Custom chin implant

Double eyelid tape and glue – an Asian lid crease without surgery

Double eyelid tape creates an Asian crease without surgery

double lid NY








How do you get an eyelid crease without going under the knife? You use tape or glue.  There have been countless times here in my cosmetic eyelid surgery practice in NYC that patients have come in with lid tape to achieve a double eyelid or to create symmetry between the two eyelids.  Many of them will eventually have surgery which is more permanent.

How does eyelid tape work ?

There are many different types of eyelid tape on the market, some using thinner strips, some more tranparent, and some are barely noticeable.  They work by forcing the eyelid skin to crease and at the same time they expose an area of eyelid platform, framing the eyes and making them appear to be more open.

Some varieties of eyelid tape come with an applicator so the tape can be evenly applied at the desired level with consistent a consistent pressure and shape:

wand lid tape








Is lid tape only for Asians ?

Anyone can use eyelid tape to attempt to raise the fold of upper eyelid skin.  I’ve seen it used successfully to reduce sagging of extra skin in non-Asians.

Tape vs. eyelid surgery

Eyelid tape has some downsides.  The adhesive on the tape can become an allergen, causing redness and itching of the eyelid skin.  It can also fall off during the day, and it can sometimes be visible to others.

Using eyelid glue also has risks, including getting glue in the eyes which can lead to an injury.

Surgery has it’s own set of risks but in general, eyelid surgery is safe although it does have a recovery period which can be a week or more.  I’ve seen an increasing demand for Asian eyelid surgery in my NY practice as there is a large Asian population in New York City.

What about creasing tools?

Because there is such a popular demand for double lids in Asia there is a big market for gadgets that are meant to create a more defined lid crease. Some of these gadgets look like medieval torture instruments but made in colorful plastic hues.

There is no evidence that repeated pressure with a creasing tool will help to define an eyelid crease.  If anything, they could induce eyelid ptosis, or a droopy eyelid if there is excessive, repeated pressure on the eyelid.


If you are interested in improving your  eyelid crease definition and tape just isn’t doing it anymore, seek a consultation with a cosmetic eyelid surgery expert that is experienced with double eyelid surgery.



Cannula tear trough filler under eyes for dark circles and eye bags

Cannula tear trough filler

Eye bags and dark circles may be present from birth or can develop with age.  They make us look older and more tired.

In my NYC practice I fill the so-called tear trough to minimize hollowing under the eyes and to soften the under-eye contour.  Filling this area makes the eyes look less tired.

Here is what a tear trough is: it’s a valley under the eyelid that contributes to shadows, dark circles, and the appearance of under-eye bags.  I describe it at more length here.  It is caused by the tight attachment between the eye closure sphincter muscle (orbicularis oculi) and the rim of bone under the eye.

The cannula tear trough filler treatment is a way to minimize or eliminate eye bags without surgery.

See this example:

filler under eye

Another example:

How is cannula tear trough filler done ?

An injection delicately and precisely places a biocompatible material under the skin to lift the sunken area.

There are a few filler types available (Restylane, Juvederm, Restylane Lyft, Belotero, Volbella, Vollure,  etc.), and these consist of gels that are packaged in a syringe or a tube.  At the tip of this tube is a needle or a cannula that delivers the gel in the right place.

Restylane is arguably the best filler for the under-eyes.

Read this article to hear more about why Restylane is the best for under eyes based on my experience with thousands of treatments over more than 12 years.

Needle vs. cannula

A needle is the traditional way of performing filler treatments.  It has a sharp tip and works with a high degree of accuracy.

A cannula is similar to a needle but the tip is not sharp, it is blunt and rounded.  The cannula eye lift has a few benefits:

1. Cannulas can be less likely to cause bruising after filler treatment

2. Cannulas may be less painful than needles

3. Cannulas may require less entry points because they tend to be longer than needles

4. Cannulas may be safer than needles because it is less likely to puncture a blood vessel and inject filler where it doesn’t belong

Which one do I use?

I use cannulas for the tear trough, mainly because of the improved safety and reduced risk of bruising.  Here in NYC, my patients want to be able to return to their busy lives with minimal recovery time.  The cannula makes that much more likely than needle treatments for eye bags.

