This 70-year-old woman had droopy upper eyelids as well as significant puffiness on her lower lids. She had always considered her eyes to be her best feature and was pleased with the results of her surgery, which enabled her to apply makeup and enhance the look of her eyes.
The image you see in your mind’s eye is the one you should see in the mirror. New York Cosmetic Surgeon, Dr. Prasad can help you look how you want to be seen. You send out messages about yourself by the expression in your eyes – so what do you do when the appearance of your eyes is not solely in your control?
The eyes are the first of your features to show signs of aging. Eye plastic surgery or non-invasive eyelifts allow you to recapture your youth and give you control over your expressions.
Eye plastic surgery offers a safe and easy solution to problem signs of aging for both men and women. Conditions from aging, prior surgery, trauma or hormones (wrinkles, scars, or a deformity of the eye area) can be corrected with eye plastic surgery.
Uneven Eyes Fixable With Surgery?
I would like to know if it would be possible to fix my uneven eyes with surgery. I fell down some stairs at the age of three, and have a scar on my right eye. I think it’s the reason my right eye is droopy. I also have had eye bags under my eyes since late twenties and sick and tired of people telling me I look tired. I was thinking of having the eyelid surgery to correct the unevenness and lower blepharoplasty to get rid of bags. Also, would it be too complicated to get rhinoplasty at the same time?
Thank you for your question!
You submitted a question about improving the uneven quality of your eyes and you drew some very nice horizontal lines to demonstrate that and you’re also concerned about bags under the eyes.
Well, to begin with, the reality of the face and the human face is that it is intrinsically asymmetric. That means, one side is always a little bit different than the other. Now in some people, it is more pronounce than the other side, I should say, more pronounced compared to other people where if you were actually going to take a picture of yourself, and you split the photo in half in a program like photoshop, and you flip it and open it up so that you can double it. One side will look very narrow and the other picture would typically look wide. Intrinsically, we’re all imperfect and that is part of the character of your face.
Now, the key thing to understand is much of the difference of one side versus the other has to do not so much on the superficial part of the face, like the skin, or rather, it’s about the bone structure. There’s a term that we use called hemifacial microsomia. And it just basically means that one part of the face is smaller than the other side.
So when people come to me in consultation about making themselves more symmetric, I also explain that I can improve symmetry but I cannot perfect it because there’s so much more deeper levels of structure that’s responsible for this difference that we can only take it so far without discussing options which are unrealistic and disproportionate of the cosmetic concern is. So the question about helping improve symmetry certainly we do that routinely. Sometimes with eyelids, one person’s eyelids is a little bit heavier on one side compared to the other and the bag can sometimes be a little bit more than the other side. And very often, the cheek projection can be different on one side compared to the other. So we can compensate for these things by customizing a surgery and that the art of doing cosmetic surgery is taking all of these factors into consideration when you’re doing the procedure.
I do my procedures under local anesthesia with LITE IV sedation and whenever I’m considered about maximizing symmetry on someone with a lot of room for subtle improvement, I’ll actually have their cooperation. They won’t feel anything but I’ll ask them to open their eyes and look at different angles. I even let them sit them up just to see how things look and make sure I can maximize the symmetry.
As far as treating the under eyebags, this is a very common problem in my practice, in plastic oculofacial surgery, is having bags under the eyes. Now, there are different methods in treating bags under the eyes. One is called a transcutaneous approach which means making an incision underneath the eye lashes to access the bags and those bags are fat pockets. And those fat pockets are often referred to as herniated fat. The other procedure is called a transconjunctival blepharoplasty and that’s basically the surgery where we do the procedure from inside the eyelid. In my practice, most of my lower eyelid procedures, as a primary procedure not as a secondary or revision procedures for patients who are referred in, I tend to do a lot from the inside of the eyelid. I find that preserving the muscle, shape and the integrity of most of the anatomy of the lower eyelid really works out well just trying to work out the fat. You can do other things such as skin pinch removal for extra skin or PRP to improve skin quality.
So there are a lot of different options and also depends a lot on the tone of the eyelid on which procedure is right. It’s not just the approach but also some of the support procedures. One of the most common pitfalls of lower eyelid surgery is something called lower eyelid retraction. Which is the pulling down of the eyelid which is much more common that most people realize. It is actually, the lower eyelid is deceptively complex and the dynamics of support and maintaining a natural look has a lot of subtleties to it that requires in the toolbox for someone who has a lot of experience in dealing with these kinds of procedures.
So in summary, we can do something to improve symmetry as long as your goal is not unrealistic and you’re not aiming for perfection. And yes, we can do a lot of things to help improve the bags under your eyes to further enhance the overall appearance.
A take home message is, you look at yourself with very, we all do this, naturally we look at very strong detail and focus and then we magnify everything. Well, other people look at us and they see the whole picture. No one’s looking at us unless they really are very close and they do that a lot but most people look at us at one millisecond snapshot. And as long as you look well rested and you look good, if that’s your objective, then I think you should get a good journey of finding the right doctor for you.
