dan landmann before and after eyelid surgery photobook

2

Welcome to the Practice

4 A Personal Note from Dr. Landmann

6 Meet Dr. Landmann

10 Humanitarian Work

18 FAQ - Cosmetic Eyelid Procedures

Surgical

26 Blepharoplasty (Eyelid Surgery)

28 Women : Upper Lids

51 Women : Upper & Lower Lids

59 Male : Upper Lids

68 Male : Upper & Lower Lids

72 Ptosis Repair

injectableS

82 Wrinkle Relaxers

84 Facial Fillers

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A PerSonal Note From Dr. LandmannThank you for taking the first step toward learning more about eyelid surgery. One of my primary roles as a physician is to help educate patients so that they can make well informed decisions. By viewing ‘Before & After Photos’ and learning about eyelid surgery, you are taking an important step in your health. This is something you should be proud of.

I specialize specifically in eyelid surgery and facial rejuvenation. This is an amazing way for you to improve your appearance in subtle, but dramatic ways. Both droopy upper eyelids and puffy lower eyelids can impart a tired or sad look, even after a good night’s sleep. So addressing those features can result in a more alert, energetic and positive appearance. However, eyelid surgery should not change who you are or what your face looks like. As a conservative and minimalist surgeon, I firmly believe that anti-aging procedures should enhance your own features. For the majority of my patients, their main goal is simply to feel better about the way they look. In fact, my favorite compliment is when patients return after surgery and say that their friends keep mentioning that they look more well rested and happy. Ultimately, you should see the improvement - but acquaintances should only see a more rested, more refined and less eye-shadow-smeared version of you.

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Beyond eyelid surgery, there are many anti-aging products that can further enhance your natural beauty. Many of my surgical patients come back and tell me that they are ecstatic about their eyelids, but are bothered by the wrinkles around their eyes, flat cheeks or the lines and folds around the nose and face. In the old days, we would have to do a facelift to address many of these issues. The problem with facelifts is that they involve more risk, more downtime and usually result in a “surgical look”. Now, we have wonderful products like Botox, Juvederm, Latisse, Voluma, Restylane and Radiesse. These are all very safe, can be performed in less than an hour, and involve minimal downtime.

Most importantly, please feel free to ask myself or my staff any questions that you have. As a surgeon, it is my responsibility to provide not only the highest quality of care, but also provide that care in an empathetic, friendly and welcoming environment. Like a true surgeon, I live and dream about cosmetic and reconstructive eyelid surgery. At the same time though, I truly enjoy learning about my patients’ goals, interests and lives. For me, forming that bond and working with patients has been the most rewarding part of being a physician.

Best wishes and I look forward to meeting you,

Dan Landmann, MD

6 Meet Dr. Dan LanDMann

Dr. Dan Landmann is a board-certified New York, New Jersey and Connecticut based Ophthalmologist. He is sub-specialized in Oculo-Plastic Surgery, which focuses on cosmetic & reconstructive surgery of the upper and lower eyelids as well as the face.

His career started in High School, when he was accepted to an undergraduate and a Master’s degree program in Electrical Engineering as well as Medical School. He graduated Magna Cum Laude from this accelerated, combined degree program before continuing to medical school, where he was inducted into Alpha Omega Alpha, the honor society for the top 6% of his medical school class.

meet dr. dan landmann

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UndergradUate

• Tufts University School Of Engineering, Magna Cum Laude• 1st Major: Electrical Engineering

• 2nd Major: Biomedical Engineering

gradUate School

• Tufts University Graduate School of Engineering

• Master’s in Electrical Engineering

Medical School

• Tufts University School of Medicine, Alpha Omega Alpha Honor Society

internShip

• Columbia University College P&S at St. Luke’s Roosevelt Hospital

reSidency

• Tufts Medical Center / New England Eye Center - Ophthalmology

FellowShip

• Tufts Medical Center / New England Eye Center

• Oculo-Plastic, Reconstructive and Cosmetic Surgery

FaSt FactS

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Both his residency in Ophthalmology and fellowship in Oculo-Plastic, Cosmetic & Reconstructive Surgery were completed at Tufts Medical Center in Boston, Massachusetts. This is one of the most prestigious Ophthalmology programs in the country, and is known for hands-on patient care.

