Botox versus Filler

Posted by Dr. Orin Zwick

Oct 9, 2014 11:49:01 AM

What is the difference between Botox and filler? This is a very reasonable question since they are both used to treat facial lines and wrinkles, but there is in fact, a difference between them.

Botox versus Fillers



Botox and its competitor, Dysport, are made from the botulinum neurotoxin, which blocks the action of nerves on muscles. Botox and Dysport are used to treat dynamic wrinkles. Dynamic wrinkles are the wrinkles caused by muscle activity. They are the wrinkles you see when you animate your facial muscles, such as the "11" between your eyebrows when you frown or the lines across your forehead when you look up or raise your eyebrows. The smile lines in the corner of your eyes, also known as crow's feet, are another good example of dynamic wrinkles.

What are fillers? 

Fillers on the other hand, are used to increase the volume of tissue underneath lines and folds. Usually administered to the lower half of the face, fillers are commonly used on the creases that run from the nose to the mouth (nasolabial folds). They can also be used to enhance cheekbones, lips and the area under the eyes. Fillers are used to treat lines that develop in tissues that are normally at rest, versus those treated by the neuromodulators as a result of overuse.

Why you should see an Oculoplastic surgeon for Botox treatments

An oculoplastic surgeon specializes in cosmetic, corrective, and reconstructive surgery of the structures surrounding the eye. These structures include the eyelids, tear ducts and orbit (bony socket surrounding the eye). Oculoplastic surgeons are board-certified ophthalmologists who have completed several years of additional, highly specialized training in plastic surgery. Because of this advanced training, they are especially qualified to assess the impact of the eyelids on the health of the eye.  When it comes to cosmetic treatments, such as Botox®, having a doctor with this level of expertise and knowledge, is reassuring to people.  If you are considering Botox® treatments, make sure your doctor has the experience and qualifications to give you the results you want.

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What are Aesthetic Services?

Posted by Chesapeake Eye Care

Oct 2, 2014 2:22:51 PM

facialAesthetic services, commonly known as cosmetic enhancements, allow a patient to enjoy a more youthful appearance. The eyes are often the first part of the face to reveal visible signs of aging. Skin laxity and descent cause the eyebrows to droop and the upper eyelids to sag and accumulate extra folds. Fat pockets, puffiness and dark circles under the eyes are common complaints. In any rejuvenating process, a well-rounded approach is required to address not only the current aging changes, but also to stress the preventative aspects and identify underlying medical problems.

At our Center, we offer patients a unique medical approach to aesthetic enhancements. Our aesthetic services range from non-invasive skin care applications to microdermabrasion, chemical peels, DermaFrac micro-needling, Botox, facial fillers and surgical procedures.

Aesthetic Services We Offer

Dr. Orin Zwick, our specialist in Oculofacial cosmetic and reconstructive surgery, and K.C. Johansson, our Medical Aesthetician, have teamed up to offer you a unique medical approach to aesthetic enhancements. Whether a patient is seeking medical or cosmetic services, Dr. Zwick and his team address each person’s individual needs. 

Aesthetic Services

  • Botox®
  • Facial Fillers:
    • Juvéderm®
    • Restylane®
    • Voluma
    • Radiesse®
    • Bolotero®
  • Latisse®
  • DermaFrac
  • Chemical Peels
  • Microdermabrasion
  • Skin Care Products

Skin Care Products

We offer products to address all types of skin from dry to oily to sensitive. Each product line utilizes different ingredients and ranges of strength to address specific needs.

Our skin care product line includes:

  • SkinMedica
  • ZO Medical
  • Glytone
  • Avene
  • Colorescience

In any rejuvenating process, a well-rounded approach is required to address the current aging changes, as well as identify any underlying medical problems and discuss possible preventative measures.

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What Are My Oculoplastic Surgery Options?

Posted by Dr. Orin Zwick

Aug 19, 2014 2:51:00 PM

Oculoplastic surgery is a highly specialized field that includes cosmetic and reconstructive surgery of the eyelids and surrounding areas. It also includes a wide range of aesthetic and medical services, such as upper or lower eyelid surgery, eyebrow surgery, and orbital area surgery. It encompasses facial rejuvenation procedures – more commonly known as cosmetic enhancements - like Botox®, facial fillers and various skincare treatments.

