The most important health tips


´╗┐Dear Dr. Seckel, Is eyelid rejuvenation the same as reducing circles and drooping under the eyes? I'm not sure about this. My problem is under my eyes which makes me look tired and older. Do I need a blepharoplasty or eyelid lift? Thank you, Florence, Boston, MA.

June 28th, 2006

Dear Florence,

Thank you very much for your inquiry about eyelid rejuvenation.

The short answer to your question is yes, eyelid rejuvenation refers to the correction of loose skin, puffiness and dark circles under the eye which makes a person look tired.

Some patients who only have wrinkles and old looking skin can be made to look much better with a Laserlyte peel also called an ActiveFX Laser Peel and Botox. We are the only center in Boston who has experience with this eyelid rejuvenation technique. The Laserlyte peel or Active-FX Peel with the Lumenis Ultrapulse Encore CO2 Lyte is the newest and best technology available.

Most patients however need an eyelid rejuvenation procedure called a blepharoplasty to make the lower eyelid look refreshed and young.

I also use the laser to do this procedure and use a modern technique called a transconjunctival laser blepharoplasty which involves a tiny incision on the inside of the eyelid to correct the aging changes. The benefit is that there is no visible scar on the outside of the eyelid and the natural shape of the eyelid is not changed.

Most other Plastic Surgeons do this operation through a scalpel incision on the outside of the eyelid which leaves a scar and changes the shape of the eyelid.

Finally, to remove dark circles under the eyes we do a procedure called an arcus marginalis release and fat grafting or tear trough implant to plump up the dark circle. This is a new technique and is also done through the inside transconjunctival incision.

I would be delighted to offer you a complimentary consultation in Boston to discuss your situation.

Please call Michele at 617-262-2208 if you would like to come in for a consultation.


Dr Seckel



Nail Patella Syndrome (NPS) is a form of rare genetic disorder. It causes impairment of bones, joints, nails and even kidneys. An absence or immature kneecaps and thumbnails are responsible to cause Nail Patella Syndrome in an individual. Statistics of government agencies and hospitals says that one in every 50000 newborn babies is affected by this disease.

Scientists have established the close relation between glaucoma and nail patella syndrome. At several circumstances it has been found that a newborn affected with this rare disorder has no thumbnails or underdeveloped thumbnails. The mother of such babies and other family members has also found with an absence of thumbnails in most of the medical examinations. However, it is not clear yet, whether glaucoma directly relates to the mutation of NPS gene or it is the deficiency of a separate gene linked with the gene of nail patella disorder.

Sign and Symptoms of Nail Patella Syndrome

General Symptoms- Some of the general symptoms of Nail Patella Syndrome (NPS) are

1. Low peripheral eyesight

2. Blind spots

3. Requires frequent change of spectacles

4. Blurred vision

5. Sore or red eyes or both

6. Seeing rainbows or halos around light source

7. Extreme headache, nausea and eyes pain in some of the cases

If you have any of the above symptoms, it may be because of Nail Patella Syndrome. Go for professional medical help to fix the problem.

Pathological Symptoms- Nail Patella Syndrome (NPS) is identifiable at two different systems, namely; Musculoskeletal and Renal.


Nails- About 80 to 90 percent cases of nail patella syndrome (NPS) show dystrophic nails. Normally nails are found absent or deficient. Some of the symptoms are discolored nails, kolinonychia, longitudinal ridges, triangular lunulae. Fingernails or thumbnails are generally affected.

Knees- Knees patella closely associates with osteoarthiritis, osteoarthrosis and the knee weekness. About in 60% cases knee patella is either found absent or hypoplastic. An after displacement on knee flexion some time also called knock ' knee deformity can also be found.

Elbows- Deformity in elbow is not common, but aplasia, hypoplasia, posterior process at distal ends of humerus with increased angle, limit to extension and suppination is found in some of the cases.

Pelvis- Horns or sours can be found in llic bone and these are detectable by X-rays only. These are pathognomic form of Nail Patella Disorder (NPS).


Renal diseases are closely associates with nail patella disorder (NPS). Studies and hospital surveys shows that about 10% patients of NPS have renal disease. Foremost renal manifestations are: microscopic hematuria, nephritic or minimal proteinuria, edema and hypertension.


The treatment for Nail Patella Syndrome (NPS) and glaucoma varies vastly patient to patient. It also depends on age factors etc and the fact that the patient is either newborn or an young person or an old age person. Although, there is no remedy to cure the glaucoma and NPS fully, but it can be controlled with the expert medical help. There are so many procedures like eye drops, pills to swallow, laser techniques, and surgery. However it is very importance to provide regular and periodic treatment to the affected person.