Dr. Landmann has expertise in a broad range of surgical procedures, including cosmetic and reconstructive eyelid surgery for the treatment of drooping or malpositioned eyelids, tear outflow obstructions and eyelid cancers. He is specifically interested in cosmetic blepharoplasty of the upper eyelids (for hooding) and lower eyelids (for bags under the eyes).

One of the unique aspects of working with an oculo-plastic surgeon, is the ability to complement surgical procedures with numerous non-surgical procedures. Dr. Landmann is proficient in many anti-aging techniques using Botox and Facial Fillers. These minimally invasive procedures are performed in the office and can frame your eyes and smile beautifully.

Meet Dr. Dan LanDMann

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In his spare time, Dr. Landmann is actively involved in both local and international philanthropic organizations. One of the most rewarding aspects of his medical career has been the ability to volunteer in Guatemala for cataract and reconstructive surgery missions. Most recently, he went in September 2012 and May 2013. He is an avid skier and enjoys traveling as well as building contemporary furniture. As an electrical engineer and entrepreneur, he is currently working on three medical devices for the diagnosis and management of eye diseases.

Dr. Landmann is known for his clinical acumen and surgical precision. But, it is his empathetic bedside manner and philosophy on treating patients with respect, that many patients state was the reason for choosing him as their surgeon. He takes pride in listening carefully to patients, so he can help alleviate any uncertainty by explaining all surgical and nonsurgical options.

All patients that undergo surgery with Dr. Landmann are given his personal cell phone number, as he believes that patients should be able to contact their surgeon easily if they have any questions or concerns. Ultimately, his goal is to provide exceptional care that exceeds expectations.

10 HuManitarian Work

PaSSion and dedication For humanitarian Work

Dr. Dan Landmann is a strong believer in giving back to his community, both locally and internationally. He has volunteered his time at the Boston Food Bank, as a judge for High School Engineering competitions and as a surgeon in Guatemala. Because he was accepted to medical school at the age of 18, he was able to spend a significant amount of time at Tufts University giving back to the local community. He was even elected to be the President of the Volunteering Society and served on the commencement committee for the Jonathan M. Tisch College of Citizenship and Public Service.

Humanitarian Work

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Dr. Landmann just performed cataract surgery on this 53 year old patient who was blind in the left eye (July, 2008).


The organization that Dr. Landmann is most committed to is called

hoSPital de la Familia

What iS hoSPital de la Familia?Hospital de la Familia (HDLF) is an eye hospital located in a remote village in Guatemala. Every 3 months, teams of eye doctors volunteer to trek to Central America to perform vision restoring cataract surgery for patients who would otherwise never be able to see. Established in 1973, HDLF has been providing medical, surgical, pediatric, obstetric and hearing services to over 15,000 patients annually. Dr. Landmann was first given the opportunity to work there during his residency. Since then, he has made it a priority to go back every year!

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Because there is such limited space, a cardboard box is cut out and placed over patients. This serves as an instrument stand.


What We do

Our primary focus in Guatemala is cataract surgery – because it is in high demand, readily curable, cost and time efficient. We provide high quality surgical care to patients who are “legally blind”. Even after years of blindness, patients can often obtain what would be considered ‘legal driving vision’ after a 45 minute surgery. Teams of nurses, doctors, technicians and translators are inspired by their desire to cure blindness in this developing country. The cost to the patient is nominal. Often, they give what they can afford.

ImPact

Blindness caused by cataracts not only affects the individual who is taken out of the workforce, but also the patient’s caregiver, usually a young child who is taken out of school. It is easy to imagine the impact on the family and the community.

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Dr. Landmann operating on a patient.


give the giFt oF viSion

Please help us provide vital medical and surgical services to this impoverished region. All the nurses and physicians that travel to Guatemala pay for their own flights and volunteer their time. So essentially, all donations are used to pay for intra-ocular lenses, medical supplies, surgical instruments, eye glasses or glaucoma drops.

