Dr. Prasad’s Signature Style in Cosmetic Upper Eyelid Surgery
Hairdressers and makeup artists are some of the biggest fans of Dr. Prasad’s work. The way he designs his upper eyelid procedures and his fine stitching technique continue to impress the people who are referred to him and the clients who come to him. In fact, Dr. Prasad has seen work done by other doctors who claim to do a great job at doing their stitches and has found them to be less than impressive. One of his patients said to him when they saw another well known doctor’s stitches, “he doesn’t sew like you Dr. Prasad”.
Many of Dr. Prasad’s clients ask “where are the stitches?” when they look in the mirror after surgery. After they have healed, many of his patients show off their eyes to friends who admire the fact that there is practically no sign of previous surgery on their eyelids. Upper eyelid surgery is not just a simple removal of extra skin. In fact, the skin plays only a part of the procedure. Sculpting the soft tissue and creating a natural appearance is more art than it is technique alone. “Most doctors who perform cosmetic eyelid surgery can do a decent job which many people find acceptable (since they don’t know better) but very few Cosmetic Surgeons perform exceptional eyelid surgery. I see people all the time whose upper eyelid incision scars fall outside the crease and can be seen when the eyes are open or the crease incision is too high on the upper eyelid.”
Blepharoplasty or Filler?
I am a 28-year old Indian female w/ asymmetric drooping upper eyelids, dark under eye circles, and fine lines under eye. Will an upper and lower blepharoplasty cure all concerns? Is filler better for my under eye region instead? My under eye’s are hollow and my nose is large (and had a 1 year lasting result of liquid nosejob to straighten it). Would there be complications from nose filler? What would be the NYC cost of eye procedures you recommend, what results do you expect?
Thank you for your question!
You have addressed a few concerns. We’ll start with the asymmetric upper eyelids. Looking at your upper eyelids, I can say that the option for upper eyelid enhancement is probably blepharoplasty. Looking at your right upper eyelid compared to your let upper eyelid, if you feel like there’s a little bit too much skin, well, I would typically recommend upper eyelid blepharoplasty. And when we do that, we try to customize and that’s the art of doing blepharoplasty, is that you try to balance out as much as possible what the amount and volume of skin is in one side versus the other. So it’s very important to have that artistry and when you’re young, the amount of elasticity and forgiveness is less as when you are older so you have to choose a surgeon whom you really feel has an artistic skills to do that.
As far as your lower eyelids are concerned, there are options in improving pigmentation. In my practice, I commonly use something called platelet-rich plasma and very often I actually combine that with hyaluronic acid. So let’s break it down, the platelet-rich plasma is derived from your own blood, and if you’ve ever heard something called a vampire facelift, it’s something like that where we draw your own blood and we concentrate the platelets which are the active growth factors used for healing. And when we place this under the skin of the eyelids, we actually improve this quality and texture of the skin. And very often the darkness and the wrinkling of the under eye area of the dark circles has some improvement. We can’t get rid of ethnic pigmentation but we can improve the skin quality.
Hyaluronic acid used in the form of Restylane can help fill a hollow and when done very well, it can look imperceptible. It can improve and look very nice. Unfortunately, a lot of colleagues or doctors who do this injection make the area too lumpy because the skin here is very thin and very unforgiving and every week, we have a few patients come to us who come to have it dissolved. So we just have to be mindful and again choose a doctor you feel comfortable with.
Last, you asked about injectable fillers for the nose. I can tell you being trained and being boarded in facial cosmetic surgery that most doctors who perform rhinoplasty or nose surgery are not big fans of nose filler. The typical one being radiesse or calcium hydroxyapatite. Now this is a controversial issue but there have been issues where there’s been problems with the skin quality after the placement of these fillers. Sometimes I’ve used it in the deepest part of the nose where the forehead, the skin is thicker and so it’s a little bit more forgiving when place a filler down at the root of the nose. So it’s worth considering but I would be very careful. And since you didn’t send pictures of your nose, I can’t really comment on that any further.
So again, to summarize, my recommendation is upper eyelid blepharoplasty for the upper eyelids and enhancement of the lower eyelids with hyaluronic acid and platelet-rich plasma and of course depending where the filler is placed for the nose you just have to be cautious about the safety and the predictability. I hope that was helpful and thank you for your question.
Upper lid blepharoplasties are performed to get rid of the hooding of the eyes. Lower lid blepharoplasties address the bags (buggy eyes)or festoons that appear under the eyes that give a person an angry or exhausted expression. Upper lid blepharoplasties are performed through the lid crease and the scar is well hidden whether the eyes are open or closed. Women will find that eyeshadow is much more easily applied. All patients will find that their face is significantly rejuvenated and they will be described as “energetic”. Dr. Prasad has pioneered a particular technique in blepharoplasty surgery known as the “SmartLift™ eyelift,” which involves minimal incisions, local 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 local anesthesia 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.
How do I fix my lazy eyelid?
I’m concerned that my lazy eye and eyelid is going to get worse and that is visible to others around me. Is there anything I can do to make it open as much as the other eye so that they look equal?
