Custom chin implant

How to fix a droopy eyelid

3 mistakes to avoid when getting lip filler

Lip filler injections can be great or gruesome

Lips that look done usually don’t look very good.  Over-plumped, distorted lips were somewhat popular several years ago but now most consumers seeking lip enhancement want a more natural look.  Here in NYC, my patients don’t want to be stared at just because their filler treatment went overboard.

This is where Restylane Silk comes in.   It was FDA-approved for lip plumping and to soften the wrinkles that form around the lips. It’s different from regular Restylane because it’s softer, which is perfect for the lips.

Like many of the popular wrinkle fillers it’s made from hyaluronic acid which is safe because it’s a substance that is naturally in the body.  Restylane Silk will last for about 9 months and it is reversible with an enzyme injection.

How to avoid fake-looking lips

I made the video above to convey the 3 most important ways to avoid the overdone lip look.  It’s crucial that you and your injector are on the same page when it comes to aesthetics.  You have to tell them what you like and what you don’t like.

In general, you want to:

1. Avoid too much filler and use legitimate fillers (not industrial caulking!)

2. Respect the shape of the lips and don’t try to completely change their shape

3. Keep it subtle and make small changes at a time and pick a provider that is experienced and well-trained

The mini-lip fill

The modern lip enhancement is a subtle, beautiful thing.  A mini lip fill uses just enough filler so the lips look plump but they still look like your lips and they definitely don’t turn heads in a bad way.

The best fillers for lips are Juvederm, Belotero, Prevelle Silk, and now Restylane Silk. Each of these fillers is reversible, meaning you can take them away with a simple injection (hyaluronidase) whenever you like.

How the lip filler treatment works

When I perform lip filler on my patients, I recommend a local anesthetic to help numb the area.  The lips are extremely sensitive.  I place very thin layers of the filler (a soft gel) under the mucous membrane of the lips.  Occasionally I will outline the edges of the lips and fill the philtrum to enhance the cupid’s bow, that curve at the middle of the upper lip.

The treatment takes about 10 minutes.  While bruising is uncommon, it can occur and it may last for a few days.  Some swelling is also normal for the first week after the treatment, but this is usually not very noticeable.

juvederm lips

Before and After lip enhancement with filler injection








Brett Kotlus, M.D.

135 E. 71 street

Phone: 212-882-1011

This is what happens when you get an eyelift

What happens during eye lift surgery?

Eye lifts are done to make the eyes look younger, less tired, less heavy, and less baggy.  It’s what I do the most of in my cosmetic practice in NYC.  So what does the eyelift involve?


It’s an outpatient procedure

You don’t have to stay overnight, and it’s done in an accredited surgical suite.  The total operating time for just the upper eyelids is under an hour, longer if the upper and lower eyelids are done together.

To make the upper eyelids look younger, a thin strip of skin is removed and the eyelid is sculpted on the inside by shaping the fat and muscle.  Then stitches are used to close the skin and to improve the contours of the eyelids.

Downtime can be 1 – 2 weeks

Some people look great after a week (which is usually when any stitches are removed), but others may have bruising and swelling that lasts longer than a week.  The vast majority of my patients use only Tylenol for some mild discomfort during the first week of healing after their eyelift.

Will an eyelift make me look strange?

A natural-looking eyelift surgery will only make you look strange during the early healing time- so perhaps a few weeks.  Over-done eyelid lifts when too much skin or fat was removed can make your face look different.  A key is finding a surgeon you trust and has specialized eyelid training.  Their before and after photos should provide examples of results that match your goals.  And they should be able to tell you if your expectations are realistic.  These are issues I focus on when I see prospective clients in my offices in NY.

The goal of cosmetic eyelid surgery is to rejuvenate the eyes without calling attention to the fact that something was done.  The results can be nothing short of amazing.  Click here to see what I mean.





How do you put ointment in your eyes after surgery ?

Putting ointment in your eyes

It sounds tricky but there is an easy way to apply ointment in your eyes after surgery.  After a lower eyelid lift (blepharoplasty) when the incision is created behind your eyelid or the transconjunctival approach, Dr. Kotlus prescribes an ointment containing antibiotics or a combination of antibiotics with steroids. These ointments are safe for contact with the surface of the eye.

The tube

The ointment tube will read “ophthalmic use” and it should not be confused with other medications in your house, and special care should be taken to keep it separate from any tubes of super glue!

Using the tube

The tip of the tube should not touch your skin or the surface of the eye.  In a mirror, use your index finger on one hand to gently pull downward on your lower eyelid.  With the tip of the tube near the edge of the eyelid, very carefully squeeze and allow a thin strip of ointment to reach the eyelid; approximately 1/4 inch long.

If the ointment is on the eyelid margin or very close to it, you can then blink several times and it will work its way over the surface of the eye including the incision area.

It is common to use this ointment after cosmetic lower blepharoplasty.  In his Manhattan and Westchester offices in NY, Dr. Kotlus routinely  uses the transconjunctival approach to the lower eyelid fat pads.

The video above shows exactly how the ointment can be applied.