William Portuese MD

Facial Plastic Surgery Questions and Answers: Part 10

Question: I am trying to figure out what can be done for my under eyes I look tired with circles and puffiness all the time? 
Answer: The primary goal for lower eyelid surgery is to remove the fatty deposits creating the puffy look. The secondary or minor goal is to remove any excess skin that rest, not upon smiling. For many examples of upper and lower blepharoplasty, please see link and the video below.

Question: Can someone with dry eyes have a fat bag removal through a trans-conjunctival approach?
Answer: Yes, a transconjunctival approach lower blepharoplasty can accomplish  fat bag through the incision located on the inside of the lower lids.  The incision is completely located on the inside, no external incisions are required.

Question: Can I fix my uneven eyes? 
Answer: An upper blepharoplasty procedure can accomplish addressing asymmetries in the upper eyelids by removal of more skin and fat from one side versus the other. For many examples, please see the link and the video below.

Question: Can I get surgery to see more of the white part of my eyes?
Answer: From the one limited photograph, you are not an eyelid surgery candidate,  so best to leave well enough alone. Trying to show more white part of your eyes can create scleral show and ectropion.

Question: Is there any way to improve the asymmetry of my lower/bulging eyes?
Answer: There is no way to make the bony orbital sockets different, however the fatty deposits in the lower lids, especially on patient’s right side can be addressed and removed a trans conjunctival approach lower blepharoplasty.  The incision is located on the inside of the  eyelids. For many examples and more information, please see video below.

Question: How can I make asymmetry less noticeable on my face, especially eyes? 
Answer: Everyone has some degree of facial and eyelid asymmetry.  The Photograph is rather limited, it’s probably best to just leave well enough alone. For information about cosmetic eyelid surgery.

Question: Eyes don’t match. Would there be any way to fix this? 
Answer: An upper blepharoplasty procedure can accomplish differential amount of skin, fat, and muscle removed from the more full side to match the more open side. Everyone has some degree of asymmetry, they can be made much more symmetrical.

Question: Want to do something to address the tired and aging look of my eyes and have gotten conflicting opinions from doctors. Thoughts?
Answer: The primary goal for upper eyelid skin is to remove excess skin creating the tired look.  The incision is located directly in the upper eyelid crease.  The primary goal for lower eyelid surgery is to remove the fatty deposits creating the puffy look.  The secondary goal for lower eyelid surgery is to remove a conservative amount of excess skin at rest( not  when smiling). The photographs demonstrate hoodeded upper eyelid skin, and fat bags located in the lower lids.   As long as you are in excellent health, you are a good candidate for both upper and lower blepharoplasty.  The procedure is usually performed under general anesthesia as an outpatient procedure.

Question: Options for bags under my eyes and a double chin? 
Answer: A full set of facial photographs from all angles are required to make a determination about two completely separate surgical procedures.  Both procedures can be performed simultaneously under one anesthesia. Fatty deposits in the neck removed with liposuction. A lower blepharoplasty is performed to remove fatty deposits in the lower lids creating the puffy look. For many examples of both procedures,  please see video below.

Question: What did Kylie Jenner do to make her eyes bigger and eyelids sultry?
Answer: It is very difficult comment on what type of injections or surgical procedures were performed. In addition, many of these celebrity photographs are Photoshopped and airbrushed. Best to have realistic expectations, since you always want to look natural.

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