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Eye Lift Questions and Answers

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Eye Lift Surgery Questions Answered by
Cosmetic Eyelid Surgery Specialist – Dr. Amiya Prasad

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Dr. Amiya Prasad is highly respected Cosmetic Oculofacial Plastic Surgeon whose offices are located in Manhattan’s Upper Eastside and Garden City, Long Island. Dr. Prasad is committed to education through activities such as writing his highly acclaimed book, The Fine Art of Looking Younger and his “You Asked” questions which he answers on his YouTube Channel

QUESTION: What is a Blepharoplasty – What Does It Do?

ANSWER: Blepharoplasty is a medical term for an “eye lift”
Blepharoplasty, commonly known as an eye lift, is surgery for the eyelid by addressing fat pockets as well as excess tissue that causes drooping eye lids or puffy eyes. Blepharoplasty can make a real difference in your appearance. Dr. Prasad’s style and technical skills is well known for creating natural results.

QUESTION: Eyelid Blepharoplasty Risks, Problems, What to Know in Advance
ANSWER: Blepharoplasty 101
First and foremost, you should know whether your surgeon is experienced and can handle complications. After establishing qualifications, I would ask:
- Am I a candidate for this procedure and why?
- Can you explain to me how you foresee my procedure would go specifically? (how am I different than other cases?)
- How many Blepharoplasty Procedures do you do on a weekly basis?
- May I see before and after photos of your patients?
- How will I be sedated?
- What is the recovery time needed?
- What are the potential side effects?
- Will there be visible incisions?
- Where is the procedure done and is that facility certified?

The surgeon’s answers should be honest and direct. The surgeon needs to spend time talking to you and examining your eyes.Trust is very important for any surgical procedures, If you are not comfortable with your surgeon’s answers, look elsewhere.

QUESTION: Can I change my eye shape?
ANSWER: If you’re a good candidate, you can change your eye shape
One of the most popular procedures in our practice we call “Almond eyes,” or “exotic eyes”. The goal is to create a natural and attractive lift to the outer corners. This shape is often described as attractive and alluring. Almond eyes can appear youthful, boost one’s confidence. Many men and women are blessed with natural almond eyes, but for those who are not, procedures can be customized to create almond eyes.

QUESTION: How long is eyelid surgery recovery
ANSWER: In general, 5-10 days depending on the extent of the procedure
In our practice, most patients return to work in less than 1 week. Recovery time varies from patient to patient. Some of your recovery time is in your control, while other factors are not.

Many of our patients go back to work as early as 3 days, but if the goal of the patient is to be discreet, 7 days is better to be away from work. Prior to surgery, it’s important to avoid blood thinners such as aspirin, motrin, advil, ibuprofen, and Vitamin E

It’s important to refrain from strenuous activity during recovery . Light activity is fine In general,
Smokers beware. Healing time is significantly longer for those who smoke regularly and risk a higher rate of complications.

QUESTION: Under Eye Crepey Skin Wrinkling After Bleph Surgery?
ANSWER: Treatment of Crepey Skin Around Eyes
Crepey skin around eyes that is thin and wrinkled can be managed in many ways from using topical creams to using lasers or radio frequency skin tightening (Pelleve). Eyelid surgery may help the skin look better if the there is redundant or excess skin before blepharoplastry. In my practice in New York, I often perform blepharoplasty to remove or reposition fat as well as excess skin and combine this surgery with the use of the Mixto SX microfractinal CO2 laser to improve skin texture and wrinkles.

QUESTION: What can be done when too much fat was taken out above the eyes and below the eyes?
ANSWER: Revision Eyelid Surgery
There are several factors which contribute to the changed appearance of your eyes. I perform revision eyelid surgery in New York routinely for patients who are unhappy with results from other doctors. Specializing in oculofacial eyelid surgery in NYC, I can share with you the importance of properly performed primary surgery. When revision work is necessary the “golden rule” is to restore the anatomy so that the eyelids look good and function well to protect the eye. You may have exposure of your eyes at night from lower eyelid retraction. You should be comfortable and confident in who you choose for your procedure. Besides eyelid surgery surgery, your options for fillers include hyaluronic acid fillers and platelet rich plasma (PRP).

QUESTION: What can be done for hollow eyes
ANSWER: Tear trough volume correction with hyaluronic acid and prp (platelet rich plasma)
Genetics and aging can result in volume loss in the area of the tear trough and the eyelid-cheek junction. I have had a lot of success with combining hyaluronic acid filler such as Restylane with PRP (platelet rich plasma). Platelet rich plasma has helped our patients improve the appearance of fine lines, wrinkles and under eye dark circles. As opposed to using hyaluronic acid alone, I have found that combining hyaluronic acid with PRP to create better looking results.

QUESTION: I’m 40 and my brows make me look angry. What can I do to lift my brows without surgery?
ANSWER: Botox Brow Lift 
A Botox brow lift can help improve the position of the brows so you look more relaxed. In my practice, I help my patients with this procedure and find that they look natural and many notice that they even feel better.

