William Portuese MD

Facial Plastic Surgery Questions and Answers: Part 6

Question: What is average down time for a surgical under-eye lift? 
Answer: Most patients tend to have some degree of bruising and swelling for two weeks after a lower blepharoplasty. Most patients who are less than 50 years of age can undergo a trans conjunctival approach by the Placement of the incisions completely on the inside of the eyelid. If there’s excess skin present , then a small incision is made at the eyelash line, and then this incision is closed with tissue glue, which that takes about 10 days for it to dissolve.

Question: How many days until I can open my eyes and resume normal activities?
Answer: Patients are able to open their eyes and get around the next day after eyelid surgery. When performing eyelid surgery together with a rhinoplasty, there is additional swelling and bruising underneath the eyes as well. In our practice, these procedures can be performed together under general anesthesia, however you will need a caretaker to be with you for the first 24 hours after the procedure. We also ask patients to refrain from any exercise for 2 weeks after both procedures.

Question: Non-invasive options to address heavy eyes and prominent orbital bone? 
Answer: Your side profile shows fat deposits located in your neck, so consider liposuction to address removal of those fat deposits. Your eyelids appear normal and nothing need to be done at age 29.

Question: Would I benefit from eyelid surgery as I feel like my skin sags too much? 
Answer: A conservative upper blepharoplasty procedure can accomplish removal of excess skin on the upper eyelids to raise the crease and get more eyelid platform show. The procedure can be performed under local anesthesia or general anesthesia as an outpatient procedure.

Question: Upper (maybe lower) eyelid lift and brow lift options? 
Answer: The photographs demonstrate hooded upper eyelids and low-set eyebrows. An upper blepharoplasty can accomplish removal of the hooded extra skin, while a Coronal approach forhead lift can accomplish adjusting the asymmetry of the eyebrows, lifting the eyebrows, and surgically softening the muscles that create the 11’s between your eyebrows. Based on the placement of incision, you can actually lower your hairline if so desired.

Question: Will a rhinoplasty make my sunken under eyes worse? 
Answer: No, a rhinoplasty procedure is not going to make your eyelids looked worse. Your nose looks pretty good now, so be careful about what you wish for. The amount of change you would see with the rhinoplasty procedure would be rather minimal at best. You’re not a candidate for lower eyelid surgery at this point either.

Question: Does this look like ptosis or just more excess skin on one eye? 
Answer: You do not have ptosis in your eyelids. You have significant asymmetry of your eyelids due to one eyebrow being lower than the other. A conservative upper blepharoplasty procedure performed under local anesthesia should be all that is required to improve the asymmetry.

Question: Should I get eyebrow lift or blepharoplasty on my upper lids? 
Answer: You do have facial and orbital asymmetry which is quite normal. Everyone has some degree of asymmetry. The position of your eyebrows is great, therefore an eyebrow lift is not necessary. Consider an upper blepharoplasty procedure to remove the extra skin creating the hooded look along with some fat deposits on the inner corners of your upper eyelids. This can be performed under local anesthesia in the office setting.

Question: Addressing signs of aging around the eyes: Non-surgical methods or straight to brow lift and blepharoplasty? 
Answer: From the photographs presented, you do not need a brow lift procedure, since the height of your eyebrows is acceptable. You do have asymmetrical eyelids, so just a conservative upper blepharoplasty procedure would be all that is recommended. An upper blepharoplasty procedure can be performed under local anesthesia as an outpatient procedure. Botox is the best treatment for crows feet.

Question: F, 24, 5’1”, 105lbs, what can I do to fix my uneven eyelid? 
Answer: A very conservative skin only pinch removal of excess skin can get rid of the excess pleat on your right eyelid. This can be performed under local anesthesia.

    Contact Dr. William Portuese