Your donationS Will make a diFFerence

• $25 – Glaucoma drops

• $50 – Personalized eyeglasses

• $75 – Pterygium surgery for scarred cornea

• $100 – Specialized Cataract surgery

• $1000 – Sponsor a nurse or resident

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If you are able to fund or donate a Surgical Microscope or autoclave, then please call 510-235-1121

Please feel free to ask Dr. Landmann or his staff if you would like to make a donation. You can also make a donation directly at www.hospitaldelafamilia.com

Not All Cataracts are the SameUSA Guatemala

Symptoms Blurry vision, glare, problems reading, watching TV & driving

Legally Blind - patients cannot work or feed themselves. Need 24 hour/day assistance

Vision Worse than 20/60Can’t see the “Big E” or even someone waving a hand in front of them. Sometimes, all patients

can perceive is if the lights are on/off

Cataract Like a dirty lens. Able to be chopped up by ultrasound machine

Literally, has the consistency of a small rock inside the eyeball. Opaque, white and solid.

Surgery $100,000 ultrasound machineThe old, “crowbar & the back of your foot”

technique. Frequent flash storms and power outages cripple the ultrasound machine.

Time 15-30 minutes 45-60 minutes

Cost of Surgery $961, with Medicare Can be as little as $15-$20

Barriers to Care

Need to get a ride to the Surgery Center

Some patients come from neighboring Mexico. Some travel as far as 170 miles.

Some walk or ride a bus for 2 days.

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What tYPeS oF coSmetic eYelid ProcedureS doeS dr. landmann SPecialize in? Dr. Landmann primarily performs cosmetic and reconstructive eyelid surgeries. The most common types of surgeries are:

• Upper lid blepharoplasty “Eyelid Lift” - to fix the hooding over the eyes.

• Lower lid blepharoplasty “For bags underneath the eyes” or when there is excess skin underneath the eyes.

• Ptosis repair - when the muscle that opens up the eyelid gets detached, patients are unable to keep their eyes open.

• Mohs reconstructions on the face - when a skin cancer on the face is removed, it must be repaired correctly or the eyelids won’t be able to open and close correctly.

FAQ- coSmetic eYelid ProcedureS

FrequentLy askeD questions

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In addition, Dr. Landmann performs a multitude of other more complicated reconstructive surgical procedures. These include surgeries for eyelids that are turned-in or turned-out, removal of tumors behind the eyeball, trauma, issues related to excess tearing or dryness, thyroid related eye problems, as well as surgeries on the forehead, eyebrows and cheek.

What are the beneFitS oF coSmetic eYelid ProcedureS?These procedures primarily help with the signs of aging - namely when skin becomes too loose, muscles become lax and fat pooches forward. Patients often complain that the excess skin makes it difficult to apply makeup, so by removing the excess skin, patients have a larger lid platform on which to apply makeup. These procedures can also help with the bags underneath the eyes or on the inside corner of the upper eyelid.

hoW much time do theSe ProcedureS take?

On average, procedures performed on the upper eyelids usually take between 30 - 60 minutes and procedures on the lower eyelids take between 60 - 90 minutes.

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Where are the ProcedureS PerFormed?Cosmetic eyelid procedures can be performed in the office or an outpatient surgery center. Regardless of where the procedure is performed, most patients come in the morning and leave by lunch time. Patients do not get admitted to the hospital nor need to stay overnight.

What kind oF aneStheSia iS uSed? When performed in an office setting, local numbing medication is used on the eyelids. When a procedure is performed in an outpatient center, Monitored Anesthesia Care (MAC) is administered by an anesthesia team. Sometimes this is referred to as “Mild Sedation” or “Twilight”. The advantages of this type of anesthesia are:

• It is not General Anesthesia, so a breathing tube and breathing machine are not used.

• Patients recover and feel like their normal selves very quickly.


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Ultimately, Dr. Landmann will take into account your health and the proposed procedure to determine what type of anesthesia will be the safest and most comfortable in each specific situation.

hoW much Pain iS there aFterWardS?

Everyone’s perception of pain is different, so it is impossible to answer that directly. But to give you a framework, here are some key points.

• Dr. Landmann never prescribes prescription pain medications.

• He does recommend taking over-the-counter Tylenol for the first few days after surgery.

• Most patients reported that they stopped using Tylenol after the 2nd or 3rd day.

What iS the doWntime For moSt coSmetic eYelid ProcedureS? Most patients will feel back to normal within a few days, but the patients who take it easy for the first week afterwards usually bruise the least and heal the fastest. It is generally recommended to avoid exercise, heavy lifting, strenuous or stressful activities for 7 days. Most patients go back to work after 6 -7 days. Some patients have the procedure done on Thursday and fly to the Caribbean for vacation on Saturday.