So I hope that was helpful and thank you for your question.
Dr. Prasad is an Oculofacial (eye-face) plastic surgeon, with over 16 years expertise practicing eye surgery, performing unique procedures not offered by many cosmetic surgeons including: Asian eyes, exotic eyelifts, eyelash transplant and non-invasive eyelifts.
Dr. Prasad is an eye “superspecialist” and a Fellow of the prestigious American Society of Oculofacial Plastic and Reconstructive Surgery.
A candidate for blepharoplasty surgery, also known as eyelid surgery, is any person who wants to look younger and fresher without making drastic changes to his or her face. “Family resemblances” of puffy eyelids, pouch-like lower lids, and drooping skin over the eyes becomes more and more noticeable with age. Certain lifestyles such as smoking, sun worshipping, excessive weight gain, or high stress are more likely to make droopy lids appear as well.
in her twenties in the sun. As a teacher she was noticing that she was
having difficulty keeping her eyes open while working and noticed that
lifting the skin off of her eyes resulted in her feeling relief. She also
felt frustrated with applying makeup to the eye area since this extra
skin caused it to smear. Dr. Prasad performed cosmetic upper eyelid
blepharoplasty, which revealed the natural shape of her eyes and
further allowed her to apply cosmetics as she wished.
There is no such thing as the right age for eyelid blepharoplasty surgery or for any type of cosmetic surgery. Some of our patients are as young as 14 and as old as 100. When considering if you are a candidate for blepharoplasty surgery, you need to decide whether you feel the need to change your appearance. No one should ever convince you to get cosmetic surgery. Ultimately, the decision to have blepharoplasty surgery is a highly personal choice and will depend on your own cosmetic goals.
Patient Testimonial Video
If you do decide that blepharoplasty surgery is right for you, schedule a consultation with Dr. Prasad, super specialist in eye and eyelid surgery.
Dr. Prasad’s Blepharoplasty Surgery: The SmartLift™ Eyelift
Dr. Prasad has pioneered a particular technique in blepharoplasty surgery known as the “SmartLift™ eyelift,” which involves minimal incisions, LITE™ Anesthesia, and very natural results. The SmartLift™ eyelift differs from traditional eyelid blepharoplasty surgery because it involves minimal risk, minimal anesthesia and maximal results. Using Dr. Prasad’s LITE™ Anesthesia for Plastic Surgery means that the downtime after the procedure is much less than blepharoplasty surgery performed under general anesthesia. In addition, general anesthesia has more attendant risks than local anesthesia, so generally speaking, the SmartLift™ approach is certainly a safer option.
difficult to place eyeshadow onto her upper eyelids because of the
excess skin. She was also a runner and complained that her upper
eyelid skin would get irritated because the skin was loose. Dr. Prasad
performed a cosmetic upper eyelid blepharoplasty which allowed her
to apply her makeup in a way that she desired.
Dr. Prasad has developed a standardized SmartLift™ System for blepharoplasty surgery to properly classify a person’s eyelids on the basis of gender, age, ethnic background and skin condition. This analysis allows him to select the right approach that is properly personalized to an individual patient’s eyelift. The SmartLift™ System is a useful tool, but the personalized artistic touch of Dr. Prasad is what makes all the difference in the beauty of your results.
httpvh://youtu.be/mt8gKlV5csClick here for transcript.
Filler under Eyes VS Lower Blepharoplasty?
I am a 32-year-old female and looking for the best treatment for under eye hollows/wrinkles. I went to a dermatologist to discuss fillers. To my surprise, she recommended a lower blepharoplasty instead of fillers. With work, surgery really isn’t an option. Is there ANY filler that will treat under eye hollows/wrinkles? If so, is it better to inject them into the cheeks or tear troughs?
Thank you for your question!
You’re submitted question with some information about your age, 32, and having the puffiness under your eyes and visiting a dermatologist about addressing the puffiness non-surgically. I’m actually impressed that the dermatologist recommended that you have a blepharoplasty all though based on your work schedule it might not be practical. And the reason I say this is, in my area in the upper east side of Manhattan in New York City and in Garden City, Long Island, there’s lots of non-surgical physicians who are trying to address under eye bags by adding volume. Unfortunately, a lot of these efforts are very misguided and there’s a reason for this
Anatomically, facial aging, I actually wrote a book called “The Fine Art of Looking Younger” is a couple of different processes and one of them is volume loss. However, the tissue as we get older also gets thin so trying to fill tissue that’s thin with volume that compensates the loss of bone, muscle and fat makes a lot of people in our area look very strange and look very amorphous. In fact, a significant number of patients come to our office every week looking to have the filler, typically Restylane and Juvederm that’s placed in their tear trough, removed with the use of an enzyme called hyaluronidase in order to stop their bags from looking even worse because when you they add in the volumes, everything swells.