QUESTION: I’m a 30 year old African-American Male – am I a candidate for transconjunctival blepharoplasty with CO2 Fraxel?
ANSWER: Transconjunctival Blepharoplasty for Darker Skin Types
I have performed a lot of lower eyelid surgery on people with dark skin. In my experience, I don’t recommend laser or skin removal for someone your age. The risks of discoloration from laser and a line of incision which can be seen below the eyelashes make the choices you’re considering less desirable. I have performed radiofrequency skin tightening under the eyes using Pelleve Skin Tightening which is safe for all skin types. I would suggest you consider having the transconjunctival blepharoplasty alone and making the decision to tighten your skin after the surgery, in which you will probably not need to have a skin tightening procedure. This transconjunctival procedure which I perform routinely in my practice in New York  and Long Island allows my patients to avoid any external scar and enjoy a natural appearance.

QUESTION: Eye Shape Surgery To Make My Eyes More Masculine?
ANSWER: Male Eye Lift Surgery for “More Masculine” Look
When choosing an eye plastic surgeon for male blepharoplasty, it is important this specialist knows how to differentiate the techniques used in male blepharoplasty from those meant for female blepharoplasty. It is important that men retain their masculine image rather than the more stereotypical feminine result. A man’s eyes may be characterized as feminine if they appear round or doll-like. Typically, a man’s upper eyelid crease is lower than a woman’s and the eyebrow is more level (as you probably achieve a more masculine look by squinting and lowering your brow.) These features should be preserved during blepharoplasty for men in order to retain the masculine appearance of the face. Another important factor is not to over-correct a man’s eyelid during male blepharoplasty. As men age, their eyelids will differ from those of their youth, and blepharoplasty for men should appreciate this subtle difference.

QUESTION: For Blephoplasty, Which Would Be More Competent…a Oculoplastic Surgeon or a Regular Plastic Surgeon?
ANSWER: Oculoplastic Surgeon vs General Plastic Surgeon for Eyelid Surgery
Great question! Eye plastic surgery (Oculoplastic) training is specialized compared to general plastic surgery. This extra focused training as a specialist serves as the foundation for expertise in Cosmetic Eyelid Surgery. As an Oculofacial Plastic & Reconstructive Surgeon in New York, super-specializing in the eyes, I have spent much more time than a general plastic surgeon on advanced eye plastic surgery and have spent many years instructing other eye surgeons on the topic. A second level of expertise is based upon types of experience (training pursued after residency, the number of years spent during and after formal training on specific types of procedures, teaching others his craft, before and after photos to show).  Hope this helps!

QUESTION: Eye Injury Caused Eye to Be Bigger, Can Plastic Surgery Fix It?
ANSWER: Eyelid Surgery for Bigger Eye
Eyelid plastic surgery or cosmetic eyelid surgery may be an option for you. A qualified doctor can examine your eyes will help determine if your asymmetrical eyes can be fixed surgically. An experienced surgeon who specializes in Oculofacial plastic and reconstructive surgery would be able to perform corrective surgery on your eyes that best suits you. Do your research before having eye surgery.

QUESTION: I Am 20 Years Old and Thinking About Upper Eyelid Surgery?
ANSWER: Upper Eyelid Surgery for Bright-Eyed Appearance
20 years old is young to elect for cosmetic surgery, so I recommend consulting with a qualified Oculofacial cosmetic surgeon who will understand what it is you want and to help determine the best approach for you. Recently, I performed upper lid eyelift surgery on a young woman who had a similar problem – although hers was not asymmetry to the eyes (as it seems to be slightly in your case judging from the photos). She had excess skin that caused slight hooding to her upper eyelids. People always thought she was tired and she couldn’t correctly apply her eye makeup to the upper lids. By removing the excess skin in an artistic way, she healed with natural appearing results so that no one knows she’s had any surgery, and is now happy with her bright-eyed appearance. Being young, you do not want to appear as if you’ve had surgery to correct a perceived problem. I’ve attached a video of this young woman’s experience to help you better understand.

QUESTION: Sore and Tender Upper and Lower Eyelids 8 Weeks Post Op?
ANSWER: Eyelid Surgery Recovery: Soreness and Tenderness After
Swelling after eyelid surgery could last up to 6 months to a year to complete the healing process after blepharoplasty. You had combination procedures (Ptosis surgery, lower eyelid surgery) which makes your case unique. If you are concerned, you should seek your doctor’s advice.

QUESTION: Am I A Candidate For Blepharoplasty For Bags and Hollowness?
ANSWER: Lower Eyelid Surgery for Under-Eye Bags
Fixing the problem with the puffiness below your eyes by “masking” with Restylane filler is a temporary solution and you seem to be looking for a more permanent fix. You may be a candidate for lower eyelid surgery should you elect to have the fat removed surgically. Because hollowness is also an issue, you may want to do a comprehensive procedure in repositioning fat. As an oculofacial cosmetic surgeon in New York for over 15 years, I strongly recommend you consult with a qualifies doctor who understands your goals and can give you natural-looking results from blepharoplasty.

