Facial Plastic Surgery Questions and Answers: Part 06

Question: Will forehead lift help wrinkles on forehead, lift the outer brow & reduce migraines? 
Answer: Much more information is as needed such as a Full set of facial photographs from all angles including your eyelids, forehead, and hairline level. A brow lift is performed to raise low set eyebrows. When an eyebrow lift is performed, the hair line need can be shifted upward or downward upon the pre-existing condition of the hairline itself. A brow lift will not help with migraines, and is only done for cosmetic purposes.

Question: I have large round eyes – where exactly do they cut for a brow lift? 
Answer: Much more information is needed, such as a full set of facial photographs demonstrating where your current hairline is, and the extent how low both of your your eyebrow positions are. If you have a high hairline, then the incision is placed at the frontal forelock and the non-hair bearing skin is removed which lowers the hairline. If you already have a low hairline, then the incision is placed behind the hairline. Asymmetry of the eyebrows can also be adjusted in addition to softening the frontalis and corrugator muscles the forehead which create vertical and horizontal lines in the forehead itself. Choose your surgeon wisely based on extensive experience. Our current price list is located on the link below.

Question: Are brow lifts only able to lift laterally and immediately?
Answer: In our practice, a brow lift involves lifting the entire forehead, both medially and laterally. There are many parameters to consider such as raising a low hairline, lowering a high hairline, softening the vertical and horizontal creases in the forehead, and softening the corrugator, frontalis, and procerus muscles in addition to actually lifting the eyebrows. Also important to adjust any pre-existing asymmetries in the eyebrows which is very common.

Question: Can anything be done to improve this eye and brow asymmetry?
Answer: From the limited photographs, it appears that there is eyebrow and eyelid asymmetry due to ptosis present in your left eye. Seek out an experienced ocular plastic surgeon for best results. You do not need a brow lift or a blepharoplasty.

Question: Should I get an upper blepharoplasty or would Botox be enough to fix my issue?
Answer: Botox is best used for the corrugator muscles above your eyebrows and crows feet. It works to temporarily reduce muscle action like scowling. An upper blepharoplasty procedure can accomplish a conservative amount of skin removal from the upper lids with the differential amount of skin to make your upper eyelids look more symmetrical.  The procedure would only give you minimal benefit, since you are so young. If you’re having one eyelid drop-down later in the day, best to take pictures of that  issue and show it to your eyelid surgeon because you may have something called ptosis. From the one limited frontal photograph, there does not appear to be ptosis.

Question: Brow lift recommended for angry eyebrows? I’m 33 years old, what would be the longterm implications be for someone my age?
Answer: The photographs demonstrate low eyebrow position for which a brow lift can improve. The goals of a brow lift are to not only to lift low set eyebrows,  address asymmetry in the eyebrows, and  soften the corrugator muscles above the eyebrows that depress the eyebrows even more when you scowl.

Question: What are the risks of doing a revision after a lower bleph with fat repositioning?
Answer: Revision blepharoplasty is more difficult than a primary blepharoplasty, therefore a full set of eyelid photographs from all angles are going to be required.

Question: What would be the best option to target under eye bags? 
Answer: The under eye bags that you’re referring to are herniated orbital fat creating the puffy look. When they are significant enough, a lower blepharoplasty procedure can accomplish a conservative removal of that fat through a trans conjunctival approach. The Incisions are located completely on the inside of the lower lids. No external incisions are required. The procedure is performed under a brief general anesthesia as an outpatient procedure.

Question: Would I benefit from facelift/ neck and eyelid surgery?
Answer: Regarding your neck, your fat deposits are located both above and below the platysma muscle in your neck. Liposuction is an integral component of a lower face and neck lift, however it can only remove the compartment of fat above the muscle. The majority of your fat is located underneath the muscle which is genetic, and this must be surgically removed. A platysma plasty is also performed to tighten the neck muscles after the fat has been removed. In addition to fat removal in the neck, a face and neck lift accomplishes tightening loose facial and neck skin tightening the SMAS and lifting the jowls. The goal of upper eyelid surgery is to remove the excess skin creating the hooded look, while lower eyelid surgery involves mostly removing fat bags creating the puffy look. Blepharoplasty surgery and a lower face neck left can be performed together under one anesthesia with one recovery period. Look for a facial plastic surgeon with extensive experience rejuvenating the neck. Study your prospective surgeon’s before and after face/necklift photo Gallery to make sure that the results look natural and there is significant change in the neck.

Question: What is causing my dark circles and eye bags? 
Answer: First of all, make sure that your allergies are under good control with nasal sprays and antihistamines. Also try a low salt diet and see if that helps. If the bags are still present after you’ve tried the above measures, it’s due to herniated fat. A lower eyelid blepharoplasty can accomplish a conservative fat removal from the inside of the lower lids. This is known as a trans-conjunctival approach with all of the incisions located completely on the inside of the eyelids.

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