William Portuese MD

Facial Plastic Surgery Questions and Answers: Part 8

Question: I’m 39 years old, and considering upper eyelid lift, my question is would I also need lower eyelid lift? 
Answer: The Photographs demonstrate extra skin on the upper lids creating the hooded look, therefore your very good candidate for an upper blepharoplasty. It does not appear that insurance would cover your upper blepharoplasty. Your Lower lids demonstrate fat bags, therefore you are a great candidate for the lower eyelid surgery as well through trans-conjunctival approach on the inside of the lower lids. This procedure is performed under general anesthesia, and anticipate two weeks of visible bruising and swelling.

Question: Can eyelid surgery fix asymmetrical eyelids that don’t have an underlying cause? 
Answer: Everyone has some degree of Facial and Eyelid Asymmetry. A conservative skin only upper Blephararoplasty can accomplish your goals. This can be performed under local anesthesia.

Question: Should I have an upper and lower eye surgery?
Answer: The primary goal of upper eyelid surgery is to get rid of excess skin creating the tired look in your upper eyelids. The primary goal for lower eyelid surgery to get rid of the fat bags creating the puffy look. The incision for the upper lids is located increase, while the incision for the lower lids is completely placed on the inside of the eyelid known as a trans-conjunctival approach. No external incisions are required. Choose your surgeon wisely based on extensive experience producing natural results.

Question: Is a nose job, upper eye job and a breast revision all possible in one surgery as far as safety goes?
Answer: Performing all 3 surgeries is certainly possible in one anesthesia with one recovery period. It is important to ask your plastic surgeon how long each 1 of those procedures takes, since outpatient surgery should be limited to probably about 5 hours. Revision rhinoplasty is 1 of the most difficult operations to perform correctly in the entire field of cosmetic surgery, so it is important to find a surgeon who has extensive experience.

Question: Can my eye asymmetry be fixed? 
Answer: Everyone has some degree of eyelid and facial asymmetry, and when the asymmetry is significant enough, then you can consider medical or surgical treatment. The asymmetry that you’re experiencing may be related to your eyebrow asymmetry since your right eyebrow is higher than your left, and therefore the crease is higher on right eye than your left eye. Try Botox first to see if you can lower the higher eyebrow. Also important to make sure you don’t have any ptosis present. A skin only upper blepharoplasty procedure can also accomplish making the eyelids more symmetrical.

Question: Do I need a brow lift?
Answer: Your eyebrow position is acceptable, and a brow lift is not required. You have an upper blepharoplasty performed as the excess skin on the upper lids is bothering you. Ptosis correction will actually open up the aperture of the Eyelid so that your upper eyelid margin is not cutting across the black part of your pupil and improves vision.

Question: What can I do to remove the extra fold on my eyelid? 
Answer: A skin only upper blepharoplasty can accomplish removal of the extra pleated skin on your upper eyelids. This procedure can be performed under local anesthesia as an outpatient procedure and takes less than an hour.

Question: Eyelid Lift: Should I do upper and lower? 
Answer: From the one very limited photograph, it appears that there’s hooded and excess skin on the upper lids, and puffiness with fat bags in the lower lids. Both your upper and lower eyelids can be improved with an upper and lower blepharoplasty. Upper eyelid surgery is performed through an incision directly the upper eyelid crease with removal of hooded and excess skin in the upper lids. The fat bags in the lower eyelids is with a sub-conjunctival approach on the inside lower eyelids which prevents an external incision.

Question: Would AccuTite help address under eye bags and circles? 
Answer: Noninvasive treatments are not going to make the 6 herniated fat compartments in your lower lids go away. A trans-conjunctival lower blepharoplasty can accomplish removal of those fat deposits creating the Puffy look. All The incisions are on the inside of the eyelid and the procedure is performed under a brief general anesthesia as an outpatient procedure.

Question: Better candidate for brow lift or upper blepharoplasty? 
Answer: A full set of facial photographs are required to make a determination about two different surgical procedures. If you have low set brows, then a brow lift is necessary. If your brow position is adequate, and you have a hooded skin in the upper eyelids, then a blepharoplasty is indicated. An upper blepharoplasty can be performed under local anesthesia, while a brow lift is performed under general anesthesia.

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