QUESTION: Are There Any Exercises That Can Improve Upper Eyelid Muscle Tone and Result in Lifting Them?
ANSWER: Improve and Lift Upper Eyelids with Surgery
With over 15 years experience as an Oculofacial plastic and reconstructive surgeon, I can tell you there aren’t any exercises that will tone the muscles in your upper eyelid. Droopy eyelids can be corrected with eyelift surgery, in some cases eyelid ptosis surgery. However, a proper consolation with a qualified cosmetic surgeon will help you determine what is the appropriate treatment for lifting your eyes.

QUESTION: Had Upper/Lower Blepharoplasty 3 Wks Ago, Can I Dye My Lashes?
ANSWER: Dying Eyelashes after Eyelid Surgery
Although the normal healing time for upper/lower blepharoplasty about 1-2 weeks has passed, I suggest asking your cosmetic eyelid surgeon as you don’t want to risk complications.

QUESTION: Is This Normal – Blepharoplasty?
ANSWER: Incision Will Fade After Eyelid Surgery
It is still very early and the incision marks from eyelid surgery should heal fine and fade in 6 months up to 1 year. You may want to followup with your doctor for advice during the healing process for your blepharoplasty. I recommend using sunscreen or keeping out of the sun while the area is still healing to prevent scarring from getting darker.

QUESTION: How Long After Eyelid Surgery Should Stitches Be Removed?
ANSWER: Removing Sutures after Eyelid Surgery
About 1 week is normal for removing sutures after blepharoplasty. Waiting 2 weeks after a blepharoplasty follow-up with your doctor is a bit overdue, and you don’t want to risk an infection.

QUESTION: How Long Do Results Last After a Blepharoplasty of the Lower Eyelid?
ANSWER: Eye Lift Surgery Results are Long-Lasting
That is great that you are happy with your blepharoplasty results. That being said, you shouldn’t have to re-do your surgery as long as you have a proper diet, sleep, exercise and skin care. Properly done eye lift surgery can reverse the aging clock by up to 15 years. If you are still looking to improve your facial appearance, you may consider non-surgical enhancements, such as Pelleve Skin Tightening for the eyes, etc. At my practice, I see many patients who come to my practice in New York for revisional eyelid surgery after having had one or two attempts by their original surgeon and wish for us to correct problems.

QUESTION: Naturally Puffy Upper Lids. What Can I Do?
ANSWER: Cosmetic Eye Lift Surgery for Puffy Upper Eyelids
If the excess skin or fat, causing the puffiness on the upper eyelid, is bothersome, then a cosmetic upper eyelid blepharoplasty is the best choice for you. I’ve attached a video with before and after photos of upper eyelid surgery performed on a patient at my New York offices who had a similar problem. Excess skin on the upper lid made it difficult for her to apply makeup the way she desired and also after caused others to believe she was tired when she was not.

QUESTION: I Am 24 Years Old with the Begining Onset of Festoons. I Have Vertical Lines on my Cheeks. Is There Any Thing I Can Do?
ANSWER: Treatment for Festoons Below Eyes On Cheeks
These festoons could be caused by fluid in this area can be caused by several factors such as sinus and allergy. it may be beneficial to check if sinus or allergy problems are contributing to the swelling in your upper cheek area below eyes. In our practice we have had success with treatment of some cases of malar swelling with nonsurgical treatment such as Pelleve Skin tightening for the eyes and face and Fractional CO2 laser skin resurfacing for the eye area and face. It may also be best to just wait for a few weeks more and seeing the progress.As a Cosmetic Oculofacial Plastic surgeon operating in New York City, I might also recommend (with a proper evaluation of festoons) a lower eyelid surgery. Lower lid blepharoplasties address the bags (buggy eyes) or festoons that appear under the eyes that give a person an angry or exhausted expression.

QUESTION: Had Lower Bleph but Still Have Bags, Is 1 Week Post-Op too Soon to Worry?
ANSWER: Lower Blepharoplasty for Under Eye Bags
Swelling can last for months after eyelid surgery. At my practice in New York, if a patient is concerned about a fat pocket remaining after blepharoplasty, I recommend to wait at least a month before considering additional surgery for bags beneath the eyes. After the proper recovery period, consult with your cosmetic surgeon.

QUESTION: Had Lower Skin Pinch Blepharoplasty 5 Days Ago. Eyes Still Very Puffy.
ANSWER: Swelling and Puffiness After Lower Eyelid Skin Pinch Blepharoplasty
Being a Cosmetic Oculofacial Plastic Surgeon super-specialist of the eyes and face in New York, swelling under the eyes after blepharoplasty is something I deal with on a daily basis with eyelift surgery patients. Swelling after eyelid surgery can be variable and can last from a week to a month. Even with minimal trauma after lower lid skin pinch blepharoplasty, you can still get obvious swelling and puffiness under the eyes during the recovery period. After having the lower eyelid pinch bleph, you may notice the first 2 days that swelling is at its maximum. Usually at 5 days, you can use warm compresses for your puffy eyes or and carry on with normal activity (moving, blinking, talking, smiling). Compared to standard blepharoplasty, a limited amount of skin removal during a skin pinch eyelid surgery is less traumatic than removing fat or other surgery. However, in my 16 years of practice, I’ve witnessed a wide variation in recovery after eyelid surgery a lot of swelling for a little procedure and virtually no swelling for a lot of surgery. If you’ve ever had particles or debris go into your eyes or rubbed your eye due to allergies, you can remember your eyes are very sensitive to any kind of trauma. I recommend following the instructions given to you by your eyelid surgeon for after care following eyelid surgery. As long as your doctor sees no immediate concerns, you should be optimistic that the swelling will do down after eyelift surgery.

