William Portuese MD

Facial Plastic Surgery Questions and Answers: Part 08

Question: Can cheek implants yield good results? Could they make big, deep set eyes worse?
Answer: A full set of facial photographs from all angles, especially the three-quarter angle are going to be required to make a determination about whether or not your candidate for the procedure. Cheek implants are manufactured in a large array of thicknesses, sizes, and shapes which is best determined  at the time of the consultation and examination. They can also be custom carved when necessary to match patient unique anatomy. In our practice, we place cheek implants through an intra-oral approach under brief general anesthesia as an outpatient procedure.

Question: Can a dorsal augmentation help make my eyes look closer together? 
Answer: First of all, your nose does not need dorsal augmentation, so it’s best to leave well enough alone. The distance between the eyeballs is permanently set by the bony eyesockets and cannot be changed.

Question: Are individuals with eyelash extensions at risk for infections?
Answer: In our practice, we have not seen an increased risk of infections with eyelash extensions.  When performing facial cosmetic surgery, the entire face is scrubbed with antibacterial soap, which also includes the eyelashes. Occasionally a few eyelashes will fall off during that process.  In addition, we also place specialized tape across the eyes to prevent corneal abrasion. It was not necessary to remove them prior to surgery, however it is probably best to just have them reapplied sometime after the surgery.

Question: I hate my eyes. Do I need blepharoplasty? 
Answer: It does not appear your lower lids would need any surgery whatsoever. A very conservative  skin only upper blepharoplasty can accomplish removal of the hooded skin touching your eyelashes. This can be performed under local or general anesthesia.

Question: Would a Rhinoplasty make my Eyes Appear Closer Together?
Answer: A rhinoplasty is performed to make the nose blend in and better with your facial features.  It will not make your eyes look further  apart or closer together.  Digital computer imaging of your nose upon your facial features would be helpful to give you an idea of what can be accomplished with a rhinoplasty procedure. For many before and after surgical closed rhinoplasty examples,  please see the link and the video below.

Question: Are my eyes too far apart? 
Answer: No, your eyes are not too far apart. From the 1 limited photograph, it appears that you may have ptosis present in both eyelids.  This is best treated by an oculoplastic surgeon. There is nothing that can be done to move the eyes closer together in the bony eye sockets.

Question: Eyebrow lift: would a temporal lift open my eyes? 
Answer: The current level of your eyebrows is more than acceptable, therefore brow lift is unnecessary. Raising your brows any higher will make you look unnatural

Question: What can be done to treat my tired looking eyes, jowls, and jaw line at the age of 57 
Answer: The primary goal of  lower eyelid blepharoplasty is to remove the fat bags creating the puffy lock.  The secondary goal is to tighten up any loose skin that may be present on the lower lids.  A lower face and neck lift can accomplish tightening loose facial and neck skin, tightening the loose facial and neck muscles, lifting the jowls, and removing any fatty deposits in the neck.

Question: I am Hispanic. Is there any surgery that could be done due to the fact that my eyes seem to look sort Asian? 
Answer: It’s impossible to  change the ethnicity of your eyelids, however a conservative upper eyelid blepharoplasty can accomplish removal of the extra hooded skin creating the tired look. The procedure can be performed under local or general anesthesia.

Question: Do I need eyelid surgery or will tear trough fillers help sunken eyes? 
Answer: The primary goal for lower eyelid surgery is to remove the fat bags creating the puffy look.  This can be accomplished through a transconjunctival approach on the inside of the lower lids.  No external incisions are required.

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