It's HOT! How to keep heat from destroying your skin

by Andrea L. Algar

We all know that triple digit heat can make us feel heavy, sweaty, labored, tired and in extreme cases can even make us feel nauseous, light-headed or faint, and even physically sick. But can heat affect our skin?

HUMAN SKIN
Photo Credit: medicineworld.org

Heat affects how we feel and what we do. Exposure to heat also can take a toll and effect unwanted changes in our skin. Considering that skin is our largest organ, and does more than you might realize, it's very important that we take care in our exposure to heat.

We all know that sun exposure is a danger in itself because of the increased risk of bad burns and potential skin cancer. But, we also know that it's difficult to escape the heat in Southern climates and especially here in Texas where we now have temperatures in the triple digits.

In order to fully appreciate why you need to protect your skin, you first need to know the facts about the skin you live in!

Skin is AMAZING - Facts about skin you might not know!

• Skin is the largest and heaviest organ in our body
• The average adult has 8 pounds of skin!
• Skin is 70% water, 25% protein, and usually less than 5% fat
• Skin protects everything inside your body (veins, arteries, blood vessels)
• There are 3 layers in human skin: epidermis, dermis and subcutaneous
• Skin is your body's waterproof covering
• Skin is a barrier to harmful chemicals and germs
• Skin is a shock absorber
• Skin moderates your temperature and helps keep you cool in the heat
• An adult has about 22 square feet of skin (the size of a twin bed or doorway)
• Skin helps you retain water 
• Skin produces nutrients and vitamins
• Skin helps prevent infections
• Skin is the organ primarily responsible for our sensory functions (feel/touch)
• Skin is constantly evolving
• We shed about 40,000 skin cells per minute
• Skin self-lubricates
• Skin renews itself once every 35 days
• Skin holds us together!

You can see how skin is a truly amazing and that it is a most necessary and important part of our bodies. What isn't talked about much is the damage that HEAT can do to our skin. 

Heat can rob skin of vital nutrients, making skin look older. With prolonged exposure, fine lines and wrinkles become more pronounced. With age and continued exposure, sun spots (also called age spots) pop up seemingly overnight. What was once beautiful smooth skin is now marred. It is also much more difficult to keep well hydrated.

Heat can also lead to skin problems such as heat rash. Many people are familiar with heat rash in infants and young children, but it also occurs in adults, with the same annoying bumps and blisters that trap moisture under the skin and can itch, cause peeling, and soreness as they burst open. Heat rash can occur anywhere on the body, but is most often seen on the torso, legs, back and neck areas where perspiration can accumulate and cause rashes. If your skin is prone to breaking out (acne), take extra precautions by washing skin periodically with a gentle cleanser and pat drying. Even those not prone to acne can develop a type of acne common in hot weather called acne mechanica.

To minimize negative effects of heat on your skin:

• Use sunscreen (and use it on your face and body)
• Wear protective clothing including hats and lightweight clothing
• Shower to reduce the risk of heat rash and to help keep your core cool
• Use gentle skin cleansers so your skin isn't dried out or irritated
• Gently exfoliate to release trapped irritants and remove dead skin cells
• Use facial and body moisturizers to lock hydration in following showers
• Hydrate from the inside out! Drink lots of water!
• Alternate water with fruit juices and other nutritious beverages 

Quality Sunscreens Rule!

There are a number of excellent sunscreens in SPF ratings that can help keep your skin safe. I love NeoCutis' Journee Day Cream SPF 30 with PSP growth factors (great for those who don't want to look like they're using a sunscreen). And, fantastic for those who must spend time outdoors is the ViDerm SFP 55 Sunscreen with titanium dioxide and octinoxate that provides oil-free and water resistant 98% protection from UVA and UVB rays at the same time providing EGCG antioxidants as well as vitamins A and E.

As a board certified plastic surgeon, San Antonio's Dr. Robert N. Young suggests you get in the habit of using sunscreens every day. He states, "Remember that even the best sunscreens wear off. If you're spending the day at the pool or beach, they also wash off eventually, even if they are water resistant or waterproof. Reapply sunscreens periodically and use them even on overcast days. As you age, you'll be glad you did. Women I see who have protected their skin from the damage of sun and heat age much better and have fewer complaints about their skin."

Bottom line:  Take care of your skin. Although it is forever changing and renewing itself, the damage that comes from the sun and exposure to heat can last a lifetime!

