Facial Plastic Surgery Questions and Answers: Part 07

Question: Would these changes I want done make me a good candidate for rhinoplasty and an endoscopic eyebrow lift? 
Answer: Much more information is needed, such as a full set of facial photographs from all angles when you are not smiling.  A brow lift is performed when the eyebrow position is low.  It will not make your eyelids more open or elongated.  A closed rhinoplasty approach can accomplish narrowing the bridge line and refining the nasal tip and shaving down the dorsal hump.  Rhinoplasty is 1 of the most difficult procedures to perform correctly in the entire field of cosmetic surgery, so choose your surgeon  based on extensive experience.

Question: How can my asymmetrical eyelids be fixed? 
Answer: Your left eyelid has an extra pleat of skin which can be removed by a unilateral upper blepharoplasty procedure performed under local anesthesia. Your eyelids will never be symmetrical, just improved.

Question: What would be the best procedure for my upper/lower eyelids? 
Answer: The goal of the upper eyelid surgery to remove the excess skin creating the hooded look and lift the crease higher to get the skin off of your eyelashes. The incision is located directly in your existing crease. We use dissolvable stitches for the upper lids. The goal of lower eyelidsis to get rid of the puffiness created by herniated fat pads. We remove that fat through an incision completely on the inside of the lower lid known as a trans conjunctival approach. The Procedure takes approximately one hour under general anesthesia, and then anticipate two weeks of visible bruising swelling.

Question: What will be the best treatment with long term results for my eyes? 
Answer: A full set of facial photographs that are in focus are going to be required to make a determination about being a candidate for upper eyelid surgery and lower eyelid surgery. The primary goal of upper eyelid surgery is to remove the excess skin and a small amount of fat on the inner corners. The primary goal for lower eyelid surgery is to remove the fat bags and sometimes a small amount of skin at rest, not when smiling.

Question: Help! Need suggestion to fix facial skin laxity? (sagging) my lower eye lids starting to sag, my neck is fat! 
Answer:  A lower face and neck lift can  accomplish tightening loose facial and neck skin, lifting the jowls, tightening loose facial and neck skin, and removal of the fatty deposits in the neck along with the platysma plasty to significantly improve the jawline.  The determining factor will be the skin tone present in your neck at age 40.

Question: I just had filler removed, would a lower blepharoplasty help?
Answer: As long as all of the filler has been removed, the photograph demonstrates herniated fat pads in the lower lids creating the puffy look. A trans- conjunctival approach lower blepharoplasty can accomplish removal of those fat bags to rejuvenate your lower lids. There’re two little tiny incisions placed on the inside of the eyelid. No external incision is required. This procedure is performed under a brief general anesthesia, and expect about 10 days of visible bruising and swelling.

Question: Are non surgical upper lower eyelid procedures as good as surgical?
Answer: A full set of full facial photographs including the eyelids is going to be very important to make a determination about being a candidate for surgical or nonsurgical procedures.  In our practice, we do not recommend fillers placed around the eyes, only Botox for crows feet.  The primary goal for upper eyelid surgery is to  remove the hooded and excess skin creating the tired lock.  The primary goal for lower eyelid surgery is to remove the fat bags creating the puffiness in the lower lids.  Seek out a busy facial plastic surgeon who performs slots of eyelid surgical procedures.

Question: 38 year old female. Upper eyelid skin starting to age. Should I get an upper blepharoplasty? 
Answer: The photographs demonstrate hooded skin on your upper eyelids creating the tired look. You are an excellent candidate for an upper blepharoplasty procedure. In our practice, we perform this procedure under local anesthesia as an outpatient procedure. Anticipate 10 to 14 days of visible bruising and swelling after the procedure has been performed.

Question: Is this Ptosis? Can surgery help? 
Answer: The photographs are rather limited, but it does not appear that you have eyelid ptosis. You have very low-set eyebrows and would be a candidate for a brow lift. This would be a cosmetic procedure, not covered by medical insurance since there’s no medical necessity. There are a lot of nuances to the brow lift procedure, so choose your surgeon wisely based on producing natural results.

Question: I’m 60, in great shape. I don’t look or feel 60 but I have lots loose skin under my eyes. What options do I have? 

Answer: A full set of eyelid pictures from all angles are required when you are not smiling in order to make a determination about how best to proceed.  The primary goal for lower of the surgery is removal of the fat pads, and  the secondary goal is to remove any excess skin at rest, not when smiling.  In our practice, we close the lower eyelid incision with tissue glue.


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