Commonly asked questions about Botox

Botox is the first and only FDA-approved treatment to temporarily improve the appearance of moderate to severe frown lines, crow’s feet and forehead lines in adults. 

How does it work?

Botox targets the underlying cause of frown lines, crow’s feet and forehead lines by temporarily reducing muscle activity. Facial expressions such as frowning, squinting, raising the eyebrows and smiling, all lead to these unwanted lines and wrinkles. 

Who is a good candidate for Botox? 

If you have dynamic wrinkles caused by repeated muscle contractions in the upper third of the face, then you would be a good candidate for Botox injections. There isn’t a specific age. Often, patients are in their early 30s when they start getting Botox. Genetics and environmental factors also contribute to the level of wrinkle severity and when you can benefit most from Botox injections. 

How long is treatment?

After a thorough consultation, your treatment may take place on that same day and only consist of 15-30 minutes. You may have ice or topical numbing cream applied to the area before treatment to help with any discomfort. 

Is there any downtime?

Botox treatment requires minimal to no downtime. Most people return to their routine immediately after their treatment session. The convenience is one of the reasons it’s such a popular non-surgical cosmetic treatment. 

When will I see results?

Most people see results within 24-48 hours after treatment. Full results appear in 30 days and last for 3-4 months. 

Will I look like I’ve had work done?

Botox injections deliver predictable, subtle results that smooth out lines and wrinkles while you still look like yourself. No one should notice that you’ve had anything done, but they may ask you what you’re doing to stay looking so young. 

If you’ve been thinking about Botox treatment and wondering if it’s right for you, set up a consultation by calling Maehara Eye Surgery & Laser at 808.955.3937. 

9 things you need to know about medical marijuana use

Chronic health conditions make up the majority of qualifying medical conditions to obtain medical marijuana. The application process for a medical marijuana card can be overwhelming.

Here are nine things you need to know about medical marijuana and how to complete the application process:

  1. Cannabinoids in medicine have hundreds of therapeutic uses to improve function and quality of life. 
  2. Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the two main chemicals that are sought after for medicinal use. 
  3. Some of the more common qualifying medical conditions are glaucoma, cancer, lupus, epilepsy, post-traumatic stress disorder, multiple sclerosis, rheumatoid arthritis, AIDS and other chronic or debilitating diseases. 
  4. Cannabis is especially helpful for patients who have glaucoma, as it lowers the eye pressure but for a limited amount of time. 
  5. Cannabis is also effective for eye conditions that come with chronic pain or nausea. 
  6. Some patients have used medical marijuana for long-term treatment of anxiety, chronic pain and other conditions. Some patients who have seizures have said that medical marijuana is the only effective treatment for this condition. 
  7. The State 329 Medical Marijuana license card is necessary for the legal possession and use of marijuana products in Hawaii. This card is recognized only in Hawaii. 
  8. The application process consists of an online application and a physician evaluation. The medical marijuana evaluation takes about 15-20 minutes. After completing both the application and evaluation, the State will issue and mail the 329 medical marijuana license card. It may take 2-4 weeks to get the card. 
  9. You can use your 329 card in one of several medical marijuana dispensaries in Hawaii. There are many ways to use medical marijuana, and it all comes down to personal preference. It can be smoked, inhaled through a vaporizer, eaten in baked goods such as brownies or cookies, placed in drop form under the tongue or applied to the skin as a lotion or cream. 

There is much more to know about medical marijuana. If you are interested in learning more about registering for a medical marijuana license, call 808.955.3937 for an evaluation. 

The latest technique in corneal transplantation

The cornea is known as the “window of the eye,” protecting the eye from infection and foreign material and focusing or refracting light. The cornea needs to be clear and the correct shape for you to see accurately. When it becomes cloudy or misshapen, a cornea transplant may be necessary. Read on to learn about the latest technique in corneal transplantation called the DSAEK procedure.

What is DSAEK?

DSAEK is short for Descemet-Stripping Automated Endothelial Keratoplasty. It is a less-invasive procedure that gives the patient clear vision and a shorter recovery time than with traditional corneal transplantation methods. Conventional surgery requires 16 surgeries and a prolonged recovery time, plus many patients experience astigmatism after surgery, with full recovery taking up to two years.

What happens during the DSAEK Procedure?

During this outpatient procedure, the patient is given topical anesthesia so they don’t feel anything. The damaged endothelial layer is replaced, while the remainder of the cornea is left undisturbed. The new cornea is inserted through a tiny incision that needs one suture for closure. The surgeon then injects an air bubble underneath the cornea to make sure it is centered on the eye.