ABOUT THE AUTHOR:
Andrea Algar is an author who writes on topics that interest her. Over the last 30 years she has written articles on a variety of topics and currently contributes to several blogs on a regular basis.

Plastic Surgery Procedures Increase as Trend of "Selfies" Grows

by Andrea L. Algar

We've all seen how the trend of taking "selfies" seems to be out of control. It is now being reported that this growing trend is leading to some pretty unexpected outcomes. Cosmetic surgery is on the rise!

Selfie found on the Internet

The American Academy of Facial Plastic and Reconstructive Surgery as well as the American Society for Aesthetic Plastic Surgery reports that in 2013 Americans spent almost $12 billion on plastic surgery and nonsurgical procedures to enhance their looks. What they didn't report is that procedures such as hand rejuvenation and facial procedures have taken a sudden swing upward. Many are concluding that this is because of the increase in social media and people taking "selfies" which become closely scrutinized.

Certainly the face is important because it is the focus of photos. The hands become important because they're often an unintended object in selfies. People want to put their "best face" forward on social media, whether they prefer Facebook, Linked In, or other sites. But, does it actually change the way we look at ourselves?

Anyone who looks very closely at themselves is apt to find SOMETHING they don't like. Whether it be that their lips are too thin, their nose is too big, or that they lose count on the number of chins they see, our appearance is under much closer observation and assessment. It is now much easier to obsess over perceived inadequacies because we have much more opportunity to see ourselves through others' eyes.

Plastic surgeons are now noticing the change in cosmetic patient coming to their practice for hand and face enhancements...the two areas most noticed in "selfies". Surgical procedures for eyelid surgery and rhinoplasty grew in 2013 at an unexpected rate. And, non-surgical treatments including injections for the face and hands, have grown even more briskly. So much so that it has many industry analysts thinking that minimally invasive procedures will be the next hot trend in plastic surgery.

If the "selfie" trend continues, there's little doubt that men and women of all ages will continue to pay more attention to how they appear to others. Whether it influences more young people to get cosmetic procedures, drives up the number of facial and hand procedures, or even gets more men running for plastic surgery remains to be seen.

What do you feel about "selfies" influence on the way we look at ourselves?

10 Reasons Not To Get Breast Implants

by Andrea L. Algar

San Antonio Board Certified Plastic Surgeon Dr. Robert Young has taken a look at the Top 10 Reasons to Get Breast Augmentation, but recently he's been asked to take a look at the Top 10 reasons why women might NOT want to get breast implants.

We all can safely assume that the prominent reason women want breast augmentation is to increase the size of their breasts. The reasons they choose do so, however, are as varied as the women who get breast implants. Whether a woman chooses saline breast implants or silicone gel breast implants, and whether they choose round, shaped, textured or smooth has little to do with whether or not they decide to get them in the first place.

What Dr. Young has found is that the reasons women delay or avoid getting breast implants boils down to ten or so most-cited reasons.

Here's our list:

"Afraid what others will think" This is actually more common than you might think. Even those determined to get their breasts enhanced often worry about this. Luckily, most people are very accepting of breast augmentation and in fact most forms of cosmetic surgery. Old stereotypes just don't hold up anymore.

"I'm happy with my breasts"  Undoubtedly there may be women who actually are happy with their breasts just the way they are. Or at least it's their story and they're sticking to it!

"Husband/boyfriend doesn't want me to"  This is also more common than you may think. Even with the progress women have made, they still look to their significant other for support and understanding. It's hard to pursue a procedure when the support is not there, although it begs the question of why he does not support it. Insecurity can rear its ugly head if the partner feels you may become more attractive to other men.

"Health conditions"  Certainly this would seem a very legitimate reason. We advise women with health conditions that pose concern to talk to the primary physician they see for that condition and get medical clearance. If they feel it's okay, then you can rest assured that breast implant surgery should be okay for you. Many women with health conditions such as arthritis,

"I don't have the money"  Finances do play a big role in a woman's decision to get the breast augmentation she's been dreaming about. However, there are many options including patient financing with attractive repayment terms that can help make it affordable to women of all ages. Some get help from friends or family who are willing to help as well.