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hoW much bruiSing iS there?

The main bruising will occur during the first two weeks. It usually looks like a ‘shiner’ or a ‘black & blue’ eye. After two weeks, patients can put makeup over the stitches and usually hide the bruising fairly well. Dr. Landmann always advises patients that if they have a big event (like a wedding, a family get together or a TV appearance) then they should schedule the procedure at least 6 weeks in advance. The entire healing process takes a full year, so there will continue to be improvements over the course of a year.

do the StitcheS need to be removed? In the majority of cases, dissolvable stitches are used, so they do not even need to be removed.


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Where iS the inciSion? hoW much Scarring Will there be? For procedures on the upper eyelids, most incisions are made in the eyelid crease. This location is ideal because not only is it hidden, but it also heals incredibly well. During your consultation, Dr. Landmann will show you examples of suture lines in various stages of healing.

What medicationS need to be avoided beFore SurgerY?Dr. Landmann strongly feels that safety is the first step in any cosmetic or reconstructive procedure. So he will take a detailed history of your medications and medical conditions at the consultation. At that time, he will also go over which medications should be stopped before surgery - especially Baby Aspirin or any medication for joint aches or headaches. The most common medications to be aware of are: Advil, Motrin, Ibuprofen, Aleve or Naprosyn. Herbal supplements that need to be avoided are: Multivitamins, Flaxseed Oil, Fish Oil, Gingko and Vitamin E.

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are there anY riSkS? Yes, it is very important to understand that any procedure or surgery has risks, and this should not be minimized. That is why safety is such a vital aspect of every procedure. Doctor Landmann has a great deal of respect for the health of his patients and their eyes. In fact, many patients say that they chose to have their surgery with Dr. Landmann because of his commitment to safety.

The risks for bleeding and bruising are minimized by avoiding certain medications before any procedure and limiting activities afterwards. Infection is very rare and is controlled by meticulous sterile technique during the procedure and using antibiotic ointment on the incisions. Aesthetically, the goal of surgery is to make both eyes look symmetric, however differences in bone structures and soft tissue may cause unevenness. Occasionally, your eyes may feel dry though this is managed with artificial tears and often resolves. Serious complications, however, are very rare. The risk of losing vision is estimated to be less than 1 in 5,000.


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iF i am intereSted, hoW can i Find out more? The best way to learn more about cosmetic eyelid and facial procedures is to schedule a consultation with Dr. Landmann. He will carefully listen to your goals and concerns. After performing a comprehensive evaluation, he will review various before and after pictures and together, you will come up with a personalized treatment plan. Prior to any procedure, it is important to have all your questions answered, so you will have ample opportunity to ask any question and discuss with Dr. Landmann. After every surgery, Dr. Landmann gives every patient his personal cell phone number so you will always have access to him.

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The eyelid skin is the thinnest skin on the body. Over time, it tends

to stretch, sag, wrinkle and get puffy. This has a profound impact

on how we are perceived: tired, listless or angry despite getting

a good night’s sleep.

Cosmetic Eyelid Rejuvenation is a subtle but dramatic way to

improve the signs of aging. By removing excess skin, the natural

beauty and contour of your eyes will be restored. The goal of the

procedure is to create a refreshed and revitalized appearance.

Also, most patients are ecstatic about being able to put on

makeup without it smearing.

blePharoPlaStY (Eyelid Surgery)

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Depending on your anatomy and your personal goals, Dr. Landmann

will customize your treatment plan to achieve a youthful and

harmonious outcome. The procedure takes 30-90 minutes and is

performed in the office or an outpatient center. Patients arrive in the

morning and leave a few hours later. Only mild sedation is needed

– not general anesthesia – so patients recover very quickly. There

is very minimal discomfort – so Tylenol is all that is needed.

If you are considering this procedure, we encourage you to schedule

a complimentary consultation with Dr. Landmann. During your visit,

he will listen to your concerns, perform a comprehensive evaluation

and determine if you are a suitable candidate. He will then discuss

the best management options for you, and together you will create

a customized treatment plan.

28 Dan LanDmann, m.D., m.S.E.E.

[woMen | upper LiDs]Before her Surgery, Patricia had more skin on the right upper eyelid than on

the left upper eyelid. This made applying makeup very difficult. But just three

weeks after an upper eyelid blepharoplasty, performed in the office, there is

minimal bruising. The incision line has not fully healed yet, but this can easily

be covered with makeup.