Oculoplastic surgery is performed by Dr. Orin Zwick, in our private, state-of-the-art surgical suite located at our Annapolis office. In most cases, oculoplastic surgery is performed as an outpatient procedure with sedation or local anesthesia.  Aesthetic enhancements, like Botox and facial fillers are administered by Dr. Zwick in our office. We aim to provide the most advanced technology, treatments and best surgeons in a comfortable setting to provide our patients with a top-notch experience.

Here's what you need to know about your oculoplastic surgery options:



Whether a patient is seeking medical or cosmetic services, our goal is to address each person’s particular needs while simultaneously achieving a natural, harmonious look to complement each individual’s features. Because of the unique function and anatomy of the orbital area, it is essential to have a skilled oculoplastic surgeon perform these services.


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Rebecca Pearson Shares Her Life-Changing Eyelid Surgery Experience

Posted by Chesapeake Eye Care

Aug 12, 2014 10:00:00 AM

zwicktestimonialHow did you hear about Dr. Zwick? 

Rebecca: He was referred to me by my doctor and I was able to get an appointment sooner than I expected.

What made you decide to have eyelid surgery?

Rebecca: I found that I was turning my head further to the right and left while driving and suspected I was losing a portion of my peripheral vision.  

What was your biggest fear before surgery?

Rebecca: I was concerned about the expense of such a procedure, but actually my insurance covered it.

What was your life like before eyelid surgery?

Rebecca: I felt that I didn't have as wide a scope of vision as I used to have. It was not just when glancing from side to side, but also when looking up. It was as if I was wearing a visor all the time.

How has eyelid surgery impacted your life?

Rebecca: I have a wider scope of vision and also feel that things are clearer, perhaps due to my non-hooded eyelids allowing more light to enter my eyes. As an artist, light is very important to my work. So many things I paint are inspired by the places I visit and the beauty of nature. My improved sight is definitely reflected in my artwork.

Are there activities that you now do, that you might not have done before eyelid surgery?  

Rebecca: Well, I'm looking forward to going snorkeling to see what a difference there will be!

What was your recovery like?

Rebecca: The first two days were uncomfortable and I didn't look great, but I followed all of Dr. Zwick's instructions and was amazed at how quickly the incisions healed.  

What would you tell someone who is considering eyelid surgery?

Rebecca: Don't put it off. Have the exam and Dr. Zwick will assess your individual need for surgery. wasn't expecting anything other than improved vision, but I'm happy to note improvement in how I look. My eyes appear less tired and I can now see the eye liner and eye shadow that I apply. Prior to the surgery, I had stopped wearing eye make-up because when my eyes were open, the excess skin on my lids covered up the make-up. This improvement was an unexpected bonus.

Why did you decide to have Dr. Zwick perform your surgery?

Rebecca: The staff was great - very polite and helpful. Dr. Zwick was very patient in answering all my questions. When you're in his office, you feel like he's completely focused on you - and you never feel rushed. I also appreciated Dr. Zwick’s follow-up phone calls after the surgery. I was disappointed when he said I didn't have to come back! That's how good I felt about my visits.

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What is Latisse?

Posted by Dr. Orin Zwick

Jul 29, 2014 3:30:00 PM

18665579_sLatisse is the first FDA-approved prescription drug for growing longer, fuller lashes. 

Latisse has the same formula as the glaucoma drop, Lumigan. Lumigan is one of several drugs in a category known as prostaglandin analogs, which help to lower the eye pressure in patients with glaucoma. A side effect is the tendency to make the eyelashes longer and fuller. This side effect is the whole premise behind the new product Latisse, and it definitely works. 

Latisse can treat hypotrichosis, or reduced eyelashes, by increasing their growth including length, thickness and darkness. This eyelash growth is believed to occur by increasing the percent of hairs in, and the duration of their growth phase. Specific instructions are supplied with the medication and it typically takes about 12 weeks to see full results. 