QUESTION: What is More Invasive..a Browlift or Upper Blephroplasty?
ANSWER: Browlift, Blepharoplasty or Both?
As a Cosmetic Oculofacial plastic and reconstructive surgeon in New York, eyelift surgery and browlift surgery is my speciality. As I consult with my clients, one must determine if a browlift or upper blepharoplasty is needed. Depending on the results that one is looking to get from cosmetic surgery of the eyes or face, sometimes a combination of a browlift surgery and upper eyelift surgery (or blepharoplasty) may be needed. One must be cautious when getting a browlifting surgery (or performing the surgery) that the brows aren’t overdone because it could result in a “perpetually surprised” look or expression if the brows become too arched. If a browlift and eyelift are performed in combination: after the browlift, it can then be determined how much excess skin is to be removed from the lids. Both a browlift and blepharoplasty are invasive surgical procedures, however they are invasive for different cosmetic goals.

QUESTION: Multiple Eyelid Creases?
ANSWER: Eyelid Surgery Specialist for Multiple Eyelid Creases
Your perception is understandable but there are many factors need to be taken into consideration before you choose to undergo blepharoplasty or upper eyelid surgery. It’s best you see a specialist with experience with prominent eyes before you make any decisions.

QUESTION: Post-op Upper Blepharoplasty – Will I Ever Be Able to Look Up Normally Again?
ANSWER: Swelling & Healing After Eyelift
If swelling due to the eyelift surgery (or blepharoplasty) is what’s causing the limitation in eye movement, there should be improvement with resolution of the swelling.

QUESTION: Eyelids Won’t Shut After Blepharoplasty?
ANSWER: Properly lubricate eyes at night after blepharoplasty
In my practice, I tell my patients that they should have no problem closing their eyes after blepharoplasty. It’s important you properly lubricate your eyes with artificial tears and ointment (at night). Seeing an eye doctor can help you avoid problems related to eye exposure.

QUESTION: Remaining Eyebag and Slight Asymmetry After Lower Blepharoplasty?
ANSWER: After eyelift, wait until healed and swelling goes down
Swelling can last for months after surgery. In my practice, if a patient is concerned about a fat pocket remaining, I recomment to wait at least a month before considering additional surgery.

QUESTION: Skin Wrinkling After Lower Blepharoplasty?
ANSWER: Eliminate Eyelid Wrinkling with Fractional CO2 Laser or Skin Tightening
Puffiness under the eyes can mask wrinkles which were already present. In my practice I offer options such as the Mixto SX microfractional CO2 laser and Pelleve’ for people with darker skin. Permanence is relative however you can expect results from these treatments to last for years depending on your health and lifestyle.

QUESTION: What Can I Do to Lessen Scars After Blepharoplasty?
ANSWER: Eyelift Revision Surgery and Seeking Opinions
Socially visible scars are a common problem and a common reason patients are referred to my practice. I stress to my prospective patients that there is an art to performing blepharoplasty so the eyes appear natural and not have obvious signs of being operated on. There may be some options such as revising the scar so it isn’t wide however, the fact that it is wide may mean there is a relative lack of skin. Seeking additional opinions if your surgeon has nothing more to offer may be the appropriate next step for you.

QUESTION: Problems Post-Blepharoplasty and CO2 Laser?
ANSWER: Follow-up after Blepharoplasty and Micro Fractional CO2 Laser Resurfacing
It’s important to work closely with your doctor to prevent the lower eyelids from pulling downwards. The CO2 laser is effective in reducing wrinkles (I routinely use a MixtoSX Microfractional CO2 laser in my practice) however the heat from the laser can cause the skin to contract significantly. It’s difficult to provide a complete diagnosis without an examination,

QUESTION: Sutures Not Dissolving on Upper Eyelids?
ANSWER: Dissolving sutures after eyelift and facelift
I’m a Cosmetic Oculofacial (Speciaizing in Eyelid and Facelift Surgery) Plastic Surgeon practicing for 15 years with offices in Manhattan’s Upper Eastside. If the dissolving stitches are 6-0 fast absorbing plain gut sutures, they should be well dissolved by 9 days after habing your eyelift and facelift. In my practice, I usually see my patients in 5-7 days to clear off any dissolving stitches which haven’t completely dissolved.

QUESTION: Corrective Measures for Eyelid Closure Problems After Blepharoplasty?
ANSWER: Revision for Eyelid Closing Problems After Eyelift
I’m a Cosmetic Oculofacial (Speciaizing in Eyelid and Facelift Surgery) Plastic Surgeon practicing for 15 years with offices in Manhattan’s Upper Eastside. Your problem is not unusual. I see patients with this problem from all over the world who seek help for revisional or corrective surgery due to an eyelift they previously had with another surgeon. Usually this problem is caused by lower eyelid retraction (the lower eyelid is not at the same level as the border of the iris or colored part of the eye). Proper examination and performing the right eyelift procedure or corrective procedures can probably provide you with some improvement of your problem with closing your eyes after having had blepharoplasty surgery to your eyes.