*Before and After Photos have not been retouched. Results may vary.

31Dan LanDmann, m.D., m.S.E.E.

[BlepharoplaSty | upper LiDs]Notice Maria’s heavy eyelids and thin lashes before using Latisse. Afterwards,

her eyelids regain their definition resulting in a more friendly appearance, while

her eyelashes are longer, thicker and fuller.


[BlepharoplaSty | upper LiDs]Before Eyelid Surgery the skin below the eyebrows sagged and caused a loss

of definition as well as a tired look. Eight weeks after Eyelid Surgery, the incision

line is easily hidden in the eyelid crease with makeup.

Also, notice how some of the lines around the mouth are not as deep and

defined. This was accomplished in the office using a modest amount of

facial filler.


[BlepharoplaSty | upper LiDs]Phyllis has excess skin below her eyebrows, which sags and causes a tired and

sad look. After an Upper Eyelid Blepharoplasty, she has a youthful and more

lively appearance.


[BlepharoplaSty | upper LiDs]Just 6 weeks after surgery, Kathy looks younger now that she is able to wear

makeup. Her eyes look brighter and bigger.



[BlepharoplaSty | upper LiDs]The goal of any cosmetic procedure is a subtle enhancement. One of the best

compliments a cosmetic surgeon can receive is when patients appreciate the

change, but friends can’t tell what happened. Here, just a small amount of skin

was removed, but this effectively removed the hoods over her eyelids.

BEFORE AFTER



[BlepharoplaSty | upper LiDs]This patient had a moderate amount of excess skin, contributing to an angry

and sad appearnce. After undergoing a delicate upper eyelid blepharoplasty,

she has a natural and happier appearance.


[BlepharoplaSty | upper LiDs]This patient is able to do a wonderful job with her makeup after the excess skin

from her upper eyelids was removed. The hollowness underneath her eyes was

corrected non-surgically, with Facial Fillers in the office.


[BlepharoplaSty | upper LiDs]Upper Eyelid Surgery can make a dramatic improvement in a patient’s

appearance at any age. The excess skin weighs down her upper eyelids and

makes it difficult to wear makeup. Afterwards, her eyes are more open and she

has a wider lid platform on which to apply makeup.


Before Surgery One month after surgery and Facial Fillers

A B


[BlepharoplaSty | upper LiDs]


Before filler, notice the hollowness in the Nasolabial Fold Facial Filler has replaced the volume loss. NB the patient does have makeup on.

C D

An Upper Eyelid Blepharoplasty was performed and Filler was placed

underneath the eyelids to fill the tear trough and in the Nasolabial Folds.

One month after getting facial filler to the Nasolabial Folds. Although

she has makeup on, the facial filler has replaced the volume loss in the

Nasolabial Folds.


[BlepharoplaSty | upper LiDs]



[woMen | upper & LoWer LiDs]An upper and lower lid blepharoplasty with removal of skin and fat. Notice the

small lesion in between her right eye and nose. This was a skin cancer that was

also treated by Dr. Landmann.


[BlepharoplaSty | upper & LoWer LiDs]Before the procedure, she had fullness of the upper eyelids and mild puffiness

on the lower lids. Notice how she now has a rejuvenated look that is both subtle

and dramatic.



[BlepharoplaSty | upper & LoWer LiDs]Janice is so happy she can’t help but smile for her “after” picture. Her upper

lids are lighter and the bags under her eyes are gone. Overall, her eyes match

her glowing personality!


[BlepharoplaSty | upper & LoWer LiDs]This patient had large bulges of skin and fat around her eyes. She is able to

wear makeup again after an upper and lower lid blepharoplasty.



[Male | upper LiDs]Blepharoplasty surgery can make a dramatic difference for men as well as

women. These photographs show a businessman who retired, but wanted to

go back to work looking young and aggressive. The droopy lids gave him a

tired and melancholic appearance, whereas after the surgery, he looks sharp

and alert.


Prior to seeing Dr. Landmann, this patient underwent a Direct Browpexy by

another plastic surgeon. His eyelids were still heavy and he was unable to open

his eyes.