As with all medications, there are rare but possible side effects which should be discussed with your physician. These include:

  • Increased brown iris pigmentation.
  • Skin color darkening.
  • Itching, redness and irritation of the eyes. 
If you have an interest in learning more about this product, you can schedule a consultation to find out if Latisse is right for you. 

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Meet Our Medical Aesthetician - K.C. Johansson

Posted by Chesapeake Eye Care

Jul 15, 2014 3:50:00 PM

johanssonK.C. Johansson, a medical aesthetician, joined Chesapeake Eye Care and Laser Center in 2012. She brings a wealth of experience to our practice and holds certifications in microdermabrasion, chemical peels, endermologie, and skin diseases and disorders. She is also certified in several Chinese specialties, including face and body reading, reflexology, stress therapy and aromatherapy.


At Chesapeake Eye Care and Laser Center, KC is part of the team that carefully evaluates each patient and offers a variety of advanced treatments to address his/her individual needs. Our practice offers different grades of chemical peels, crystal-free microdermabrasion and LED light therapy. Chesapeake Eye Care and Laser Center is also the only practice in Maryland to offer DermaFrac micro-needling.

KC's services include:
  • Microdermabrasion
  • Chemical Peels
  • Brightening Facials
  • DermaFrac Micro-Needling
  • Skin Care Consultations
  • Skin Care Products  

Skin Care Products

After thorough evaluation of many skin care companies, Dr. Zwick and KC have selected a series of medical-grade skin care products for different skin types. These products may be used for a daily skin care regimen or may be part of a doctor-recommended pre- and post-surgical skin care regimen to supplement the natural healing process.


DermaFrac is an effective and affordable combination of four therapies designed to improve wrinkles, fine lines, acne, acne scars, brown spots, enlarged pores, dry skin and uneven pigmentation. The treatment is customized to each patient’s unique skin using one machine to deliver micro-needling technology, serum infusion and LED light therapy treatments.


Microdermabrasion is an extremely useful tool in non-surgical skin conditioning that immediately improves the skin's appearance. Treatments are mild, yet highly effective at brightening the skin. This progressive exfoliation treatment resurfaces the skin by removing the outermost layer of dead cells to address sun damage, minimize pores and correct uneven skin tone and texture. It also helps reduce fine lines around the eyes, lips and neck. Most treatments take 30 minutes and are performed in a relaxed atmosphere.


Facial Peels

Melanage Mini Peel

This peel is designed to improve the overall tone and texture of the skin, lessening the appearance of hyperpigmentation, fine lines and breakouts. It can be used to treat darker complexions.

Gloss Peel

The Gloss Peel treatment refreshes stressed skin with a unique synthesis of cell turnover enhancers and Vitamin A. The peel is complemented with a take-home product kit precisely tailored to maximize the result of the treatment. The Gloss Peel restores one’s youthful glow with minimal effort.

SkinMedica® Illuminize Peel

This peel is appropriate for first-time chemical peel patients or those looking for a gentle, superficial peel to make their skin brighter and more radiant.

SkinMedica Vitalize Peel

The Vitalize Peel is suitable for all skin types and for patients with moderate skin conditions including sun damage, fine lines, wrinkles, acne, acne scarring and melisma. This peel requires little to no downtime and produces predictable, noticeable results.

SkinMedica Rejuvenize Peel

The Rejuvenize Peel is a superficial peel designed for moderate to severe skin conditions. This peel penetrates the deeper layers of the epidermis and produces the most amount of exfoliation.

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What is the difference between Botox and fillers?

Posted by Dr. Orin Zwick

Jul 9, 2014 9:00:00 AM


Botox® and fillers are both non-surgical cosmetic products that help to rejuvenate the face in complementary ways. 

How Botox® works


Botox® works by relaxing the muscles of the face that cause “dynamic wrinkles”, wrinkles caused by the repetitive movement of an area.  It works great for the lines that form in between the eyebrows, the “crow’s feet” or smile lines and deep forehead lines caused by raising our eyebrows. 

After numbing the area with ice or cream, Botox® is given as an injection into specific target muscles to limit their movement and thereby soften the lines. 

