William Portuese MD

Facial Plastic Surgery Questions and Answers: Part 02

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: 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.

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: 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: What is the best treatment option for my eyes? 
Answer: It’s impossibleTo tell if you have a ptosis in the current photo. From the one very limited photograph, you appear to have asymmetric amounts of fat and extra skin in each eyelid. An upper blepharoplasty procedure can accomplish improvement for your Eyelid asymmetry for cosmetic purposes. An upper blepharoplasty can be performed under local anesthesia as an outpatient procedure.

Question: How can I fix the unevenness of my eyes? 
Answer: The unevenness of your eyes are related to the unevenness of your eyebrows. You did not need a surgical brow lift. A conservative and asymmetrical skin removal on The upper lids to make them look more symmetrical, however there is no perfect symmetry. Everyone has some degree of facial and eyelid asymmetry which is normal since there’s a left half of the face and right half of the face that come together in the embryo phase and No face is perfect.

Question: Is there anything I can do to firm up or remove under-eye skin and fat pads?  
Answer: The primary goal of lower eyelid surgery is to remove the fat bags creating the puffy look. The Secondary or minor goal is to conservatively tighten up loose and inelastic extra skin at rest and NOT when smiling dynamically.

Question: What’s better for my puffy under eyes & eye bags, laser lipo or lower blepharoplasty? 
Answer: The fat bags creating the puffy look on your lower lids are best treated with a trans-conjunctival approach lower blepharoplasty. The Incisions are totally located on the inside of the lower lid. No external incision is required. This procedure is performed under a brief general anesthesia as an outpatient procedure. it’s impossible to do liposuction in the lower lids.

Question: What would be more beneficial for my hooded eyes, an eyebrow lift or an eyelid-surgery? 
Answer: The height of your eyebrows is excellent, and no brow lift is necessary. Consider performing an upper blepharoplasty to address the hooded upper eyelids. In our practice, upper eyelid surgery can be performed under local anesthesia as in outpatient surgical procedure.

Question: What could be done to correct the symmetry in my eyelids?
Answer: Everyone has some degree of facial and eyelid asymmetry was make someone unique. Your upper eyelid crease on the  left side in the photograph has an extra small pleat of skin which can be removed with a conservative skin only blepharoplasty. It’s impossible to change the level  of your eyesockets.

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