Facial Plastic Surgery Questions and Answers: Part 02

Question: 32 year old male – what are my options to reduce the appearance of puffy eyes? 
Answer: First of all you could try a low salt diet to see if that helps with the puffiness in your lower lids. The photographs demonstrate herniated fat pads in the lower lids which usually requires a lower blepharoplasty procedure to improve. A trans conjunctival approach lower eyelid surgery can accomplish removal of those bags with two small incisions on the inside of each eyelid. No external incisions are required. The Procedure is performed under a brief general anesthesia as an outpatient procedure.

Question: Upper eye puffiness and asymmetry – am I candidate for a brow lift, blepharoplasty or something else? 
Answer: There’s always a symmetry in the upper eyelids, both before and after the procedure. Your eyebrow position is normal, therefore a brow lift is not necessary. A conservative upper blepharoplasty procedure can accomplish removal of some of the excess fat creating the puffy look, and a conservative amount of extra skin. In upper blepharoplasty procedure can be performed under local anesthesia As an outpatient procedure.

Question: Which procedure would help minimize the appearance of under eye bags while delivering a more youthful appearance? 
Answer: A trans conjunctival approach lower blepharoplasty can accomplish removal of the herniated fat compartments your lower lids to rejuvenate them. The Incision is located on the inside of the eyelids, no external incision is required unless there’s lots of loose skin present. The procedure is performed under a brief general anesthesia as an outpatient procedure.

Question: Upper blepharoplasty or brow lift? 
Answer: From the photos presented, your eyebrow position is acceptable, so a brow lift would just make you look too surprised permanently. You also have more hooded skin on your right eyelid, and during the upper blepharoplasty procedure a differential amount of skin is removed to make them look more symmetrical. In our practice, we perform upper blepharoplasty under local anesthesia which takes about 30 minutes in our surgery center.

Question: In breast cancer remission would like to undergo upper blepharoplasty and alar reduction Is it ok? 
Answer: Probably best to wait for several months after all your treatments have been completed clearance from your primary care physician to make sure that urine excellent health before undergoing elective eyelid and nasal surgery.

Question: Facial rejuvenation procedures in stages or all at once? 
Answer: At age 50, you’re aging very well. From the photographs, it appears that you really only need your upper eyelid blepharoplasty done. This procedure can be performed under local anesthesia as an outpatient procedure which takes approximately 30 minutes. You do not need a brow lift since your eyebrows are in excellent position. Performing a brow lift would make you look permanently surprised. You do not have any excess fat in the neck jowls or loose skin, therefore you’re not a candidate for a lower face and neck lift procedure.

Question: Suggestions on how to fix my sagging brow? Temporal brow lift? 
Answer: From the photographs presented, you do not have sagging eyebrows, you have hooded upper eyelids. You’re not a candidate for a brow lift, since you would look very surprised permanently. Consider performing an upper blepharoplasty to rejuvenate your upper eyelids. The procedure can be performed under local anesthesia which takes about 30 minutes as an outpatient procedure.

Question: Concerned about eyelid retraction and ectropion – What are the chances of this happening?
Answer: First of all, a transcutaneous lower eyelid surgery can result in ectropion. Consider having the procedure performed as a trans conjunctival approach with the incision located on the inside of your lower lids. We do not recommend fat injections to the eyelids because we have seen very poor results from that procedure. Much more information is needed such as a full set of eyelid pictures to make a determination about a canthoplasty procedure that you’re considering undergoing.

Question: Is there anyway to perform lower blepharoplasty without changing the eye shape?
Answer: A trans conjunctival lower eyelid blepharoplasty accomplishes removal of the fat bags from inside the lower lid. There’s no external incisions, and it does not change the shape of the eye. The procedure simply gets rid of fat bags creating the puffy look. Make sure you seek out a surgeon who specializes in this type of procedure.

Question: How to widen/open my eyes? 
Answer: A full set of facial photographs at rest and in focus are going to be required to make a determination about how best to proceed. From the 1 Limited photo, it appears that there is extra skin in the upper lids and low brow position. You may be a candidate for a browlift.

    Contact Dr. William Portuese