Botox vs. Xeomin: Which is best for me?

It’s no doubt that Botox is a household name as it’s the most popular non-surgical cosmetic treatment around. Xeomin is a similar injectable made from the same botulinum toxin, but it’s important to know which one is best for your needs as they have some differences. Here we break down the differences between both. 

Botulinum toxin type A

Botox and Xeomin are made from the botulinum toxin type A, which is the same bacteria that cause botulism. While Botox and Xeomin both relax muscles in the treatment area, Xeomin is made only with the botulinum toxin and no other ingredients, thus getting the name “the naked injectable.” Botox contains additional proteins.


Some people have a condition called blepharospasm, in which they experience involuntary muscle spasms and contractions of the muscles around the eyes. Xeomin is an effective treatment for blepharospasm. It is injected into the muscle, blocking the signal from the nerve and effectively stopping the spasms. Treatment takes about 15-30 minutes and starts to work within a few days after injection. Effects or results last for up to three months, at which point you may need to return for treatment. 

Lines and wrinkles

Botox is the worldwide choice for the temporary reduction of lines and wrinkles on the upper third of the face, but Xeomin may be substituted for patients who have a reaction to the proteins in Botox. 

Botox works on dynamic wrinkles that form on the skin when the muscle beneath the skin contracts. These wrinkles are caused by repeated expressions such as laughing or frowning. Forehead lines, frown lines or 11 lines between the eyebrows and crow’s feet around the eyes can all be successfully treated with Botox. Similarly to Xeomin, treatment only takes 15-30 minutes, results appear in a few days and last for about 3-4 months. You may need additional treatment to maintain results. 

To learn more about cosmetic injectables and how they may help you with your cosmetic concerns or functional needs, call 808.955.3937 today to schedule an appointment.

Smiling blond woman wearing a striped shirt

Questions you should ask when considering LASIK

If you’ve been thinking about laser vision correction, you may have a lot of questions about this state-of-the-art technology that is constantly evolving. Here are seven of the most common FAQs about LASIK that you may not know to ask. 

  1. Am I at the optimal age and stage in my life to have LASIK? You will want to wait until you are an adult, usually in your mid-20s, before considering LASIK surgery. You’ll also want to wait to have surgery if you are pregnant, breastfeeding or going through menopause as your eyes and visual acuity fluctuate. 
  2. Are my eyes stable for the last 1-2 years? Your doctor can confirm whether you are a good candidate by looking at your contact lens or glasses prescription and results from recent exams. 
  3. Can my refractive error be too much? LASIK is FDA-approved to treat certain degrees of farsightedness, nearsightedness and astigmatism. If your refractive error is too severe, laser vision correction may not be for you. 
  4. What results can I expect? It’s important to have a healthy outlook and realistic expectations for the outcomes of your laser vision correction. Your doctor can walk through any concerns you may have. It’s important to ask about what the best and worst case scenarios may be for your outcomes.
  5. Do I have any eye conditions or health conditions that may postpone having LASIK done at this time or rule it out completely? Your doctor will go through all of your health history and current conditions and concerns, so it’s important that you share all the details to make sure you are a good candidate for laser vision correction.
  6. What does recovery look like and what adjustments will I need to make for a successful recovery? Your doctor should tell you what to expect and how to prepare for recovery at home and when you can return to work and other activities. 
  7. What does LASIK cost? Your doctor should share with you all of the costs involved in laser vision correction, potential retreatment and any other appointments that may be necessary. 

To schedule your consultation for LASIK, call 808.955.3937 today.

People body language facial emotion expressions people person concept. Close up portrait of excited lovely delightful cute confident manager making ok sign isolated on gray background coy-space

Will I need Botox or dermal fillers to improve the appearance of wrinkles?

Botox is the most popular non-surgical cosmetic treatment in the world and a household name, but cosmetic fillers have gained so much popularity for their ability to smooth out lines and wrinkles and fill out hollowed areas in the face and give patients a more youthful appearance. Here’s the differences between Botox and dermal fillers and how they can help you reach your aesthetic goals.


Botox works on dynamic wrinkles, which are wrinkles that form in the skin over a contracting muscle when we laugh, smile, frown or squint. Botox injections relax the muscle temporarily, smoothing out lines and wrinkles in the upper third of the face, primarily frown lines, forehead lines and crow’s feet around the eyes. 

You will see the results within just a few days after Botox treatment, which last up to four months or longer. At that time, you’ll want to return for additional treatment to maintain or prolong results. 

Dermal fillers

Dermal fillers such as Juvederm reduce the appearance of lines and wrinkles and folds while smoothing skin for an improved appearance. Dermal fillers address static wrinkles, which are wrinkles that are ever present on the skin. These wrinkles are caused by the slowing production of collagen, thinning skin, and the effects of aging and environmental factors on the skin. 

The results of dermal fillers are immediate and last anywhere from six months to a year or longer, depending on the type of filler and the area treated. Supplemental touch-up treatments may be necessary to maintain results, similar to Botox. 

Botox and dermal fillers are both popular treatments because they don’t require the need to go under the knife, provide impressive results and don’t require any downtime. Most people return to their work and other regular activities after their appointment.

Botox and dermal fillers can be used separately or together to help you achieve a more youthful appearance. If you’d like to learn whether Botox or dermal fillers are right for you, call 808.955.3937 to set up an appointment and learn more.

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.