and reducing the appearance of age spots. The Vitamin C Serum keeps the skin’s collagen healthy; it brightens, lightens, and tightens the skin giving it a healthy glow. Elastiderm® is used to reduce the appearance of fine lines and wrinkles in the delicate eyelid area. Obagi® also offers skin care systems for rosacea and acne, and of course, every kit incorporates a sunscreen with SPF 50.
An orbital fracture can occur as the result of a traumatic event such as a fall, a sports injury, a car accident, or an assault. While the patient is coping with the psychological effects of the trauma, Dr. Johnson helps to restore them as quickly as possible to their pre-trauma appearance. An orbital fracture can cause the eye to sink back into the socket – leaving a constant reminder of the trauma every time the patient looks in the mirror. Furthermore, orbital fractures can cause double vision, swelling, and pain. Minor fractures can be observed and do not usually require surgery. Dr. Johnson repairs larger fractures in the surgery center by inserting an orbital implant to bridge the area where the bone has been broken. This surgery truly helps patients to look, see, and feel their best again by bringing the eye forward, improving double vision, and allowing patients to see themselves as they truly are; not as a victim.
An orbital tumor can cause a bulging eye, double vision, swelling, and/or loss of vision, and can be either benign or malignant. In the office, Dr. Johnson gathers detailed measurements in order to determine how far the eye is protruding and to map out the pattern of double vision. The next step usually involves obtaining images with either a CT scan or an MRI. Once completed, a treatment plan is designed, and or a biopsy is performed. Each orbital tumor has its own personality and once a biopsy is obtained, a treatment plan specific for that exact tumor can be created. Therapy for orbital tumors may include surgery, radiation, chemotherapy, or simple observation. The goal is to allow the patient to look, see, and feel like themselves again while maximizing their quality and quantity of life.
Pellevé® uses radiofrequency energy to tighten the collagen in the deep layers of the skin. It involves the use of a gel and a wand that are used to deliver the energy to these deeper layers. During the treatment, the patient feels a warm sensation that is quite pleasant. The effects generally last about three months but can last longer when combined with the Vitamin C serum from Obagi®.
As we age, the eyelids can become droopy. When the eyelids droop below the pupil, they can block the top part of our vision. When this happens, most people tend to raise their eyebrows in order to see more clearly. This habit can lead to persistent eyestrain, tension, and horizontal forehead wrinkles. Most insurances will cover surgery to raise the eyelids if they are blocking the visual field. When Dr. Johnson meets with a patient who has droopy eyelids, he takes specific measurements to gauge exactly how droopy the eyelids have become. After that, the patient undergoes a visual field test to determine if they are causing a decrease in vision. Surgery for this condition is usually performed in combination with a blepharoplasty (See above) in the surgery center. Dr. Johnson makes an incision in the eyelid crease so that any scar that forms is hidden in the crease. He then removes the extra skin and fat, places one or more stitches in the eyelid muscle to raise the eyelids, and then stitches the skin closed. Most of the stitches come out in one week and the rest come out in two weeks. There is usually no pain after the procedure and the recovery period is two days. Dr. Johnson’s goal with this surgery is to produce natural-looking results that truly allow the patient to look, see, and feel their best.
Radiesse® is a filler used to restore volume to the cheeks. By doing so, it can soften the appearance of the nasolabial fold which is the deep line that runs from the corner of the nose to the corner of the mouth. It can also be used to create a more chiseled jawline. Dr. Johnson also occasionally uses Radiesse® to restore volume to the temple area when it becomes hollow. This filler lasts 12-15 months and produces natural. Dr. Johnson applies numbing cream to the area to be treated in order to make the procedure as comfortable as possible. Many patients choose to have this filler done on their lunch break as there is no down time needed.