You are asking how to improve the appearance of your lazy eyelid. By doing some research you are probably aware that the term for your situation is called ptosis. Which means droop and drooping of the upper eyelid. Since there is no history with the question you submitted, I’m going to assume that you have this problem for a while and that maybe recently it got worse.
First of all you should bring this to the attention of an opthalmologist or to an oculoplastic specialist. For one reason is to just rule out any other medical issues that may be causing this drooping of the eyelid to occur. Hopefully you would figure out when you do see a specialist.
But to answer the question what can be done for the ptosis or drooping eyelid is basically ptosis surgery. Now there are some people who have a slight ptosis who will manage their appearance by using these drops that have dilating action used by ophthalmologist to help stimulate the muscle and temporarily lift the eyelid. But the most definitive treatment is ptosis surgery.
Ptosis surgery involves working in the eyelid crease to work on the muscle called the levator muscle and it’s like the word elevator but without the letter E. Levator means to lift. This muscle is responsible for lifting the eyelid. There is a variety of different techniques but the principle is basically taking the muscle and moving it forward so that the eyelid opens more effectively.
In my practice I do this procedure routinely and we do this under local anesthesia with a little bit of sedation and we actually do this with people’s cooperation because that muscle is a very sensitive muscle and any little subtlety can throw it off when we’re doing the surgery.
What we do is we actually have the patient open their eyes and look up and have the patient sit up to make sure that the height and the shape and the contour look really really good.
The point is, is that you can have a surgery to have the procedure to improve the appearance of ptosis that it should be done in a way that you get the best symmetry possible and it’s certainly my approach of doing this under local anesthesia with cooperation and sitting you up. That is the approach that I of course would recommend to whichever oculoplastic surgeon you go to.
I hope that was helpful and thank you for your question.
Combined with Dr. Prasad’s LITE™ anesthesia technique, a Smartlift™ eyelift is able to provide the optimal procedure with the least amount of risk. 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. To schedule a consultation with Dr. Prasad to determine the best procedure for you call either our Manhattan office at (212) 265-8877 or Garden City Long Island Office at (516) 742-4636. Patient Financing options available for qualified candidates.
How Do I Know If I’m Ready For Upper Eyelid Surgery?
- Friends, coworkers or employees keep asking you if you’re not getting enough sleep or tired.
- You’re concerned that you’re working in a field where you are being perceived as “older” or “less important”.
- People think you’re older than you are.
- You look in the mirror and your eyes look like they’re small or almost closed.
- The real shape of your eyes is being hidden by a fold of skin hanging over the lids.
- You’re Asian and you want to have a “double fold” or crease to make your eyes look brighter.
- You’re frustrated applying eye shadow because your eyelids are heavy or droopy.
- As you’ve gotten older, the skin over your eyes is sagging.
Are There Special Considerations for Someone with Dry Eye Undergoing Blepharoplasty?
Previously, I asked which procedures would be best in light of my severe dry eye. The doctors have responded that I should see ophthalmologist for diagnosis. I was diagnosed with MGD (meibomian gland dysfunction). I have done as advised, including cauterizizing my upper lid tear ducts, nightly hot compresses, followed with special gel, & Restasis twice daily. It is still dry, but relatively comfortable. What would be the best way to get my upper lids lifted and the fat removed from under the eye? Thanks.
Thank you for your question!
I’m a very happy to see that you have done a lot of your homework in order to ensure that the health of your eyes are properly maintained before you consider having eyelid surgery. As an oculo-facial cosmetic surgeon, practicing over 20 years with a lot of experience with dry eye and tear duct issues and lacrimal gland issues, a very common concern that people after eyelid surgery is dry eye. And so, the ideal way to deal with your situation is to ensure that your eyes are properly lubricated before the surgery and to have the surgery performed in a way that respects the anatomy and support of the eyes.
One of the most common problems I see is malposition or retraction of the lower eyelid from cosmetic eyelid surgery performed particularly from the outside of the eyelid wherein incision is made underneath the lashes. That doesn’t mean you can’t have that procedure. But the proper procedure needs to respect the anatomy and support necessary to keep your lower eyelid in proper position.
So essentially, my approach is also to endure to deal with the second most common thing that we see with people after cosmetic eyelid surgery who come for revision, is difficulty of closure of the upper eyelids. Essentially, what ends up happening is well-meaning doctors will take away a little more skin than the patient can tolerate such that their upper eyelid closure is compromised. And if you do any research in the web, you’ll learn that it’s more common that what you would expect.
So, a strategy for you that I would suggest, considering looking at just your photos alone, would be a conservative reduction of the upper eyelid skin artfully done. I always teach doctors who are learning how to do eyelid surgery that upper eyelid surgery doesn’t require a very aggressive removal of skin. Younger looking eyes do not necessarily require the absence of a lot of skin in the upper eyelids. So it doesn’t make sense to me that such aggressive removal of skin such that it’s difficult to close your eyes is any way indicated. So I would artfully reduce the skin in the upper eyelids so that the shape looks natural and essentially the excess skin related to genetics and aging is addressed.