However, I don’t use cannulas for every filler treatment I perform because certain situations are better suited for needle injections (e.g. shallow fine lines, acne scars, surgical scars).

Example of cannula eye lift with Restylane immediately after one side was completed:

eye bag cannula

How long does the cannula eye lift last?

After under-eye Restylane treatment, you should expect a year or more of improvement in the appearance of eye bags.  If the upper cheeks are filled at the same time, the results can last longer due to the improved volumetric support.

Surgery or filler for eye bags?

Aside from the cannula eye lift, there are both surgical and non-surgical ways to improve the under eyes- I created an infographic that helps you decide if fillers or surgery are a better option for you.  You can find it by clicking here.

Before and after cannula eye lift with Restylane

eye bags filler

eye cannula
 under eye filler

cannula eye lift

Getting the cannula eye lift in NY

When patients come in for the cannula eye lift, they often have their initial consultation and their treatment on the same day.  The entire procedure takes about 15 minutes.  I highly recommend you see a cosmetic eyelid surgery specialist (oculoplastic surgeon) for the procedure.  A good portion of my practice is devoted to correction of eye procedures performed elsewhere by non-eyelid specialists (revision procedures) and this includes correction of under-eye fillers that were incorrectly administered.  It’s best to get it right the first time but if you do encounter an issue a fix is usually possible.

Phone: 212-882-1011

dr. brett kotlus cream safe topical

How to find out if your skin cream is safe

Is your skin care product safe?

When a product is applied to the surface of your skin, it has the potential to be absorbed into your bloodstream.  Not every cream can penetrate deeply enough to cause bodily harm, and this ability depends on multiple factors including the chemical nature of the product, the resistance of the outer layers of your skin surface, the length of exposure, and others.

Some creams are designed to penetrate the skin

A skin-lightening agent or a collagen-boosting cream is meant to access the middle layer of the skin in order to do its job.  In order to be effective, some of these products are chemically designed to get through the outer protective skin layers.  In doing so, the ingredients may penetrate deeply enough to contact the dense network of blood vessels and capillaries (tiny vessels) found in the face.

Which ingredients are potentially toxic

Many of the components of anti-aging creams and moisturizers that have known toxicity are stabilizers and preservatives.  The major offenders are parabens and pthalates.  Newer nanoparticle formulations have also been called into question.  The risky ones are too numerous to list, but fortunately, someone has already screened the most popular products for you…

There’s an app for that

I recommend 2 smartphone apps that can scan your skin products and give you a rundown of the ingredients and their known safety.

I looked up Regenerist Advanced Anti-Aging Night Recovery Moisturizing Cream by Olay and found “moderate risk” for developmental/reprotoxicity and “high risk” for allergy.  The ingredients with restrictions included butylparaben and ethylparaben.
skin deep

EWG’s Skin Deep app can be found for both Apple and Android devices.

think dirty

The Think Dirty app is available for Apple devices.


Virtual reality and cosmetic surgery with Google Cardboard

Your smartphone can be a virtual reality headset

Google cardboard was unveiled at the 2014 developers conference and made a giant stir by showing the world that virtual reality is accessible and relatively inexpensive.  A piece of folded cardboard becomes a headset when combined with an app platform that can show virtual tours, immersive video, and interactive 3D simulations.

Virtual reality and cosmetic surgery comes together

Surgeons have used reconstructed 3-dimensional images for years now, to aid in visualization of complex anatomic structures and in planning of surgery approaches.  Many standard CT scans can be formatted in 3D and manipulated on computer screens, but these are displayed in 2D.  With a VR headset, the 3D images come to life and can be rotated and studied from any angle.  For cosmetic surgery, where shape, perspective, and relationships are crucial, virtual reality is a powerful evaluation and planning tool.

Imagine walking into your doctor’s office…

Your 3D photo is taken and sophisticated software changes the shape of your face, morphing your cheeks and under-eyes to re-create the appearance you had 10 years ago.  Almost instantly, your image is uploaded to a virtual reality headset and your doctor inspects the changes from every angle.  Slight adjustments are made and the data is sent to a 3D printer that creates a customized implant that is instantly injected under your skin, making the simulated rejuvenation a reality.

This scenario isn’t far away.