Concerning the relative hollow that you are perceiving, clearly there’s puffiness under your eyes and that puffiness is called lower eyelid fat prolapse. And the lower eyelid fat prolapse means that the fat that’s normally behind the eye pushes forward and creates a hill. Very often people interpret it as a hollow is actually this contrast between this high hill that makes the valley of the tear trough look deep.
Now when I do an evaluation of the eye area for someone who’s concerned about it, I always look at the eye and the cheek because there is a real relationship between the aesthetics of the eye that’s also related to the cheek area. So adding a filler to the cheek area may soften the area of contrast between the eyelid and the cheek. However, I would suggest that you meet with an experienced cosmetic surgeon who does a lot of eyelid surgery and ask about techniques and methods to allow for quick recovery.
And I’ll tell you from my practice and my experience, one of the first things I did 20 years ago when I went into practice is I was determined to help people who were coming to me that were basically aging baby bloomers who don’t have time to recover to get back to normal life as quickly as possible. So I developed a particular style and process of doing eyelid surgery that we could basically call a quick recovery approach. And what that means is, very often for the right candidate, we can do a procedure on a Thursday or even on a Friday and reduce the puffy bags under the eyes and allow them to get back into work on Monday. So essentially, we use the weekend as a big part of the healing process and then where we’ll make-up their under eyes for work. And then day by day, a little bit of fluid and swelling resolves and nobody knows what’s going on and you’ll look better.
So, I don’t think you should completely take out the option of having surgery because there are techniques that do exist to allow people to recover quicker and that not only includes the surgical technique but also the anesthesia and the after care.
So I think that’s a good place to focus your energies as a way to soften this area probably because the puffiness is so significant that this dermatologist and I think any doctor who understands that softening the tear trough a little bit would probably would not make enough of a difference and in compensating the puffiness may make the eyes extra puffy. So you may want to save your money and wait for the right time to do the lower eyelid surgery first and maybe combine it something to addressing the eyelid cheek hollowing in the future. So I hope that was helpful and thank you for your question.
Upper vs. Lower Eyelid Blepharoplasty Surgery
Upper eyelid blepharoplasty surgery is performed using a small incision that is hidden in the crease of the upper eyelid. The scar usually heals extremely well and is difficult for others to see even when your eyes are closed.
He felt that he was working with people who were younger than him
and he was being labeled as “older”. He felt that his eyes were affecting
his ability to communicate and be effective in his work. He was also
very concerned that any surgery not make him look “plastic”.
Dr. Prasad performed conservative upper and lower blepharoplasty
to give his eyes a more vibrant appearance.
Lower eyelid surgery blepharoplasty surgery is used to eliminate puffiness and heavy bags under the eyes. Lower lifts have two techniques: traditional and transconjunctival blepharoplasty surgery.
Upper or Lower Bleph?
I am trying to decide if I should do upper or lower eyelids? Right now I can only decide on one or the other but maybe in a year or so I can do the other. I would love some opinions on which would be more beneficial as BOTH are really bad. Thanks for any help!
Thank you for your question!
You’re asking which set of eyelids should you do, upper eyelids or the lower eyelids. You want to, I guess, separate them. And certainly you’re going to get a lot of opinions on which you should do. But in my practice, very often, people come to me many many years ago when I was much younger, having been practicing for 20 years and they would say, a similar situation, that they don’t like their lower eyelids and that was more typical. And I would not push them to do anything else even though I notice that their upper eyelids would benefit. And of course after they did their lower eyelids, they’d come back to me and say, “Doc, why didn’t you tell me to do my upper eyelids?” I say, “Because you came in complaining about your lowers.”
So, if you have to make a choice, I would say from my experience that doing the lower eyelids has a greater overall impact on your eyes because puffiness under the eyes make people look like they’re always tired. Now if your issue about doing the two eyelids separately is a financial issue then you may just want to wait to them both together. And I’ll tell you how I counsel my patients.
When you do either lower eyelid surgery or upper eyelid surgery in our office and we have our own facility, you’re basically paying for the surgeon’s fee and you’re for the anesthesia and you’re paying a facility fee. Usually in my situation as well as many other facility, once you’ve met that cost, then any additional procedure, let’s say about an hour to, usually is much less expensive proportionately. And this opposed to going to the facility twice and paying two separate anesthesia and facility fee. So that’s one financial reason.
Aesthetically, you realize that the upper eyelids and lower eyelids should be done together and so when you do the upper and lower eyelids together, you essentially are doing something where the whole is greater than the sum of the parts. And that being said, if you can manage to do it, then do both together. However, if you have to choose one, from an aesthetic perspective, I would say consider doing the lower eyelids.
I hope that was helpful and thank you for your question!
“Awesome Eyelift! - I had been getting very tired eyes daily even though I wasn’t tired. My upper lids were covered by drooping skin and I had fat deposits on my lowers. My surgery was only 4 weeks ago and I am thrilled with the job Dr. Prasad did. It was easy, painless and very quick recovery. If you are considering this, you want Dr. Prasad, excellent results !!” Patient JC