QUESTION: Will I Have Visible Scars from Eyelid Surgery?
ANSWER: Invisible or Minimal scarring after Eyelift (Blepharoplasty)
I am a Cosmetic Oculofacial Plastic Surgeon (Specializing in Eyelid and Facelift Surgery) practicing New York City’s Upper Eastside. Depending on the type of eyelid surgery you will have, the incision lines can be very effectively placed so they are not obvious and barely noticeable. In the upper eyelids, I place the incision within the natural crease of the upper eyelids. In the lower eyelids, if an external incision is necessary (often I do the procedure from behind the lower eyelids), it can be placed strategically below the eyelashes to minimize the visibility of scarring.

QUESTION: How Long Until Plastic Surgery Stitches Dissolve?
ANSWER: Stitches Dissolve Approximately 1 Week After Surgery
I’m a Cosmetic Oculofacial (Speciaizing in Eyelid and Facelift Surgery) Plastic Surgeon practicing for 15 years with offices in Manhattan’s Upper Eastside. If the dissolving stitches are 6-0 fast absorbing plain gut sutures, they should be well dissolved. In my practice, I usually see my patients in 5-7 days to clear off any dissolving stitches which haven’t completely dissolved.

QUESTION: Droopy Eyelids – Alternatives to Eyelift Surgery?
ANSWER: Surgery might be the solution for drooping eyelids
It is natural to want to avoid surgery. It is self evident that with all the miracle creams and “non-invasive” procedures that a practice such as mine sees so many people who require surgery. In my practice, we have ben successful in minimizing the stress and difficulties associated with having surgery such that I feel that we’ve made it less stressful than most dental procedures. It’s important to spend your time and resources intelligently. I see too many people who bought into the hype of non-invasive procedures only to be disappointed and still require properly performed surgery.

QUESTION: Browlift Vs Blepharoplasty – Which is Best for Sagging Eyelids?
ANSWER: Deciding between Browlift or Blephaphorplasty
The answer to this questions depends on whether or not you have noticed your eyebrows have drooped or are lower than they have been in the past. It is common to perform a brow lift to reduce the excess tissue over the eyes and do the blepharoplasty (upper eyelids) after 3-6 months to allow for any settling of the eyebrows (depeding on the technique used to lift the eyebrows). If the upper eyelid skin excess is primarily what is bothersome, then a cosmetic upper eyelid blepharoplasty is the best choice for you.

QUESTION: Will I Be Able to Close my Eyes After Eyelid Surgery?
ANSWER: Normally, eyes will be able to close post-eyelid surgery
It is a common perception that people are unable to close the eyes after eyelid surgery. Although this may be true temporarily in procedures such as ptosis surgery (drooping eyelid muscle) or when eyelid surgery is combined with significant eyebrow lifting surgery, it is normal for the eyes to be able to close comfortably.

In my practice, I counsel my patients to expect that there will be no difficulty with eye closure after cosmetic eyelid surgery. Cosmetic eyelid surgery should restore and enhance the natural appearance of the eyes. This means avoiding the removal of too much skin from he upper and lower eyelids as well as performing procedures to prevent the lower eyelid from being pulled down.

QUESTION: When Can I Use my Contacts After Eyelid Surgery?
ANSWER: 1-2 weeks before using contacts lenses after Eyelid surgery
In my practice, I generally advise people to wait about 1 to 2 weeks after Eyelid surgery to wear contact lenses. It is normal for there to be some decrease in tear production after eyelid surgery so it is a good idea to have contact lens lubricating drops. Of course it’s important not to stretch the eyelids to place the contact lenses and to make sure your hands and contact lenses are sterile.

QUESTION: Upper Eye Hollowness with Ptosis. What Do You Recommend?
ANSWER: Ptosis Canidate
Thank your for the photos. I believe you are a good candidate for ptosis surgery. I would recommend you have that done first before considering any volume augmentation. You may find that having more open eyes will be socially inviting enough.

QUESTION: Im 21 Years Old and I Had Ptosis in my Left Eye After Giving Birth?
ANSWER: Eyelid Ptosis after Giving Birth
One week is still early. Be patient and let the eyelid heal to determine if your ptosis surgery was successful in fixing your drooping eye. In adults, the most common type of ptosis is called “involutional ptosis.” This condition is due to a stretching or thinning of the muscle responsible for lifting the eyelids. While I cannot determine if your ptosis was caused by giving birth (rare) or developed because of other factors, I recommend you consult with the surgeon who performed your ptosis surgery for follow-up advice.