"I can't get time off of work"  Everyone has concerns these days about taking time off of work. You don't want to jeopardize your job, and you don't necessarily want everyone in the office to know that you're taking the time to get your breasts done. Most women we see take anywhere from a few days to a week or two off of work.

"I'm worried about breast cancer and whether the implants will hide something, or maybe even cause me to get cancer."  Mammography has advanced so much over the last decade, and most experienced technicians know exactly how to deal with them. They've developed techniques that don't require the implant-crushing force that old-time visits used to. They're much more comfortable, and radiologists have learned to read the exams better. Studies have shown that there is no evidence that breast implants cause one to get cancer.

"I don't want to look like a clown and be laughed at. I've heard remarks some people make." This can happen, especially when women select implants that are much too big for their body. We encourage patients to try on a variety of sizes until they find those that feel best for them. You'll know whether you're picking something that's too big or that would make you feel clownish. Just remember, there are no set right-or-wrong answers when it comes to selecting the implants that you like best. Visiting a Board Certified Plastic Surgeon who shows you what various size implants would look like on you is a good step toward a satisfying choice.

"I'm athletic and fear they'll interfere with my workouts/sports"  We've seen runners, weightlifters, body builders, cyclists, swimmers, and many other types of athletes over the years. As long as you adhere to your surgeon's advice following surgery (the recovery period), which does require refraining from physical exercise and strenuous activities, you'll soon be able to return to your routines without harm to you or your implants. For some, it can take as many as 8-12 weeks for return to all of your normal activities.

"It will be costly to replace all my clothes"  Again, much will depend on how much you increase your bust line. Small changes of 1-2 cup sizes often do not require a complete wardrobe change. And, you'll find that you'll look forward to going to the store to purchase your new bras and wardrobe items!

Why would a plastic surgeon discuss why you might not want to get breast augmentation? There are pros and cons to everything in life. We know that women don't usually take breast augmentation surgery lightly, and in fact have probably been thinking about it for many years. Weighing your options is key to your ultimate happiness with breast augmentation. Once you take a close look at each of your objections, trying to think of both the negative and the positive to each, you may find it easier to make decisions you're happy with.

ASPS Report Shows Breast Augmentation Top Procedure - Buttock Enhancement and Neck Lift On The Rise

by Andrea L. Algar

More and more Americans are opting to enhance themselves with plastic surgery and cosmetic procedures. According to a new report from the American Society of Plastic Surgeons (ASPS), cosmetic surgery procedures in 2013 were up 3% from the 2012. 15.1 million procedures were performed.

Not surprisingly, breast augmentations and nose jobs (rhinoplasty) are still the most popular surgical procedures. More surprising is how sharply buttock enhancements have risen.  Almost 10,000 procedures took place in 2013, which represent an increase of 16 percent from the previous year. 

According to Dr. Robert Young, "Breast Augmentation continues to be the number one procedure I do. The Brazilian Butt Lift is also a very popular procedure in my San Antonio Surgery Center. I've noticed a sharp increase in them over the last two years. I think women like it because you're eliminating problematic fatty areas (usually the abdomen, hips or thighs) with liposuction, while adding desired volume to the buttock." Also of interest was that neck lifts also rose sharply with more than 55,000 neck procedures performed last year.

In a press release by the ASPS, President Dr. Robert Murphy said, “The demand for plastic surgery remains strong, with our statistics showing increases in both cosmetic surgical and minimally-invasive procedures… With new devices and products hitting the market each year, there are more options and choices available to consumers wanting to refresh their look or a little nip and tuck."

What does this mean for the average consumer? 

Plastic surgery procedures are far more accepted by society than in decades past. Women talk much more openly about procedures they want or have had. The Internet is alive with forums where patients can share stories, ask questions, and get information. RealSelf.com has emerged as a leader in this. With today's world of competitive work environments, even men are getting into the act. Procedures for men are on the rise, and men are losing the fear of having procedures done to enhance their looks or reverse the signs of aging. 

New products, devices and technologies are coming into the plastic surgery field every year that help to make cosmetic procedures more attractive to men and women. There are more options and choices available for everyone. At the same time, because of this, it's more important than ever to research procedures you are interested in and find qualified professionals. The ASPS, ASAPS and other professional associations recommend seeking services from a Board Certified plastic surgeon who has experience with those procedures.