What is recovery like?

The DSAEK Procedure offers a shorter post-op recovery, fast visual recovery and less chance of rejection than conventional surgery. Patients will take antibiotics and steroid eye drops and return the next day for post-surgical follow-up. Some patients may need a second air bubble injection to re-center the cornea. Patients will need to use eye drops for several years to help with anti-rejection.

What will my vision be like after surgery?

You can expect blurry vision immediately after surgery due to swelling and the air bubble used to center the cornea. When the bubble dissolves and swelling dissipates, your vision will improve. Some patients will need to wear new glasses during healing.

When can I expect full results?

It may take up to three months for your best vision to reveal itself.

If you are interested in learning more about corneal transplants and the DSAEK Procedure, set up a consultation by calling Maehara Eye Surgery & Laser at 808.955.3937.

What’s the difference between Botox and Dysport for wrinkle treatment?

Botox is a household name and consistently the most popular non-surgical cosmetic treatment around. But what about Dysport, which is often compared to Botox. Here, we break down where the cosmetic injections are similar and how they differ.

  • Botox and Dysport injections are both made from the bacterium Clostridium botulinum.
  • Both are considered safe, non-surgical ways to temporarily reduce fine lines and wrinkles.
  • Both cosmetic injections work on dynamic wrinkles, which are wrinkles that form over a contracting muscle.
  • Dysport is FDA-approved for treating moderate to severe glabellar wrinkles, which are the wrinkles between your eyebrows. Also known as “11 lines,” they are especially noticeable when someone frowns. Dysport isn’t recommended for mild glabellar lines.
  • Botox is FDA-approved for treating glabellar lines, forehead lines and crow’s feet around the eyes.
  • Both Botox and Dysport treatments are done in about 15 minutes or less in your doctor’s office.
  • Both wrinkle treatments result in little to no recovery time. You can return to your regular activities after you leave the doctor’s office.
  • Patients may experience temporary side effects, including slight pain, soreness, bruising, numbness or headaches. This applies to both Botox and Dysport.
  • You will start to see results within a few days after Botox or Dysport. Full results appear in 1-2 weeks, and results dissipate after about four months on average. You’ll want to schedule follow-up appointments to get additional treatments to maintain results.
  • Dysport is less expensive than Botox on average, and insurance doesn’t cover either type of cosmetic injection.

Cosmetic injectables are great ways to temporarily turn back the hands of time on your face and help you achieve a rejuvenated appearance without having to go under the knife or endure a lengthy recovery. If you are interested in learning more about Botox, Dysport or cosmetic fillers, set up a consultation by calling Maehara Eye Surgery & Laser at 808.955.3937.

What’s the criteria to be considered a candidate for LASIK?

Laser vision correction, or LASIK, is a type of refractive surgery that can help patients get rid of eyeglasses and contact lenses, but the surgery may not be right for everybody. If you’ve been considering LASIK, read on to learn whether you would be a candidate and what you need to consider as you weight your decision to undergo surgery.

  • You are 18 years old or older. Your vision can change throughout your youth and doesn’t stabilize until you reach adult age. LASIK is FDA-approved for people age 18 and older who have achieved ocular maturity.
  • You have a stable prescription, which means your prescription hasn’t changed for at least two consecutive years.
  • You should be generally healthy, free of diseases, injuries and infections.
  • You do not have pink eye, dry eye or another eye condition. These will need to be resolved prior to LASIK surgery.
  • You are not pregnant or nursing. Hormonal fluctuations can affect vision stability, so it’s important to wait at least three months after you’ve stopped nursing before considering surgery.
  • If you have a condition such as cataracts, diabetes, autoimmune diseases such as lupus or rheumatoid arthritis, LASIK may not be a good choice for you.
  • Certain medications such as corticosteroids and acne medications can affect the healing process, so you will need to share what medications you’re taking when you consult with your doctor.
  • If your cornea is too thin or misshapen, or if you have glaucoma or corneal scarring, you may not be a candidate for surgery.
  • If you have a positive outlook and realistic expectations for vision correction, then you may be a good candidate for LASIK.
  • You understand and you are OK with the fact that you may need to wear glasses when reading or driving at night.

If you want to learn more about laser vision correction and see if it’s right for you, schedule a consultation by calling Maehara Eye Surgery & Laser at 808.955.3937.