QUESTION: Second Upper and Lower Eyelid Surgery Recommended?
ANSWER: Eyelid Ptosis Surgery Candidate
Depending on anatomic changes such as skin excess and the development of eyelid drooping (called “ptosis”), you can safely have more than one eyelid procedure in your lifetime. I would like to point out to you that you appear to have ptosis, particularly affecting the left eye where it is difficult to see your pupil. A blepharoplasty alone is not likely to make your eyes look “brighter” without the ptosis being addressed. Ask your doctor when you have your consultation about “eyelid ptosis” and learn about your ptosis eyelid surgery options.

QUESTION: I Believe My Daughter Needs Ptosis Surgery, But She Doesn’t. Should I Force It?
ANSWER: Ptosis Eyelid Surgery for Children and Teenagers
As a Cosmetic Oculofacial Plastic Surgeon who specializes in eyelid surgery in New York, I think it is ideal to wait. There are social issues that you may want to do ptosis surgery for a drooping eyelid sooner; however, if there isn’t a basis to do surgery for vision affected by ptosis, it is best to hold off on doing the eyelid surgery. It is easier to do this type of eyelid surgery with patient cooperation as the muscles in eyelid are very sensitive. With children, surgery is done using very objective measurements and we anticipate the results from ptosis surgery will be close to ideal. On older patients, we get the cooperation of the patients, thus we are able to have the patient open and close eyes in order to do precise measurements and ensure the eyes will match as much as possible after ptosis eyelid surgery. In my practice and 20 years of experience, it is best to perform the eyelid surgery safely under local anesthesia with light IV sedation.

QUESTION: Ptosis Surgery Strange Outcome
ANSWER: Revision Surgery for Ptosis Surgery
Eyelid swelling can be significant up to 6 months and even 1 year. If the eyelid level remains after the next 2 months, a second procedure may be necessary.

QUESTION: Heavy Eyelids. In Picture It Looks Like I’m About to Blink. What Can I Do?
ANSWER: Heavy Eyelids: Upper Eyelift Surgery vs. Ptosis Surgery
As a board certified Oculofacial Cosmetic Surgeon practicing in New York, I can say based on your description that you either have excess skin on/above your upper eyelid OR weak levator muscles of your eyelids (ptosis). Pictures would better help, but you must consult with a qualified surgeon who can best determine what kind of blepharoplasty candidate you are: upper eyelift surgery OR ptosis surgery.

QUESTION: What on Earth is Wrong with my Eyes?
ANSWER: Assymmetrical Eyes
Although it is difficult to determine from your photos, facial asymmetry is normal and natural. While you do have almond-shaped eyes, the relationship between your eyes and your face is important when determining facial balance, so a full photo taken at a normal angle would help better. If it concerns you that much, you should consult with a qualified oculofacial cosmetic surgeon who understands the face and eyes to better understand your goals and a possible way to help you.

QUESTION: Will Eyelid Tape Help Improve Low Crease Line on One of My Eyes After Asymmetrical Upper Bleph?
ANSWER: Crease Assymmetry After Eyelid Surgery
The crease position after upper eyelid surgery should correspond with the incision. There may be some differences related to swelling. It is unlikely that tape will make much of a difference. Communicate with your eyelid surgeon regarding this asymmetry before doing anything on your own.

QUESTION: Does Sleeping on Your Face Cause Droopy Eyes or Uneven Eyes?
ANSWER: Sleeping Position and Droopy Eyes
Genetics and certain lifestyles such as smoking, sun worshipping, excessive weight gain, or high stress are more likely to make droopy eyelids appear. Sleeping on your face isn’t so much a huge factor usually. If it is a concern that bothers you, I recommend getting an examination by a qualified doctor who can better determine if you need treatment.

QUESTION: 10 Days Post Upper Eyelid Surgery. Woke Up With Asymmetry, and Droopiness. Options
ANSWER: Upper Eyelid Surgery and Assymetry during Healing
The left eye is noticeably lower than the right in the photo. You should followup with your eyelid surgeon to make sure that everything is healing okay and to address any concerns you have as it heals. It is still early, so the asymmetry might be due to swelling and swelling can last up to several weeks.

QUESTION: Why Are my Eyes Uneven? What Procedures Can Be Done to Fix It?
ANSWER: Uneven Eyes and Facial Balance
Facial asymmetry is normal and natural. It is difficult to tell by the picture as you show only your eyes and not the whole face. The relation of your eyes to your face is important when determining facial balance. If it concerns you that much, you should consult with a qualified oculofacial cosmetic surgeon who understands the face and eyes before electing yourself to do surgery.

QUESTION: Uneven Eyes. Would It Help if I Wore my Glasses More Often?
ANSWER: Unsure of Question
If you happen to be squinting, wearing glasses might help reduce the strain on the eyes. If you have asymmetrical eyes, you may want to consider seeing a qualified oculofacial surgeon for uneven eyes.

QUESTION: Do Eyedrops Correct Asymmetry After Blepharoplasty?
ANSWER: After Blepharoplasty Eye Care
Eyedrops moisturize your eyes and keep them from becoming dry and reducing irritation, but don’t correct asymmetry or affect the shape of the eyes. After blepharoplasty, healing could take anywhere from 7-10 days and swelling could last from 6-10 months. You’ve had blepharoplasty on both your eyes, and it is still too early to tell if your eyes are in fact asymmetrical. I recommend you consult with your eyelid surgeon for care and concerns regarding your eyelid surgery.