The Restylane® family of fillers can be used on virtually any area of the face. Restylane Silk® is the finest of these fillers. Dr. Johnson uses this filler to camouflage mild under-eye “bags,” vertical lip lines, and deep glabellar furrows (“11 lines”). Restylane® itself is a filler of intermediate density which Dr. Johnson uses to treat the nasolabial folds (the deep lines that form between the corners of the nose and mouth) and the marionette lines (the lines that start at the corners of the mouth and go downward). Restylane Lyft® is the strongest of these three fillers and Dr. Johnson uses this to restore volume to the cheek area. This family of fillers is composed of hyaluronic acid – a substance we have in our bodies naturally. Each lasts between 6-15 months and delivers beautiful, natural results. Dr. Johnson applies numbing cream to the area to be treated in order to make the procedure as comfortable as possible. Many patients choose to have this filler done on their lunch break as there is no down time needed.
THYROID EYE DISEASE
Thyroid eye disease can have a devastating effect on one’s sense of well-being. In the most severe cases, it can cause loss of vision, double vision, and an eye that is so exposed that it becomes extremely dry. In more mild cases, it can cause a bulging appearance, an unnatural “stare,” swelling, achiness, and sensitivity to light. Each patient is different, with a unique combination of symptoms and signs. Dr. Johnson designs a custom-tailored treatment plan with the goal of allowing the patient to look, see, and feel their best again. Options may involve local steroid injections, oral steroids, radiation, and/or surgery. Quitting smoking has been shown to calm down the disease process, and is recommended to all patients. Dr. Johnson also works closely with therapists to help patients cope with the psychological effects of this condition. He is committed to treating the whole patient to allow them to feel like themselves again.
Trichiasis is a medical condition where the eyelashes turn inward and rub against the eye. This can cause pain, tearing, and blurry vision. If the patient suffers from only one or two misdirected eyelashes, Dr. Johnson can remove them in the office using fine-toothed forceps. More severe cases can require the use of electrolysis or cryotherapy. Sometimes this condition can be associated with entropion (See above), in which case Dr. Johnson performs a surgical procedure to rotate the eyelid and eyelashes outward to their normal, natural position. In most cases, this procedure can take place in the office setting. Therapy for this condition truly allows these patients to look, see, and feel their best again.
Dr. Johnson occasionally sees patients from elsewhere who are unhappy with their fillers and want to have them dissolved. In these cases, Dr. Johnson injects Vitrase® which breaks down the fillers over the course of about two hours. Patients can have the injection on their lunch break, return to work, and by mid-afternoon the filler is gone. This treatment works for Belotero®, Juvederm®, the Restylane® family, Volbella®, Vollure®, and Voluma®. It does not work for Radiesse®.
Volbella® is a beautiful new filler that is used to fill the lips and to treat vertical lip lines. In the past, fillers that were used in the lips tended to produce results that were overdone, unnatural, and artificial. Volbella® is an elegant new addition to the filler family that produces results that are subtle, natural, and sensual. It is composed of hyaluronic acid – a substance that is found naturally in our bodies – and lasts 9-12 months. Many patients choose to have this filler done on their lunch break as no down time is needed.
Vollure® is a new filler that has been approved by the FDA for treatment of the “parentheses” lines that can appear on the face. It is composed of hyaluronic acid – a substance that is found naturally in our bodies. The filler typically lasts over a year and creates beautiful, natural results. Dr. Johnson applies numbing cream to the area to be treated in order to make the procedure as comfortable as possible. Many patients choose to have this filler done on their lunch break as no down time is needed.
Voluma® is a filler that is used to restore volume to the cheeks. By doing so, it can soften the appearance of the nasolabial fold – the deep line that runs from the corner of the nose to the corner of the mouth. Voluma® is composed of hyaluronic acid which is a substance that we have in our bodies naturally. The filler typically lasts about 2 years and leads to beautiful, natural results. Dr. Johnson applies numbing cream to the area to be treated in order to make the procedure as comfortable as possible. Many patients choose to have this filler done on their lunch break as no down time is needed.
Xeomin® is very similar to Botox®; in fact, the active portion in each medication is identical. For this reason, Xeomin® can be used to treat the same exact areas that Botox® does: horizontal forehead wrinkles, crow’s feet, “11 lines,” droopy eyebrows, “bunny nose” wrinkles, “gummy smiles,” and vertical neck bands. The difference between Xeomin® and Botox® lies in the fact that Xeomin® is not attached to a carrier protein and Botox® is not. Dr. Johnson tends to use this product in the rare cases when patients develop antibodies to the carrier protein in Botox®.