Facial Plastic Surgery Questions and Answers: Part 01

Question: Would AccuTite help address under eye bags and circles?
Answer: Noninvasive treatments are not going to make the 6 herniated fat compartments in your lower lids go away. A trans-conjunctival lower blepharoplasty can accomplish removal of those fat deposits creating the Puffy look. All The incisions are on the inside of the eyelid and the procedure is performed under a brief general anesthesia as an outpatient procedure.

Question: Volbella removed surgically?
Answer: It is not possible to remove fillers while performing a lower blepharoplasty. Best to have it reversed with Vitrase 2 weeks before lower eyelid surgery.

Question: Will a cheek implant or fat grafting address my flat mid-face area or would I need a lower eyelid lift as well?
Answer: From the photos presented, there does not appear to be a flat mid- face and the fat volume in your mid-face appears acceptable. Cheek implants are placed for patients who have a flat maxilla and a flat mid face offer permanent augmentation to that area. The Implants are placed through an intraoral approach under a brief general anesthesia as an outpatient procedure.

Question: Doing lower eyelid surgery to get rid of wrinkles. Will the old scar stay or should it be removed?
Answer: Much more information is needed, such as a full set of facial photographs of the eyelids. The primary goal for lower eyelid surgery is to remove the fat creating the puffy look. If there is excess skin in the lower lids, a pinch technique can remove it. It’s difficult to remove wrinkles in the lower lids since only conservative amount of skin can be removed in that area.

Question: Brow lift versus upper lid excess skin removal, any suggestions? 
Answer: The height of your eyebrows from this one limited photograph are adequate, therefore brow lift is unnecessary. An upper blepharoplasty procedure can accomplish removal of excess skin on the upper lids and making them look more symmetrical. A lower blepharoplasty procedure can accomplish removal of the fat that is creating the puffy look on the lower lids.

Question: Crease across my forehead droops downward – would a temporal brow lift help? 
Answer: A full set of photographs of your eyes and forehead are required make make a determination about how best to proceed. The primary goal for upper blepharoplasty is to remove the excess skin resting on your eyelashes creating the tired look. A brow lift procedure can accomplish softening the vertical and horizontal lines of the forehead in addition to lifting low set eyebrows. You can also try Botox in your forehead first to see if that relieves both the vertical and horizontal lines before a surgical brow lift.

Question: What can I do to minimize the appearance of drooping eyes caused by aging? 
Answer: An upper blepharoplasty procedure can accomplish removal of the extra hooded skin and a small amount of fat from the upper eyelids to rejuvenate them. This procedure can be performed under local anesthesia as an outpatient procedure.

Question: 68 y/o interested in eyelid surgery – would transcutaneous or transconjunctival blepharoplasty deliver best results?
Answer: For over 30 years, we have performed all fat removal through a trans- conjunctival approach with the incision placed on the inside of the lower lid to remove the fat deposits. If and when there’s excess skin located on the outside, then a very small incision is placed directly below the eyelash line and a very conservative small pinch of skin is performed. We close that incision with tissue glue. No stitches. Transcutaneous lower blepharoplasty can create with scleral show and ectopion at your age. The transcutaneous approach weakens the lower eyelid muscle and is not advisable.

Question: How can I fix my a symmetrical face?
Answer: Everyone has some degree of facial asymmetry, and the asymmetry in your eyebrows is normal. You can try Botox to help with some of the asymmetry on a temporary basis. A closed rhinoplasty procedure can accomplish straightening the nose, shaving down the dorsal hump, and refining the nasal tip with all of the incisions placed on the inside of it. No external incisions are required. Digital computer imaging to be helpful to understand what can be accomplished with your nose upon your facial features.

Question: What is the difference between a surgical brow lift and a thread lift?
Answer: A surgical brow lift accomplishes either raising the hairline or lowering it depending upon placement of the incision, in addition to raising the eyebrows themselves for low set eyebrows. This corrugator muscles and frontalis muscles can also be softened to help with the wrinkles in the forehead. This is a permanent solution to both vertical And horizontal wrinkles in the forehead and is performed when patients have low set eyebrows. Threadlifts are only temporary since this it’s nonsurgical and the threads dissolve within a couple months.

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