William Portuese MD

Facial Plastic Surgery Questions and Answers: Part 07

Question: Why do many celebrities that have had their eyes ‘done’ seem to have smaller eyes afterwards? 
Answer: Without a set of pictures, it is difficult  ton give a definitive answer. When lots of fillers are placed in the cheeks, it tends to make the eyes smaller. The primary goal for upper eyelid surgery is hooded skin removal, while the primary goal for lower eyelid surgery is to remove the fat bags creating the puffy look.

Question: Do I have an epicanthic fold? If so, would upper Blepharoplasty have good result for my hooded eyes? 
Answer: There is a small epicanthal fold which should be left alone, since it creates a very unique look to your eyes. There is a small amount of asymmetry in the  eyelids which can be addressed with an upper blepharoplasty. The heavier eye would require more skin removal to match the opposite side. A conservative skin only blepharoplasty  should be able to accomplish your goals. This can be performed under local or general anesthesia betting on the patient’s desires. Seek out a very experienced eyelid surgeon for best results. For many before-and-after examples, please see video below.

Question: Does rhinoplasty help with under eye bags too?
Answer: No, a rhinoplasty procedure accomplishes making cosmetic changes to the nose, not the eyelids. A lower blepharoplasty procedure can accomplish removal of excess skin and fatty deposits creating the puffy look for the under eyes.

Question: What’s the best approach for hereditary hooded eyes that make me looks sleepy/eyeless? 
Answer: The photograph is rather limited, your eyes look very acceptable in the one limited photograph. If you  want to improve the hooded look, a very conservative Upper eyelid blepharoplasty can be performed under local or general anesthesia. An in-person examinations going to be required to make that determination.

Question: How can I improve the appearance of my eyes? 
Answer: There’s only a small amount of puffiness located in the lower lids, therefore a lower eyelid blepharoplasty will  only be of minimal benefit. The fat bags are removed through trans-conjunctival brooch on the inside lower lid. No external incision is required.

Question: Recommended surgeries to fix my nose, smooth out my eyes and straighten brows? 
Answer: A revision rhinoplasty procedure can accomplish narrowing and straightening the bridge line in addition to reducing the hanging columella.  It better set of pictures are required to make a determination about eyelid surgery.

Question: What is the best way to treat the crepey skin under my eyes? 
Answer: The primary goal for lower eyelid surgery is to remove the bags which are caused by herniated fat pads. The secondary, or minor  goal for lower eyelid surgery is to remove any excess skin that may be present at rest, not upon animation. A Physical examination will be required to make a determination if the Pinch technique of excess skin can be performed safely. Botox is best used for crows feet and laser resurfacing can also help with under eyelid skin as well.

Question: What most physical evidence or sign I can see if anyone had lower eyes transconjunctival blepharoplasty?
Answer: There is no external physical evidence of having had transconjunctival lower blepharoplasty. The incision is completely hidden on the inside of the lower lid. The goal of the trans-conjunctival lower lid blepharoplasty is to remove the fat bags creating the puffy look.

Question: Follow-up question: Is transconjunctival skin pinch canthopexy to left eye and transposition to both eyes still valid? 
Answer: The primary goal for upper eyelid surgery is to remove excess skin creating the hooded look and a small amount of fat on the inner corners next in the nose. The Incision is located in the upper eyelid crease. The primary goal for lower eyelid surgery is to remove the fat bags creating the puffy look through a trans- Conjunctival incision on the inside of the lower lids.

Question: Will upper eyelid blepharoplasty make my eyes look bigger? 
Answer: No, the goal of upper eyelid blepharoplasty is to simply remove excess skin resting on the eyelashes that is creating the hooded appearance. You not want to change the shape of your eye or make it any bigger.

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