With your lower eyelids, you have some fat prolapse and you have a fair number of fine lines and wrinkles. So I would probably do a combination of transconjunctival blepharoplasty which means I would reduce the fat pockets from the inside of the eyelids. By doing that, I essentially maintain the natural support of the lower eyelid and there are several muscles that have to be in balance. And we reduce the likelihood of the eyelids pulling down. Now this is a little more advance technique but in my opinion, a very respectful of your anatomy so that your function is preserved.
To treat the fine lines and wrinkles, depending on the amount of skin you have, and that’s one thing I can’t assess just by your photo alone, is the elasticity of the skin which I would feel. I would probably do some type of laser procedure to help the skin quality and tone under the eyes. I would still be conservative because the goal is not to be so aggressive that the skin gets too tight that it pulls the eyelid down which is another common reason for people to come and seek a specialist like myself.
So, I think your procedure can be done, being mindful of proper eye lubrication and management as well as continuing proper eye lubrication after the surgery. It’s normal to have temporarily drier eyes after eyelid surgery but I’ve operated on patients who have severe dry eyes for cosmetic purposes and uniformly patients have done well with proper management from and ophthalmic standpoint as well as proper management from a surgical standpoint to ensure good function of the eyelids.
So hopefully that was helpful for you and thank you for your question.
Dr. Prasad Is An Eyelid Surgery Specialist For TV And Other Media
Dr. Prasad is often featured on TV news programs in the media for upper eyelid and lower eyelid surgery.
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Dr. Amiya Prasad – The Cosmetic Eyelid Surgery and Facelift Surgery Superspecialist
When you know the facts, you’ll be hard pressed to find another doctor with Dr. Prasad’s professional background, experience, personality, passion, staff and facilities.
Plastic Surgery as a field is too broad for one doctor to be exceptional in all areas. With the advances in technology and techniques as well as the needs of the modern client, I don’t believe that “good enough” is doing right by our clients. As Malcolm Gladwell described in his book “Outliers”, exceptionally talented people whether they are musicians or pilots have a consistent history of practicing for “10,000 hours”. When US Airways Flight 1549 had to land emergently in the Hudson River, Chesley Burnett “Sully” Sullenberger III was able to land the plane safely based on thousands of hours of experience as a commercial airline pilot. Based on this core belief of specialization as a way to provide higher level care, Dr. Prasad approached his specialty of eyelid and facial rejuvenation surgery as a specialist as opposed to the broad approach of general plastic surgery.
Dr. Prasad states, “I believe it is a great honor for people to trust me with their appearance and I treat every client as if they were my family. Physicians when asked to look for the best specialist for a member of their family, they look for doctors with specialized experience, expertise and ethics.” “When you take care of people like you would your own family, you are committed to excellence in surgical skills, safety in anesthesia and medical care and V.I.P treatment in all areas of their experience and make sure there is as rapid a recovery as possible”
“Treat your patients the way you treat your family”
How Does Dr. Prasad’s Qualifications Compare With Board Certified Plastic Surgeons or Board Certified Facial Plastic Surgeons?
Dr. Prasad’s training and experience in eye plastic surgery far exceeds the standards of these other plastic surgery boards. Surgery around the eyes is not to be taken lightly. Every year, hundreds of people have complications from eyelid surgery and desperately search for specialists like Dr. Prasad to help them. The ugly truth is that being a superspecialist in eyelid cosmetic surgery gives Dr. Prasad many advantages over other plastic surgeons but competition and professional rivalry keeps many doctors from accepting this fact and performing procedures they are not trained enough to do. In addition, Dr. Prasad has distinguished himself by his artistic touch and exceptional skill in performing blepharoplasty or eyelid surgery. In practice since 1995, Dr. Prasad has established a reputation as one of the best eye plastic surgeons for cosmetic eyelid surgery.
Not Every Plastic or Cosmetic Surgeon is an Artist
As a teaching surgeon and having worked in the field of cosmetic surgery, Dr.Prasad can share with you his firsthand experience of seeing that many board certified plastic surgeons use a “cookie cutter” approach to cosmetic surgery rather than an artistic approach. Have you wondered why so many wealthy and famous people have such bad plastic surgery? They are often advised to go to the “best doctors” as listed in magazines or in positions as department heads at major universities and hospitals and yet they have less than desirable results. “In my opinion, the ideal Cosmetic
Surgeon is technically competent, artistically gifted and deeply caring for his patients. Artistry cannot be taught. Understanding balance and natural appearance is part of your DNA”. Dr. Prasad’s talents as an artist was recognized by the Long Island Arts Council where he received “The Arty Award” and received a Citation from the Nassau County Legislature.
Watch Dr. Prasad’s Award As An Honored Artist Acceptance Speech
Dr. Prasad has always believed “If I can’t improve the way a procedure is performed, what’s the point”. Always asking a different set of questions, Dr. Prasad has demonstrated his creativity and technical skills to many surgeons from around the world who come to watch him lecture and operate.