Mommy Makeovers Are Growing in Popularity But What Exactly Are They?

by Andrea L. Algar

The American Society of Plastic Surgeons recently revealed that a whopping 62% of moms in the United States would like to have plastic surgery to get back their pre-baby figures. While it isn't shocking at all that moms would want this, it is a bit surprising that the number is so high.

Money may keep a healthy number of women from actually having their much-wanted surgery, but the high percentage of women wanting to improve their appearance after having children has people looking at why.

Is "looking good" now seen as being more important to women who have had children? Yes, probably. And there's data to back this up. The same ASPS study found that the average age of women seeking mommy makeovers was lower than it was a decade ago. Interestingly, while the age of potential plastic surgery patients lowers, the average age of mommies has actually risen. A CDC study from 1970 showed that the average age for a first-time mom was 21.4. Between 2000 and 2006, that age went from 24.6 to 25 years old.

While it’s hard to pinpoint why moms are becoming more concerned with their appearance after having children, there's no doubt that it probably has something to do with the fact that plastic surgery has grown in popularity in recent years. The procedures associated with mommy makeovers—breast augmentation, tummy tucks, liposuction, and breast lifts—are more advanced than ever.

There is also the fact that plastic surgery is getting talked about more. The old days of hiding a cosmetic procedure have changed dramatically. Not only do you have women sharing their stories with friends, family and co-workers, they're active on the Internet discussing their experiences, asking questions, and even posting photos of their post-baby bodies in hopes of getting opinions from other women and the doctors who specialize in mommy makeovers.

In San Antonio, there has been a dramatic increase in the number of women who are interested in mommy makeovers. Some know the procedures involved, while others know only the phrase. So what exactly is a mommy makeover? Contrary to what some believe, a mommy makeover can vary according to the mom's needs and can be a combination of any of the following procedures:

• breast lift
• breast augmentation
• breast reduction
• liposuction abdomen
• liposuction hips
• liposuction thighs
• tummy tuck

Patients seek out plastic surgery not only to give them physical results, but also to help them get back their self-confidence and how they felt about their body before children. San Antonio board certified plastic surgeon Dr. Robert Young explains, "I'm seeing more women in their 30's who are looking for mommy makeovers. Pregnancy, hormones, changing body metabolism and childbirth takes a huge toll on the body, especially with subsequent births, and weight gain can stubbornly remain for years after childbirth. Most women become concerned as they notice that their breasts deflate and become saggy, hips and thighs fill out, and stretched stomach muscles cause bulging, excess skin and stretch marks. These can rob women of their self-confidence. Often women cannot bounce back even with better diet and increased exercise."

Facts about Mommy Makeovers:

• Mommy Makeover describes procedures to rejuvenate the breasts and abdomen following childbirth(s).
• The goal of a Mommy Makeover is to try and return the body to its pre-baby state.
• Most women who have had children are good candidates for the procedure if they're in good health and have had all of the children she desires.
• A Mommy Makeover may be done in one or two stages depending on the problem areas being addressed and the number of procedures necessary to accomplish the rejuvenation.
• The type of procedures can vary in a Mommy Makeover.

Many plastic surgeons bundle procedures and give some type of discount on the costs. Some are bundled together such as tummy tuck, breast augmentation. These can be a good value, but you need to make sure that all of the procedures being thrown together are ones that are truly needed. For instance, some may require a breast reduction rather than a breast augmentation. You should be able to customize the "package" of procedures so that they best suit your needs and desires.

Because at least two or more procedures are being bundled together for your Mommy Makeover, you should make sure that your plastic surgeon is experienced providing multiple surgeries. Multiple procedures can increase the risk complications. Sometimes it may be necessary to break the procedures up into separate surgeries. For example, if you would like breast augmentation, but need a breast lift, it is often advisable to first have the breast lift and follow several months later with the breast augmentation.

Make sure you have the appropriate child care and help in the home as well. You'll need someone who can help out in the weeks following your surgery while you heal - something you shouldn't try to cheat on. You could be risking your health and increasing the chance for serious complications if you don't follow your doctor's recommendations concerning activities (including housekeeping, child care, lifting, cooking, working, driving, and even sex). Discuss your needs with your surgeon and get specific advice if you foresee difficulties.

My Strange Addiction Reveals Man Who Spent $100,000 to Look Like Justin Bieber

by Andrea L. Algar

I don't know whether to believe it or not. Would you ever consider spending $100,000 to look like a Hollywood star? One man reportedly has, and this is why the TLC television show My Strange Addiction did a recent story on him.

