Facial Plastic Surgery Questions and Answers: Part 08

Question: Would blepharoplasty alone take away my saggy droopy eyelid tissue or is a brow lift needed as well? 
Answer: The position of the eyebrows is acceptable, therefore an upper blepharoplasty is all that be required to remove the extra skin waiting down and touching your eyelashes.

Question: What are my options for eye bag removal/eyelid surgery that I’ve had forever? 
Answer: The primary goal of lower eyelid surgery is to remove the herniated fat bags creating the puffy look. The fat is removed through a trans conjunctival approach with the incision placed on the inside of the eyelid. When there’s extra skin present as in the photos, then a pinch technique of extra skin is performed right at the eye lash line. In our practice, we close at incision with tissue glue. No stitches.

Question: Recently developed prominent bag under one eye – filler, or is blepharoplasty the only way? 
Answer: From the one limited photograph, you have herniated fat pads in both eyelids, just one eyelid is worse than the other. A trans-conjunctival lower blepharoplasty can accomplish The fat bag removal from the inside of the eyelid without any external incisions. Choose your plastic surgeon wisely based on lots of experience producing natural results.

Question: What procedures should I consider for my under eye area?
Answer: The photographs demonstrate herniated fat pads in the lower lids. A trans-conjunctival approach lower blepharoplasty can accomplish surgical removal of those fat bags creating the puffy look. The incision is completely located on the inside of the eyelids. No external incisions are required.

Question: Will scarring in one place lead to scarring in another?
Answer: A closed rhinoplasty approach can accomplish making improvements to nose with all the incisions placed on the inside of it.  No external incisions are required, and no painful packing is required either.  Lower eyelid surgery is usually performed on the inside of the lower lids for fat bag removal, and the upper eyelid surgery incision is performed right in the upper eyelid crease and heals very well because the skin is so thin there compared to breast skin which is much thicker.

Question: Would a lower bleph fix my eye bags and line around eye socket? 
Answer: A trans conjunctival approach lower blepharoplasty can accomplish removal of those herniated fat bags in the lower lids creating the puffy look. Make sure you have any allergies under control. The incision is located completely on the inside of the eyelids. We perform this procedure under a brief general anesthesia as an outpatient procedure. Anticipate approximately 10 days of visible bruising and swelling, even though the incisions on the inside of the eyelid.

Question: Dermatochalasis? Should I get a blepharoplasty? Eyebrow lift
Answer: From the limited photographs, the eyebrows appear to be in a normal position,  and therefore  a browlift is unnecessary.  The hooded and extra skin on the upper eyelids can be addressed with an upper blepharoplasty procedure.   This can be done for either cosmetic or functional purposes.  For functional purposes, medical necessity must be met by a physical exam, pictures, and visual field obstruction tests submitted to your medical insurance.  Pre-authorization must then occur with your insurance plan. Anticipate co-pays and deductibles.

Question: Is it possible to affect the sinus cavity when doing a lower bleph with fat repositioning on the lower eye lids?
Answer: Your Sinuses are not affected when performing a lower blepharoplasty. In our practice we do not perform repositioning, simple removal of the herniated fat.

Question: What type of anesthesia is generally used for an older patient seeking an eye lift?
Answer: In our practice, we perform upper eyelid surgery under local anesthesia, however lower eyelid surgery requires general anesthesia, since it would be very painful to remove the fat bags without being asleep. There’s minimal pain and discomfort after the surgery. Anticipate two weeks of visible bruising and swelling. Our current price list is located on our website.

Question: Under eye puffiness/bags/dark circles, is there anything I can do? 
Answer: Photographs demonstrate mild herniation orbital fat creating the puffiness. The best treatment is a trans-conjunctival approach lower blepharoplasty.

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