How Fillers Work


There are many different fillers used to improve deeper lines around the face. These products are composed of a gel material that can improve volume in areas of the face that are deficient. After a topical numbing cream or nerve block, they are injected beneath the skin and are especially useful for improving the contours around the mouth.  They can be injected into the lips, cheek areas and eyelid hollows to enhance their volume and contour. 

Botox® and fillers serve a separate but unified purpose, to create a subtle and refreshed appearance to the face without surgery.

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Rejuvenating the Aging Face

Posted by Dr. Orin Zwick

May 20, 2014 5:24:00 PM

aestheticsThe approach to cosmetic eyelid surgery and facial rejuvenation has undergone a change in recent years due to a better appreciation and understanding of the aging face.  Thorough evaluations and photographic comparisons of patients in younger years help identify individual aging changes, such as loss of volume, drooping eyelids, unwanted puffy pockets and prominent lines.  Patients no longer desire a drastic plastic surgery look.  A natural result with noticeable improvement and youthful rejuvenation is the ultimate goal. 

It is evident when reviewing past photographs of patients that two main issues occur with age – decent and deflation.  As children, our faces are plump and full of fat, the overlying skin is tight with strong elasticity and wrinkles are not present at rest.  With time, fat tends to deflate and unfortunately sometimes becomes more prominent in other unwanted areas.  Additionally, skin loses its elasticity and tight texture.  After years of dynamic facial movement, wrinkles become deeper and sustained even at rest.  This accounts for the deep furrows that occur in between the eyebrows, on the forehead and around the eyes.  With descent and deflation, the folds along the sides of the mouth become more prominent, the lips become smaller and turn in, and lines above and around the lips are more noticeable. 

Aging changes of the upper face include:
  • Eyebrow drooping
  • Eyelid skin that hangs down over the eyelashes
  • Sunken upper eyelid contours or prominent herniated fat. Sometimes a weak eyelid that drops over the pupil and can block vision. 

Changes of the lower lid can include:

  • Puffy pockets
  • Skin wrinkles
  • Dark circles or pigmentation and laxity of the support structure. 
Genetics and environmental factors contribute to the variability of how each person ages.

Treatment requires an understanding of the individual concerns and addressing them with a multifaceted approach. From an outward-in concept, it is important to first address the skin.  Many medical grade cosmetic skin products are available to help improve tone, texture, pigmentation and sun-damage that our skin sustains. This requires maintenance and protection from future damage. Chemical peels, facial treatments and microdermabrasions are slightly deeper ways to enhance the underlying appearance. Non-surgical treatments including botulinum toxins, such as Botox, and fillers like Juvederm and Restylane are the next logical step to improve both the dynamic facial wrinkles of the upper face as well as the deeper facial furrows of the lower face that occur from volume loss.  Cosmetic upper and lower eyelid and eyebrow surgery can provide a significant refreshed appearance. 

Surgical procedures are specifically tailored to each individual to achieve the most natural result.  When considering eyelid surgery, it is important to consult with an Oculofacial plastic & reconstructive surgeon.


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What is Blepharoplasty Surgery

Posted by Dr. Orin Zwick

May 8, 2014 9:30:00 AM


Blepharoplasty surgery, also known as eyelid surgery, enhances the appearance of the upper eyelids or lower eyelids. With blepharoplasty surgery, patients achieve a more rested, youthful look.  Equally important, patients whose vision has been compromised by the drooping skin can regain their field of vision. 

Cosmetic eyelid surgery is increasingly common, with more than 200,000 eyelid surgeries performed in 2012 alone. 

Reasons for Eyelid Surgery 

Eyelid surgery is performed for both cosmetic and medical reasons.  It depends on the patient’s need and personal desire.  Patients seeking a more rested, youthful appearance, elect to have cosmetic eyelid surgery to address excess fatty deposits or loose sagging skin that has caused their eyes to droop and make one look tired and old.  For those whose vision is impeded because of their drooping lids, it may be medically necessary to have surgery. 