QUESTION: Asymmetrical Eyelids – 1 Year After Blepharoplasty; Options?
ANSWER: Surgery Advice for Asymmetrical Eyelids
As a cosmetic oculofacial plastic & reconstructive surgeon, I stress to my prospective patients that there is an art to performing blepharoplasty so the eyes appear natural, balanced and not have obvious signs of being operated on. Many eyelid surgery patients come to my practice in Manhattan for “revisional surgery” after being dissatisfied with results from other surgeons.

QUESTION: What Can I Do About my Uneven Eyelids?
ANSWER: Uneven Eyelids when Young
A proper analysis by a specialized oculofacial cosmetic surgeon, is necessary to determine the asymmetry of your eyes and what can be done to correct your uneven eyelids. As a Oculofacial Plastic & Reconstructive Cosmetic Surgeon super-specializing in eyelid surgery in New York, I gather it may result from ptosis, or drooping of the eyelid.

QUESTION: Eye Hollows. What Are My Options?
ANSWER: Hyaluronic Acid Injectable Treatment for Hollow Eyes
Considering that you appear to be young, a nonsurgical method (injectable) is probably most appropriate. For Hollowness beneath the eyes, I would recommend a hyaluronic acid injectable filler (such as Restylane or Juvederm) or a “Vampire Facelift” to add volume in that area . I see many patients with hollow eyes and dark circles as a concern at my practice in New York. A proper consultation with a specialized is necessary for treatment advice.

QUESTION: I Did Lower Blepharoplasty and Face Lift 1 Month Ago. Uneven, Hollowness?
ANSWER: Assymmetry and Healing after Face Lift & Eye Lift Surgery
You should communicate with your doctor and review the photos which were taken before surgery. Many times, people notice the asymmetric features they naturally have after surgery because they study their faces in more detail after surgery than before surgery. Eyelid incisions typically are thicker in 1 month after surgery and don’t require any topical medical treatment. I perform facelift with eyelid surgery routinely at my practice in New York and usually wait for at least 3 months before considering the placement of volume enhancing fillers.

QUESTION: Hollowed Eyes and Other Facial Wasting. Was Told That Fat Graft From Another Location Not Ideal. Move Fat From Outer Eye?
ANSWER: Adding Volume to Hollow Eyes
A photo of your own face might help better to determine a suggested method for you. At my practice in New York, we offer solutions for Hollowed Eyes treatment. There are certain treatments for hollowing eyes that are less invasive and beneficial for adding volume to the eye area. I have seen many people who need my help after having injectables done incorrectly and end up looking “lumpy” with many irregularities, so it is important you get the help of a qualified professional. Hyaluronic acid fillers (such as Restylane) can be injected along the orbital rim of eye as well as under brow. Platelet Rich Plasma (PRP) and Platelet Rich Fibrin Matrix (PRFM) are also very helpful for hollow eyes. PRP or PRFM, often referred to as the Vampire Facelift, which I offer in New York uses platelets and growth factors extracted from your own blood and used as injectable filler to the eye area with volume loss. The advantages of the The Vampire Facelift or PRP injections is that there is some of your body’s natural collagen being generated, so when the sunken appearance becomes more pronounced, this method helps to build collagen and thicken the skin. By can enhancing skin quality (with lasers or chemical peels) and add volume around the eyes (with Vampire Facelift PRP or Restylane), you may be able to improve your appearance.

QUESTION: I Need an Expert with Fixing a Sunken Eyed Appearance, Options?
ANSWER: Add Volume to Deep Set Eyes with Fillers
Practicing Oculofacial Cosmetic Surgery in New York, having deep set eyes and hollowed appearance is a common reason patients ask me for help with. There are certain sunken eye treatments that are less invasive and beneficial for adding volume to the eye area. Hyaluronic acid fillers (ex: Restylane) can be injected along the rim of eye as well as under brow. Platelet Rich Plasma (PRP) and Platelet Rich Fibrin Matrix (PRFM) are also very helpful for sunken eyes, often referred to as the Vampire Facelift, which I offer in New York offices. By drawing your blood, platelets and growth factors are extracted from blood and used as injectable filler to the eye area with volume loss. The advantages of the The Vampire Facelift or PRP injections is that there is some of your body’s natural collagen being generated, so when the sunken appearance becomes more pronounced, this method helps to build collagen and thicken the skin. As you age, volume of soft tissue, bone, fat starts to diminish; so if you have deep set eyes, you can naturally have a more sunken eyed appearance. There is no 100% perfect solution for deep set eyes as this is a function of your anatomy: your eyes relative to the bone have particular positions. You cant push the eyes out, however, you can enhance skin quality (with lasers or chemical peels) and add volume around the eyes (with PRP or Restylane), but it has to be done artfully by a qualified doctor able to perform these cosmetic seye treatments. I have seen many people who need my help after having kit incorrectly end up looking “lumpy” after getting injectables and creating too many irregularities.