How Belotero Balance works to rejuvenate the lower third of the face

So much attention has been paid to the upper third of the face with all the mask-wearing over the last year. But the lower third of the face shows the signs of aging and can make you look older than you are. Between the loss of collagen and elastin as you age, and repetitive expressions such as smiling and laughing, all contribute to lines and wrinkles around the lips and mouth. A cosmetic filler called Belotero Balance will help smooth out lines and wrinkles and help you appear more youthful.

What is Belotero Balance?

Belotero Balance is an injectable gel that is used to temporarily smooth out and fill moderate-to-severe nasolabial folds and other moderate-to-severe lines and wrinkles around the lips and mouth. It’s made of a substance called hyaluronic acid, which is naturally occurring in the skin. It’s formulated into a uniquely smooth and cohesive injectable gel that blends into the natural structure of the skin to fill in those unwanted lines and wrinkles.

Is treatment painful?

There may be some slight pinches as with all injectable treatments, but your doctor can help you with any discomfort you may feel. There is no downtime, so patients can return to their normal activities right after their treatment.

How is Belotero Balance different from other fillers?

It is a hyaluronic acid filler that is designed to integrate into facial skin tissue. Once injected, the soft, cohesive gel fills the skin to smooth out lines and wrinkles. It’s designed for moderate-to-severe lines, but also can treat delicate areas such as etched-in smile lines and vertical lip lines, which are thin lines above and around the lips.

When will I see results?

Like many fillers, you will see results upon treatment. While individual results will vary, it should last about six or more months. Repetitive movement such as eating, talking and smiling may affect how long results last.

Cosmetic injectables can temporarily smooth out lines and wrinkles and help you look more youthful. If you’re interested in learning more, schedule an appointment by calling Maehara Eye Surgery & Laser at 808.955.3937.


What you need to know about glaucoma

Glaucoma is one of the leading causes of blindness for people over the age of 60. When found early, glaucoma can be treated and slow or prevent vision loss. Read on to learn more about glaucoma, the signs and symptoms and treatment options.

What is glaucoma?

Glaucoma is a group of eye conditions responsible for damaging the optic nerve, which is essential for good vision. It is caused by abnormally high pressure in the eye. 

Signs and symptoms

Unfortunately, many forms of glaucoma have no waning signs. The change is so gradual that you may not notice anything is wrong with your vision until the condition has reached an advanced stage. 

If you have frequent, patchy blind spots in your peripheral or side vision or central vision or tunnel vision, you may have open-angle glaucoma. Acute angle-closure glaucoma presents with severe headache, eye pain, nausea and vomiting, blurred vision, halos around lights and eye redness. 

Regular eye exams

If left untreated, glaucoma will eventually cause blindness. Since glaucoma often comes with no warning signs, it’s vital to have regular eye exams. An eye exam should include measurements of your eye pressure. When a diagnosis can be made in the early stages of glaucoma or any eye disease or condition, it can be treated more appropriately. If glaucoma is caught early, vision loss can be slowed or even prevented. 


In addition to getting regular eye exams, it’s important to know your family’s eye health history, as genetics play a role in glaucoma development. Follow a moderate exercise program. Take prescribed eye drops regularly, even if you don’t exhibit any symptoms. Also wear eye protection as serious eye injuries can lead to glaucoma.


If you are diagnosed with glaucoma, the damage done cannot be reversed. Treatment options may include prescription eyedrops, oral medications, laser surgery or traditional surgery. 

If you are concerned about glaucoma and want to learn more about prevention or treatment, it’s important to schedule an eye exam today by calling Maehara Eye Surgery & Laser at 808.955.3937. 

Are you at risk for cataracts?

If your vision has been getting blurry or you have an increased sensitivity to glare, you may be starting to develop cataracts. Over time, this slow-progressing condition will interfere with your vision and may lead to cataract surgery. Can you prevent cataracts? Read on to learn more about cataracts and treatment.

What are cataracts?

The lens of your eye is normally clear. It’s positioned behind the colored part of the eye called the iris. The lens focuses light that passes through your eye and produces clear images on your retina. The retina function like the film in a camera. Age-related conditions and other medical conditions can cause tissues in the lens to break down, causing a clouding within the lens. A cataract develops slowly as the clouding becomes denser and consumes a larger part of the lens. Over time, your vision will become blurred.

What are the risk factors?

Age, smoking, consuming excessive amounts of alcohol, high blood pressure, obesity, diabetes and excessive exposure to sunlight are some of the risk factors for cataracts. Previous eye injuries or surgery also increase your risk. Prolonged use of certain medications may be a factor as well.

Can you prevent cataracts?

