Facial Plastic Surgery Questions and Answers: Part 1

Question: Would a lower transconjunctival blepharoplasty Eyelid Surgery help me? 
Answer: The photographs demonstrate herniated fat bags in the lower lids, and you’re a Candidate for a trans conjunctival lower blepharoplasty to remove those fat bags creating the puffy look. The incision is located completely on the inside of the lower lids. The procedure is performed under a brief general anesthesia as an outpatient procedure which takes approximately 30 minutes. Anticipate two weeks of visible bruising and swelling.

Question: Should I or should I not get fat transfer/repositioning with my lower blepharoplasty? 
Answer: In our practice we do not perform fat transfer on the lower lids, and only on specific instances on the upper eyelids. We do not perform fat injections in the lower lids either. Consider a straightforward trans conjunctival approach lower blepharoplasty for fat removal. The procedure is performed under general anesthesia which takes approximately 30 minutes. Anticipate approximately 10 days a visible bruising and swelling. The incisions completely located on the inside of the eyelids. No external incision is required.

Question: Aging eyes – What are my options with my upper and lower eyelids? 
Answer: An upper and lower blepharoplasty can accomplish significant improvement to rejuvenate your eyes. The primary goal of upper eyelid surgery is to remove the extra skin and a small of fat located in inner corner. The incision is placed directly in the upper lid crease. Regarding the lower lids, the primary goal is to remove the fat bags creating the puffy look. The fat is removed through trans conjunctival approach on the inside of the lower lids. When there’s excess skin present on the lower lids, a pinch technique is performed to tighten the lower lid skin, and we place tissue glue on that incision at the eyelash line.

Question: Do I need a brow lift?
Answer: You only have a small amount of eyebrow ptosis on your left eyebrow. If the position of your eyebrows bothers you a lot, then consider a brow lift procedure. Very important not to get over-elevated because you’ll look permanently surprised. One option would be to just perform your upper eyelid surgery to make your eyelids look more symmetrical, which can be done under local anesthesia as an outpatient procedure. If the position of your eyebrow still bothers you several months after the eyelid surgery, then consider a brow lift.

Question: Brow lift or eyelid surgery? 
Answer: The position of your eyebrows is acceptable, therefore, a brow lift is not necessary, otherwise you’ll look too surprised permanently. An upper blepharoplasty procedure can accomplish increasing your upper lid fold if you want to put more eye shadow make-up on.

Question: What would you do to improve my face?
Answer: The photographs demonstrate a recessive chin, fat deposits in the neck, and hooded upper eyelids. Consider placement of a chin implant to augment your chin forward for better facial balance and proportions. The fat deposits in your neck appear to be located both above and below the platysma muscle in your neck, so a neck lift procedure with a platysma plasty would be required to significantly improve your jawline. An upper blepharoplasty would help your hooded upper eyelids. All three procedures can be performed under one anesthesia with one recovery.

Question: Can eyelids be lifted twice?
Answer: A full set of eyelid photographs are required to make a determination about being a candidate for a revision eyelid surgery. The short answer is yes, they can be done twice in your lifetime when there’s enough skin on the upper lids to do so. In our practice, upper eyelid surgery can be done under local anesthesia as an outpatient procedure.

Question: Should I seek treatment for my under eye bags?
Answer: To make any determination about being a candidate for lower eyelid surgery requires posting of photographs of your eyelids from all angles. In our practice, the fat bags are removed through a trans conjunctival approach on the inside of the lower lid.

Question: Upper Bleph + Under Eye Filler? 
Answer: From the pictures presented, you are only a candidate for an upper lid blepharoplasty. We do not recommend fillers in the lower lids, and your lower lids look great anyway In our practice, an upper blepharoplasty can be performed under local anesthesia as an outpatient procedure, which takes about a half an hour. The incision is located directly in your upper eyelid crease.

Question: Is it a brow lift required to achieve symmetry with an upper blepharoplasty? 
Answer: While you do have some mild asymmetry of your eyebrows, you are not a candidate for a brow lift procedure due to the normal positioning of your eyebrows currently. A brow lift is only used for patients who have low set eyebrows. With an upper blepharoplasty procedure, you can have a differential amount of skin removed in order to make your eyelids more symmetrical in appearance. In our practice, this can be performed under local anesthesia as an outpatient procedure, which takes about 30 minutes.

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