Facial Plastic Surgery Questions and Answers: Part 09

Question: Lower Blepharoplasty – is there a reason a doctor would not remove skin under eye and only do a transconjunctival fat removal?
Answer: From the one limited photo, you appear to be a great candidate for both upper and lower eyelid surgery. The primary goal of upper eyelid surgery is to remove the Hooded and excess skin and a small amount of fat on the inner corners. The primary goal of lower eyelid surgery is to remove the fat bags creating the puffy look. The fat is removed through a trans-conjunctival approach on the inside of the lower lids. At age 61, you’ll most likely need some conservative tightening of excess skin at your age. In our practice, that incision is placed directly below the lower eye lash line, and we close that incision with tissue glue. No stitches are required for the lower lids.

Question: Is there any way to get rid of light eyelid excess skin without undergoing surgery? 
Answer: From the one limited photograph, does not appear that you need an upper blepharoplasty procedure. The only way to get rid of excess skin is to surgically remove it with the incision located directly in the Eyelid crease. This can be performed under local or general anesthesia.

Question: Is alar base reduction during rhinoplasty worth the small changes I want? 
Answer: To make the decision about alar base reduction requires a worm’s eye view of the base of the nose and a frontal view to determine whether your candidate for it.  When patient have wide nostrils, the incision is placed at the base of the nose where the ala attaches to the nostril.  It is a very inconspicuous incision.   A closed rhinoplasty approach can accomplish shaving down the dorsal hump and slightly decreasing the projection of the nasal tip with all incisions placed on the inside of the nose.  No external incision is required and no painful packing is required either.  Best to focus on the largest amount of change regarding your nose with a rhinoplasty procedure which is the hump reduction, not the decrease in tip injection.

Question: 34 years old and unhappy with aging eyes: am I a good candidate for eyelid surgery or a brow lift? 
Answer: Based on the eyebrow position you do not need a brow lift. You have significant asymmetry of your upper eyelids for which an upper blepharoplasty can improve, your eye lids will never be perfect.Differential amounts of skin and fat can be performed to make the eyelids look more symmetric. This procedure came before and under local anesthesia as an outpatient procedure.

Question: Will a blepharoplasty help eyelids that don’t match? 
Answer: A blepharoplasty can improve the asymmetry, but they’ll never be perfect. Differential amounts of skin and fat can be removed make your eyelids look more symmetrical. This procedure can be performed under local anesthesia as an outpatient procedure.

Question: Upper/lower blepharoplasty: should I go to a plastic surgeon with experience in face/skin surgeries or an oculoplastic surgeon?
Answer: Both groups of surgeons can perform excellent eyelid work. Study your prospective surgeon’s before and after eyelid surgery photo Gallery, and make sure that you like the results that you see, and the gallery is very extensive with lots of results.

Question: Would I benefit from a filler under my eye or blepharoplasty?
Answer: First of all, very important to get you allergies under control with medical management, allergy testing and environmental avoidance. Once your allergies are under control, then reevaluate your treatment options. When patients have significant fat bags in the lower lids, a trans-conjunctival approach lower blepharoplasty accomplishes a conservative removal of that herniated fat in the lower lids.  The incision is completely located on the inside of the eyelid.

Question: Is a blepharoplasty alone enough to take away my saggy eyelid tissue? Or is a brow lift in order as well? 
Answer: The photographs are rather limited, so a better set of facial photographs looking directly into the camera be required. An upper blepharoplasty procedure accomplishes removing the hooded and saggy skin in the upper Eyelids. A Brow lift is performed when there is low set eyebrows, and the proposition  of your eyebrows in the photographs does appear slightly low.  A brow lift not only lifts the eyebrow position, it can address asymmetries, and soften the horizontal and vertical frown lines in the  forehead.  Depending upon placement of the incision for the brow lift, the hairline can be raised or lowered. An upper blepharoplasty procedure can be performed under local anesthesia, while the brow lift  is performed under general anesthesia. Both procedures can be done independently or together.

Question: Sun worshipper, lopsided eyes – what procedures would I benefit the most from? 
Answer: An upper blepharoplasty procedure can accomplish rejuvenating your upper eyelids by removal of excess skin and a small amount of fat creating the hooded look. This can be performed under local anesthesia as an outpatient procedure.

Question: Would I be better off waiting to get my lids done knowing eventually I will need my lowers done as well? 
Answer: The primary goals for upper eyelid surgery is to remove mostly skin and a little bit of fat. The primary goals for lower lid surgery is to remove mostly fat bags and a little bit of skin. Your upper lids are certainly ready to do at this point, and you’ll get it nice improvement. You’ll only get a minimal improvement if you perform the lower lids at this time. In our practice, an upper blepharoplasty can be performed under local anesthesia As an outpatient procedure. When we are performing upper and lower eyelid surgery together, Lee perform both procedures under general anesthesia.

    Contact Dr. William Portuese