While there isn’t a way to prevent cataracts, there are some things you can do to improve your risk factors. Be sure to have regular eye examinations based on your age and family history. If you smoke, quit. It’s important to manage certain health conditions such as diabetes, obesity and high blood pressure that increase your risk. Consume a healthy diet rich in fruits and vegetables. If you drink, reduce your use of alcohol. Be sure to wear broad-spectrum sunglasses that block ultraviolet B rays when you’re outside.

What are the treatment options?

Once your lenses have started to cloud, they will not stop and won’t return to their original clear condition. The only treatment for cataracts is surgery to replace the lenses. Surgery consists of replacing the clouded lens with an intraocular lens implant, or IOL. It’s a minimally invasive, small-incision, no-stitch procedure. Vision begins to improve a few days after surgery, and full healing can take up to two months. If both eyes require surgery, the second surgery will be done 1-2 months after the first surgery.

If you’re concerned about cataracts or other eye conditions, schedule an eye exam today by calling Maehara Eye Surgery & Laser at 808.955.3937.

Why the eyes are getting more attention

With the increasing, often mandated, use of masks to help prevent the spread of COVID-19, there is an increase desire by patients to help wake up tired-looking eyes and reduce the appearance of lines and wrinkles in the upper third of the face. Read on to learn more about Botox treatment and why it may be a treatment you want to consider.

What is Botox?

Botox is the best-selling cosmetic treatment of its kind. It’s FDA-approved to improve the appearance of moderate-to-severe forehead lines, frown lines (what looks like “11” lines between the eyebrows) and laugh lines (crow’s feet around the eyes).

Dynamic wrinkles

Botox treats dynamic wrinkles, which are wrinkles that are formed by repeated facial expressions such as smiling, laughing, squinting or frowning. These wrinkles form in the skin when the muscle beneath contracts. Botox temporarily blocks the nerve signal from reaching the muscle, which relaxes the skin and smooths out wrinkles.

The magic ingredient

Botox is made from the botulinum toxin type A, which is the same bacteria responsible for botulism. It is not harmful, however. Scientists discovered years ago that a tiny injection of this toxin into the muscle can stop the muscle from contracting safely and effectively.

Treatment time

Botox treatment only takes about 10 minutes. You may feel a slight pinch, but most patients don’t feel much or any discomfort. Treatment areas can be iced beforehand to help reduce discomfort.


You’ll see final results in just a few days, and results last for about four months. After that time, the body absorbs the harmless ingredients and muscles will start contracting again. You’ll want to return for follow-up sessions to maintain your results.

Botox can help turn back time without the need for downtime that other wrinkle-reducing procedures may require. To set up a consultation and learn if Botox is right for you, call Maehara Eye Surgery & Laser today at 808.955.3937.

Why choose Bladeless LASIK eye surgery?

LASIK is the most commonly performed laser eye surgery to treat nearsightedness, farsightedness and astigmatism. But how much do you know about Bladeless LASIK? Read on to learn more about this vision correction surgery and why you should consider it.

How does it work?

LASIK, which is short for Laser-Assisted in Situ Keratomileusis, works by reshaping the cornea, which is the clear front part of the eye. Bladeless LASIK uses targeted excimer laser beam energy to gently ablate corneal tissue to correct refractive errors and help patients see more clearly.

Bladeless LASIK is an outpatient procedure that takes only a few minutes to perform on each eye. While you will be given medicine to help you relax, you are awake and asked to focus on a point of light during the procedure. This keeps your eye fixed as the laser reshapes the cornea. Your eyes will have numbing drops, so you will feel no pain or discomfort.

What is recovery like?

LASIK is a popular treatment as there is minimal downtime and little to no discomfort after the procedure. After the procedure, you rest in the office for a short time before a trusted friend or family member drives you home. Once at home, you should rest for a few hours before returning to regular activities. Avoid strenuous activity for at least a week.

What should I expect for results?

Full results may take several months, but you’ll notice significant improvements to your vision immediately after the Bladeless LASIK procedure. Many patients achieve vision that is 20/20 or better, eliminating or reducing the need for glasses or contact lenses.

Am I a candidate?

During your thorough consultation and evaluation, Dr. Maehara will determine whether Bladeless LASIK is right for you or if you would benefit from another procedure. Good candidates are age 18 or older, have had stable vision for at least six months, has a healthy cornea that’s thick enough for a flap, and have treatable refractive errors. Patients also need to have realistic expectations for procedure outcomes.

Interested in learning whether Bladeless LASIK is right for you? Schedule a consultation with Dr. Maehara at Maehara Eye Surgery & Laser today by calling 808.955.3937.