[reviSional BlepharoplaSty

| upper LiDs]Dr. Landmann was able to address his

true problem: Excess eyelid skin.

A blepharoplasty was performed and

he is now able to open his eyes.



[Male | upper LiDs]Most casual observers would not know this gentleman had eyelid surgery.

The subtle difference makes a big statement.

BEFORE AFTER


[Male | upper LiDs]


[Male | upper anD LoWer LiDs]



[Male | upper anD LoWer LiDs]Eyelid surgery on men demands a more conservative approach. Removing

a fine amount of excess skin is all that is necessary to acheive an esteeemd

appearance. Bags under the eyes are often worse in men than woman, but

improving them just slightly can go a long way.


[Male | upper anD LoWer LiDs]Three months after an upper and lower lid blepharoplasty.

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Ptosis is a condition that develops when the muscle that pulls open

the eyelid gets stretched out and detached. In the next few photos,

notice how the eyelids are not even able to open. The drooping

of the upper lid can cause a significant decrease in one’s field of

vision. Ptosis Repair can not only help lift the upper lids, but also

restore one’s field of view. This is significantly more challenging than

a simple “Lid Lift” because the muscle that opens the eye needs to

be reattached to the eyelid.

PtoSiS Repair

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[ptoSiS repair]Even at 90 years young, Polly

only had mild bruising just 6

days after her Ptosis Repair.

Doctor Landmann has operated

on patients as young as 3

weeks postpartum and up to

101 years old.


[ptoSiS repair]This patient has ptosis of both the right and left upper eyelids. The muscle that

opens the eyelid is almost completely detached on the left side, so when she was

asked to ‘Look Straight Ahead’ she could barely see anything unless she tilted

her head back. After ptosis repair, her eyelids look natural and function normally.


[ptoSiS repair]Ptosis is a condition that develops when the muscle that pulls open the eyelid

gets stretched out and detached. Before surgery, Tom wasn’t able to open his

right eye, even when pulling it open with his eyebrow. After surgery, you can

see that his right eyebrow is relaxed, but his eye is open.


[reconStrUctive eyelid SUrgery]This patient developed a red lesion on her right upper eyelid. It was biopsied and

found to be a Squammous Cell Carcinoma. If the lesion was simply cut out, then

the eyelid would scar and have difficulty opening and closing. Dr. Landmann was

able to combine both reconstructive and cosmetic techniques to provide her with

both a cure and an excellent aesthetic outcome. He performed a blepharoplasty

on the left upper eyelid and used that as a skin graft to fix the right upper eyelid.

Five months later, there is minimal scarring and the eyelid functions normally.

The outlined area on the top is a Squammous Cell Carcinoma.

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Wrinkle Relaxers can help patients achieve the most aesthetically natural,

restful and smooth appearance possible. The wrinkles around the eyes are

formed by muscles contracting. Wrinkle Relaxers work on these muscles,

whereas fillers and surgery are used to replace volume and remove skin.

These are quick procedures. They take as little as 5 minutes to perform,

and often you can go back to work immediately. The effect develops

within a few days and typically lasts from three to four months. Dr.

Landmann always invites patients to come back two weeks after their

first treatment to ensure that they are 100% happy with their result. Of

course, that appointment and any necessary dosage adjustments are free.

Wrinkle relaxerS

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*Before and After Photos have not been retouched

BEFORE AFTER


BEFORE AFTER

[wrinkle relaxerS | BetWeen tHe eyes]


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LIke the name implies, fillers simply “fill” areas of soft tissue to

flatten wrinkles, fill creases and create a full, youthful contour

to the face. Fillers are used to help fill out skin depressions and

some types of scars.

Dr. Landmann most commonly uses fillers to treat the smile lines

(from the nose to the corners of the mouth) and the cheeks. These

procedures take slightly longer (about 20-30 minutes), but the

result is immediate. Some patients have bruising, but make-up

can be used to conceal it.

Facial FillerS

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BEFORE AFTER

[Facial Filler | nasoLaBiaL FoLDs]


*Before and After Photos have not been retouched

BEFORE AFTER

dan landmann, md, mSeeBoard Certified Ophthalmology | American Board of Ophthalmology | Oculo-Plastic Surgeon

www.DrDanLandmann.com • [email protected] • 201.696.2646

dan landmann before and after eyelid surgery photobook

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