In his attempt to look more like Justin Bieber, the popular show claims this young man has become addicted to plastic surgery. The man came up with the idea when he was 28, realized he was aging and became depressed about it.

Deciding he wanted to look like popular teen star Justin Bieber, he has reportedly spent $100,000 on approximately 100 plastic surgery procedures in his attempt to accomplish this. And, realizing that he hasn't quite reached his goal, he has vowed to continue with even more plastic surgery.

What do you think?

• Is it ever worthwhile to try plastic surgery to look like a star you admire? 
• Does this cross the line of "reasonable" self-enhancement? 
• At what point should a surgeon question whether more surgery is the right thing to do?

WATCH THE VIDEO CLIP:
gawker.com - Man Spends $100,000 on Surgery to Look Like Justin Bieber, Fails

Patient Financing: Care Credit Just Got Even Easier To Use

We try to make patient financing as easy as possible for our plastic surgery patients who would prefer to pay for services over time. It can be an excellent way of building credit while you enjoy the results of your cosmetic enhancement procedures. Care Credit has always been one of the leading sources of financing the cost of plastic surgery for our cosmetic surgery patients.

Many times, patients with "less than perfect" credit who are denied credit on their own, are able to obtain financing by opening a Care Credit account with a co-signer. Sometimes this is not possible. Another option is to become an "authorized user" on another person's account. By having a friend, spouse, or family member add you to their account as an authorized user, you are able to legally access their line of credit without having to qualify solely on your own credit.

Now, Care Credit has improved the system for authorized users by issuing an actual Care Credit card in the authorized user's name. This simplifies using the card in your doctor's office, vet's office, or other places where Care Credit is accepted!

If you chose to use Care Credit as an authorized user at Dr. Young's office, we can now process your payment without the primary cardholder being present. If you are an authorized user on someone else's Care Credit account, contact Care Credit and request your new card.

Many Women Can't Live Without Their Spanx - But Is It Dangerous?

They say that history has a way of repeating itself, and this is yet another example of that. It was just a matter of time before someone would find something wrong with Spanx and other shapewear.

What goes around comes around.

PhotoCredit: 2ndSkin.ie

Think back to the 1950's and early 60's when girdles were a daily necessity for so many women. Yes, they helped create the hourglass figure which was so desirable at the time, but they came under scrutiny too, much to the relief of an entire generation or two of women. Corsets were popular before that, and they, too, disappeared after setting fashion trends for decades. "Shapewear" in one form or another have come into fashion and back out of fashion for hundreds, if not thousands of years.

Thanks in great part to the popularity of Oprah and her vocalSpanx, shapewear seemed to become an overnight sensation in our lifetime. But, perhaps for different reasons that girdles died out over fifty years ago, shapewear is now under criticism for causing a host of potential problems for women who wear them on a regular basis. Among the problems reported by physicians across the country:


WHAT SHAPEWEAR DOES       HOW IT AFFECTS YOUR BODY
Compresses your stomach           Can worsen heartburn and acid reflux
Compresses diaphragm                Can cause pain, shallow breathing, nausea, lightheadedness
Compresses intestines                 Can affect your digestive tract causing bloating, gas, pain
Compresses colon                       Symptoms of irritable bowel and/or incontinence
Restricts blood flow                      Can decrease circulation, increase risk of blood clots
                                                   Develop varicose veins, swollen ankles
Compresses nerves                      Can cause tingling, numbness and pain in legs
Cradles muscles                          Can weaken muscles you are no longer using
Traps moisture                             Increased risks of bacterial or yeast infections

Experts advise that you select any type of shapewear with a goal of proper fit. While style is something we always look at, it is far more important to make sure that you select the right type of garment. If you are prone to acid reflux, for example, you want to avoid a garment that sits right under your bra, as it may worsen your symptoms.If you suffer from gastro-intestinal problems, you may want to avoid a waistband garment, and if you have varicose veins, make sure that the legs are not too tight.

Dr. Robert N. Young adds, "If you have large breasts, you may want to avoid shapewear with thin shoulder straps, as it could worsen back, shoulder or neck pain and cause painful grooves.They can provide excellent support, but should fit right so they don't make your problem worse." While shapewear can temporarily smooth your body, they don't offer lasting solutions. If you have problems with shapewear but can't imagine life without it, Dr. Young points out, "You might want to see if liposuction would be helpful for you."