QUESTION: Volume Loss Under Eyes and Cheeks. Have Tried Fat Transfer, Restylane, Radiesse With No Results. Other Options?
ANSWER: Vampire Facelift® for Volume Loss Under Eyes & Cheeks
Being that you haven’t had any success with Restylane or Radiesse, I might recommend a non-surgical procedure I perform for my patients at my Manhattan and Garden City, New York offices called the Vampire Facelift®. The Vampire Facelift® is a unique approach to helping you look younger using the natural growth factors in your own blood with a filler such as Restylane or Juvederm performed in a special way. After drawing your own blood, it is processed so the platelets (cells which stimulate collagen for healing) from the other main components of the blood (this is called “platelet rich plasma” or “PRP”)
The platelets are processed and made into a platelet-rich fibrin matrix (PRFM) which becomes a gel. Since PRFM is like a gel, it has similarities to other fillers, and can be used to sculpt the face. When the growth factors activate the stem cells of the skin, then the stem cells generate:
New Skin
New Blood Flow
New Collagen
New Tissue

QUESTION: The Best Solution for Sunken/droopy Eyes?
ANSWER: Injectable for Sunken, Droopy Eyes
For hollowness beneath the eye, I would recommend a hyaluronic acid injectable filler or a Vampire Facelift to add volume in that area. For my patients with tear trough deformity, I sometimes perform tear-trough implant surgery. Tear trough implants are made of silicone – a soft rubber-like material that is inserted through a small incision and placed over the bone mass under the eyelid to augment its shape and create a more youthful appearance. A proper consultation is necessary for treatment advice.

QUESTION: Dark Under Eye Circles After Lower Eye Lift?
ANSWER: Dark Circles Under Eyes After Lower Eye Lift Surgery
Dark circles under the eyes after eyelid surgery, there can be some temporary darkening of the skin (particularly for people who tan easily). Dark circles below the eyes are a combination of ethnic pigmentation, skin thickness, vascularity, and other factors such as allergies. In my practice in New York, I advise my patients after blepharoplasty to use an under eye cream with sunblock and typically the skin color returns to it’s normal pigmentation. I even developed a medical-grade skin care line in helping my patients maintain their skin after surgery, including Eye Rescue and an antioxidant sunscreen.

QUESTION: What Are These Dark Circles/marks Under Eyes After Lower Bleph? Can They Be Fixed?
ANSWER: Lower Eyelid Surgery and Dark Circles
Dark circles under the eyes are a combination of ethnic pigmentation, skin thickness, vascularity, and other factors such as allergies. After eyelid surgery, there can be some temporary darkening of the skin particularly in people who tan easily. In my practice in New York, I advise my patients after blepharoplasty to wear an under eye cream with sunblock and typically the skin color returns to it’s normal pigmentation. I even developed a medical-grade skin care line dedicated to helping my patients maintain their skin after surgery.

QUESTION: Skin Health Around Eyes Destroyed After Lower Bleph?
ANSWER: Skin Health and Color After Eyelid Surgery
It is possible that too much fat was removed. For the dark circles beneath your eyes, Laser skin resurfacing by a qualified professional may be a solution. The Micro Fractional CO2 Laser treatment shows dramatic improvement in skin texture and color and leaves it smooth, firm and even-toned. Also, at my practice in New York, after a proper consultation, to determine if I might offer PRP or platelet rich plasma injections combined with a hyaluronic acid filler to help fill out the hollowing beneath eyes and restore color to the skin. In my years of experience skin mainentance is important following surgery, so I formulated a medical grade line of skin care products in which we carry Eye Rescue (by Prasad Medical Skincare) to reduce dark circles and has vitamins to help nourish the delicate skin around the eye.

QUESTION: Recommendations For my Eyes?
ANSWER: Treatment for Dark Circle Under Eyes
While it is hard to tell by this photo, dark circles under the eyes can be caused by allergies, genetics, sun exposure and even smoking. Proper skin examination is necessary to determine the best plan. At my practice in New York, options for treatment can include topical creams, chemical peels and lasers. When dark circles are caused by sun damage, I use the Mixto SX microfractional CO2 laser with very nice results. Before choosing a procedure, a proper diagnosis needs to be made. I’ve attached a video on how to get rid of tired eyes and dark circles for a similar question.

QUESTION: Will my Insurance Pay for Blepharoplasty?
ANSWER: Not very often will insurance pay for Blepharoplasty
In most cases, the simple answer is no. In the case of vision blockage due to ptosis or excess skin, there are very specific vision tests that insurance companies will demand as well as photo documentation before approving such a surgery. There are times a procedure can be approved because of medical necessity. That said, if it is approved, the insurance company will have an amount that they deem normal for the procedure and the area it is performed in. Often times, in a private cosmetic practice, that covered amount is a fraction of the actual cost of surgery. Insurance companies rarely account for the specialty involved in these surgeries.
My advice would be to deal with your insurance company first. Get approval from them. Submit it all your i’s dotted and t’s crossed and then knock on wood and cross your fingers that the claim will process.

Prasad Cosmetic Surgery
61 E 66th St. New York CityNY10021 USA 
 • 212-265-8877

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