Given time and gravity, the thin layer of skin and muscles that surround the eyes weaken and begin to sag.  Prior to surgery, it is important to have a thorough consultation with an oculoplastic surgeon to determine which surgery is appropriate to address these changes. It may be a result of excess skin (dermatochalasis), weakened eyelid muscles (ptosis) or even weakened eyebrow muscles. 

In the case of droopy, excess skin in the upper eyelid area, a blepharoplasty is the appropriate course of action.  Loose skin can create folds and distort the natural shape of the upper eyelid and, in some cases, saggy skin can impede one’s field of vision.  An eyelid lift surgery can, therefore, bring the natural shape of your eyelid back while ensuring a full field of vision, including peripheral vision.

Lower eyelid surgery (lower eyelid blepharoplasty) can be very effective in correcting bags or puffy pockets under the eyes, skin laxity, hollow depressions or remedying a lower-eyelid droop. Through either an internal and/or external eyelid incision beneath the lashes, skin can be tightened, fat can be removed or contoured and the eyelid can be supported to help improve the overall appearance. In some cases, a medium depth acid peel will be performed in conjunction to help with skin tightening.  There are a host of changes that occur to the lower lids over time, exacerbated by genetics, sun damage and other environmental factors.  Each patient requires a thorough evaluation to determine which factors contribute to their appearance. 

Is Eyelid Surgery right for me?

The first step in determining if eyelid surgery is right for you is to schedule a thorough consultation with an Oculoplastic surgeon.  During that appointment, it is important for the surgeon to determine the cause of droopy lids and the patient’s desired outcome.  The eyelids and their surrounding area are a delicate part of the face, but selecting an experienced surgeon with a track record for delivering great results, there are several outpatient surgical procedures that can help open the eyes and improve the overall appearance of the upper face.

Results and Recovery Time  

Blepharoplasty is an outpatient procedure.  Typically, the procedure is done with sedation and local anesthetic. An incision is made in the creases of the natural upper eyelid to remove excess skin and fat. For lower eyelid surgery, either an internal or external incision is made beneath the lashes to tighten skin and remove excess fat.  Bruising is usually minimal and patients may expect to return to work in approximately one week.


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Why go to an Ophthalmologist for Botox treatments?

Posted by Dr. Orin Zwick

Apr 22, 2014 12:00:00 PM


With more people seeking a refreshed, youthful look, Botox® has become a hot commodity.  What people may not realize is the importance of finding a qualified person with experience and training.  An interesting, but not well known fact is that Ophthalmologists are the most experienced administrators of Botox®.  

For over 20 years, ophthalmologists have been using Botox® to treat a variety of eye conditions, including eyelid spasms and eye muscle disorders.   When Botox® is injected into the eye muscles, it reduces their movement and can be very effective in aligning the eyes.  When injected for eyelid spasms, it can help limit the overactive blinking.  Patients who were treated for spasms noticed that it also helped soften their wrinkles.  This realization led to the use of cosmetic Botox®.

Botox for Cosmetic Purposes

So, how does this experience relate to Botox® treatments for cosmetic purposes?  Botox®, a non-surgical cosmetic product, is used to relax the muscles of the face that cause “dynamic wrinkles” which are the result of repetitive muscle movements. Botox® works great for treating the “l l” lines between the eyebrows, “crows feet” or “smile lines” and deep forehead lines caused by raising our eyebrows.  After numbing the area, Botox® is injected into specific target muscles to limit their movement and thereby soften the lines.  It is the experience that ophthalmologists, particularly oculoplastic surgeons, have with these complex muscles that sets them apart from other Botox® administrators.

What is an oculoplasic surgeon?  

An oculoplastic surgeon specializes in cosmetic, corrective, and reconstructive surgery of the structures surrounding the eye. These structures include the eyelids, tear ducts and orbit (bony socket surrounding the eye). Oculoplastic surgeons are board-certified ophthalmologists who have completed several years of additional, highly specialized training in plastic surgery. Because of this advanced training, they are especially qualified to assess the impact of the eyelids on the health of the eye.  When it comes to cosmetic treatments, such as Botox®, having a doctor with this level of expertise and knowledge, is reassuring to people.  If you are considering Botox® treatments, make sure your doctor has the experience and qualifications to give you the results you want.  

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