When shopping for Spanx or any type of shapewear, try different brands as they can vary a lot in fit and body styles. Make sure you can wiggle into your garment without a struggle. Remember you will be pulling the garment on and off several times thoughout the day or evening and it should be something you can do easily.

Are the potential dangers of shapewear worth the risk? Some symptoms can become permanent. Varicose veins don't go away on their own and peripheral nerve damage from extended compression can become constant. It may very well be that it is best to avoid wearing shapewear on a daily basis. Save the Spanx for evenings out and special events where you want to look your best, or to wear with a special dress or slacks that require that special touch.

Drop a comment and let us know what your experience with shapewear has been.

ABOUT THE AUTHOR:
Andrea Algar is an author who writes on topics that interest her. Over the last 30 years she has written articles on a variety of topics and currently contributes to several blogs on a regular basis.

Eyelid Surgeries Can Lead To Temporary Dry Eye Symptoms For Some

by Andrea L. Algar

In my experience, any potential side effects, whether from surgery or a medication, can often be more easily tolerated if you know in advance what the potential complications may be. Not only will it avoid an unpleasant surprise, but you may have the opportunity to identify it quickly and get practical advice on how to handle them.

Eyelid Surgery is known
as blepharoplasty

An article which appeared in the October 15, 2012 Archives of Facial Plastic Surgery addressed the fact that following eyelid surgeries many patients experience "dry eye" symptoms.

Dry eye is definitely an irritating thing to develop. I've had it myself, and not from eyelid surgery. It can be extremely uncomfortable.

Some follow up studies show that as many as one fourth of men and women who have blepharoplasty (eyelid) procedures experience some degree of dry eye following their procedure.

Dry eye symptoms can include:

• stinging or burning of the eye
• scratchy sensation in eye
• a sandy or gritty feeling as if something is in the eye
• feeling like someone is "blowing through a straw" in your eye
• excessive "tearing"
• production of mucus in or around your eyes

Symptoms can range from mild to persistent, but not everyone develops these symptoms and there is no definitive test to determine who will and who will not develop symptoms. That said, it seems that some may be more prone to experiencing dry eye with or without eyelid surgery. Women who are menopausal, just starting hormone replacement therapy or going on birth control for the first time, and men or women who have had difficulty wearing contact lenses may be more at risk.

One of the surprising findings of a study which was performed by a Minnesota facial plastic surgeon on 892 patients over a ten year period, was that dry eye was more common in those patients who had both upper and lower lids done at the same time. It also seemed to indicate that the more aggressive the surgical techniques were, the greater risk of dry eye. Disruption of the "blink", which causes the eye surface to lose some of the lubrication provided by one's blink response, seems to be one of the most probable causes.

The good news is that dry eye is fairly easy to treat. Often, symptoms can be helped with eye drops or ointments. It is not usually an indicator of something bad happening, and should not be cause for alarm. If you develop dry eye following an eyelid lift, make sure you discuss it with your physician at your post-op visit. He/she will be able to help advise you on the best treatment for the type of symptoms you're experiencing.

Eyelid lifts average of $3,000 to $4,000 in the San Antonio area, depending on whether you get two lids or all four lids done. According to the  American Academy of Facial Plastic and Reconstructive Surgery, eyelid lifts were the second most popular type of facial plastic surgery after rhinoplasty (nose jobs) in 2011.  Board Certified plastic surgeon, Dr. Robert Young says, "Eyelid surgery is an excellent way to create a more youthful appearance for men and women at the age where they are starting to notice more wrinkles and loose skin around the eyes. It can shave years off one's appearance. Most patients are extremely happy after their eyelid lift procedures. We've always had women request eyelid lifts as they age, but we've seen a noticeable increase in the number of men wanting eyelid lifts in recent years. It's a relatively easy procedure that produces real results."

Should you be overly concerned about dry eye if you're thinking of an eyelid lift? Probably not. But, it is something to know could develop, and if it does, that there are effective treatments for a problem which is usually very short term.

What do you think? Have you ever considered eyelid lift to refresh your face?

REFERENCE:
Archives of Facial Plastic Surgery, October 2012
WebMD - Dry Eyes: Causes and Treatments