Facial Plastic Surgery Questions and Answers: Part 7

Question: What are my permanent options to correct my eyelids and achieve a less tired look?
Answer: A trans-conjunctival lower blepharoplasty accomplishes removal of the fat bags that are creating the puffy look in the lower lids. The incisions are completely located on the inside of the eyelid, and there are no external incisions.

Question: Order of facial and scalp cosmetic surgeries?
Answer: Hairline lowering surgery and an eyebrow lift should be performed together. Hair transplant would be done separately. Facelift, eyelid surgery, rhinoplasty and chin implant can be performed together simultaneously under one anesthesia with one recovery. A full set of facial photographs from all angles are required to make a determination about being a candidate all these procedures.

Question: Do Ineed a browlift or upper blepharoplasty?
Answer: The eyebrow position is acceptable, and a brow lift is not necessary, because you look too surprised. Consider aconservative upper blepharoplasty to remove the excess eyelid skin and create more of a curvature to your upper eyelid fold.

Question: I’m 45 years old, very healthy. Am I a candidate for facelift, rhinoplasty and facial implants? 
Answer: From the photograph presented, you do not appear to be a good candidate for a rhinoplasty procedure, since your nose looks quite good and very little improvement could be achieved. A neck lift alone can accomplish removal of the fat deposits above and below the platysma muscle in your neck along with the platysma plasty to significantly improve the jawline. A full lower face and neck lift would not be required as long as your skin tone is acceptable in the neck. You do appear to be a good candidate for upper and lower eyelid surgery. The goal of upper eyelid surgery is to remove the excess skin creating the hooded look, and the goal of lower eyelid surgery is to get rid of the fat bags creating the puffy look. Your midface does appear rather flat, and a set of small cheek implants can accomplish augmentation in that area.

Question: Will a endoscopic mid face lift, fat transfer and lower eyelid skin pinch help me correct hollowing and crows feet? 
Answer: From the one photograph presented, you do not need any surgical procedures whatsoever. In our practice we do not perform a mid facelift and fat injections for a long variety of reasons. At age 36, you do not need a pinch of the lower lid skin. Consider Botox for your crows feet.

Question: Fat bags on corner of eyes and bleph recommendations? 
Answer: There are three compartments of fat in the lower lids, and from this one limited photograph, you have herniated fat in the outermost lateral compartment. A better determination can be made while looking straight ahead into the camera and post another photo. In our practice, we remove these fat bags through a trans- conjunctival approach with the incision completely located on the inside of the eyelids. It is performed under a brief general anesthesia as an outpatient procedure.

Question: Would it be recommended to do rhinoplasty before eye surgery, or does it matter?
Answer: In our practice, we do rhinoplasty, eyelid surgery and necklifts separately or in combination on a routine basis. Look for a facial plastic surgeon who specializes in facial cosmetic surgery. Study their before after Photo Gallery to make sure that it is expensive with lots of results that look natural. You should be able to find a surgeon that can do all three procedures simultaneously under one anesthesia with one recovery period. It does not matter which procedure goes first or last if you going to separate them out in time.

Question: Can a blepharoplasty pinch and lower blepharoplasty be done at the same time?
Answer: The photographs demonstrate fat deposits in the neck most likely located above and below the platysma muscle in the neck. You also have a recessive chin profile for which a chin implant could offer much better structural support for the soft tissues in the neck. Liposuction alone will only remove fat deposits above the platysma muscle, while a neck lift procedure accomplishes removal of fat deposits below the platysma muscle and a platysma-plasty which significantly improves the jawline.

Question: Which procedure should I consider to minimize the frontalis muscle after fat grafting? 
Answer: More information is needed such as a full set of facial photographs at rest determine the height of your eyebrows in relation to your eyelids to see if you’re even a candidate for a forehead lift. A coronal approach forehead lift can accomplish softening the frontalis Wrinkles only in the central two thirds of the forehead. The outer forehead wrinkles from the frontalis cannot be surgically adjusted over the tail of the eyebrow, therefore Botox would be required for those wrinkles. It will be impossible to remove the fat injections that you had done in the forehead.

Question: Would I be a good candidate for ptosis surgery, blepharoplasty or a brow lift? 
Answer: A full set of eyelid photographs from all angles that are unadulterated are going to be required to make a determination about how best to proceed. From the limited photograph, your eyebrow position appears normal, And a brow lift is unnecessary. An upper blepharoplasty procedure can accomplish removal of excess skin on the upper lids. Ptosis surgery involves tightening the eyelid muscles when the upper eyelid margin is cutting across the black part of your pupil.

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