Facial Plastic Surgery Questions and Answers: Part 2

Question: I know I need a blepharoplasty, but do I need a brow lift also?
Answer: The photograph demonstrates adequate position of your outer eyebrows, only very mild brow ptosis centrally closer to your nose. It wwould be best to just perform an upper and lower blepharoplasty to rejuvenate the eyelid area. The primary goal of upper eyelid surgery is to remove mostly skin to improve the hooded look, while the primary goal for lower lid surgery is to remove the fat bags creating the puffy look.

Question: Is it better to do all face procedures at the same time?
Answer: Yes, indeed, it’s certainly possible to undergo a lower face/ neck, lift, a brow lift along with upper and lower eyelids all done at the same time under one anesthesia with one recovery period. A full set of facial photographs are required to make a determination about being a candidate for all of these procedures. For many examples from our practice of all of these procedures done together and separately, please see the link below.

Question: 48yo female. I had VSG 06/20/20. Lost 100lbs. Best options for neck skin sag and forehead wrinkles from weight loss? 
Answer: As far as your forehead goes you do not have low eyebrows, therefore a brow lift is not required. Consider Botox for forehead wrinkles. With respect to your neck, the inelastic skin in the neck is due to the deflation of your face and neck from the hundred pound weight loss. The loose and an elastic skin is going to require a lower face and neck lift procedure at age 48. This procedure involves tightening loose facial and neck skin, tightening loose facial and neck muscles, removing any residual fat in the neck, and lifting the jowls.

Question: Do I need a brow lift?
Answer: You only have a small amount of eyebrow ptosis on your left eyebrow. If the position of your eyebrows bothers you a lot, then consider a brow lift procedure. Very important not to get over-elevated because you’ll look permanently surprised. One option would be to just perform your upper eyelid surgery to make your eyelids look more symmetrical, which can be done under local anesthesia as an outpatient procedure. If the position of your eyebrow still bothers you several months after the eyelid surgery, then consider a brow lift.

Question: Can I get a nose job, chin lipo & a brow lift without a visible scar?
Answer: The position of your eyebrows is acceptable, and a brow lift is not necessary. You will look permanently too surprised. The photographs are inadequate to determine how much fat is located underneath your chin, so a full set of facial photographs from all angles are going to be required. If there’s a small amount of fat in the neck, liposuction can be performed. A closed rhinoplasty approach can accomplish refinement of the nasal tip, narrowing the bridge line, shaving down the dorsal hump and preventing the tip of the nose from drooping when smiling with all incisions placed on the inside of the nose. No external incisions are required. Digital computer imaging of your nose would be helpful.

Question: Brow lift or eyelid surgery?
Answer: The position of your eyebrows is acceptable, therefore, a brow lift is not necessary, otherwise you’ll look too surprised permanently. An upper blepharoplasty procedure can accomplish increasing your upper lid fold if you want to put more eye shadow make-up on.

Question: Would a brow lift fix divot between brows?
Answer: A full set of facial and forehead pictures of your eyebrows are required to make a determination. A brow lift is only performed when there’s low set eyebrows. If there is a divot present, the corrugator muscles are usually softened surgically in addition to placement of a fascia graft in that area.

Question: Is it a brow lift required to achieve symmetry with an upper blepharoplasty?
Answer: While you do have some mild asymmetry of your eyebrows, you are not a candidate for a brow lift procedure due to the normal positioning of your eyebrows currently. A brow lift is only used for patients who have low set eyebrows. With an upper blepharoplasty procedure, you can have a differential amount of skin removed in order to make your eyelids more symmetrical in appearance. In our practice, this can be performed under local anesthesia as an outpatient procedure, which takes about 30 minutes.

Question: How can I get ready for the recovery process for a face, brow and eye surgery?
Answer: Every plastic surgeon has their own preoperative and postoperative protocol, so it’s always best to check with your operative surgeon Regarding these three procedures.

Question: Would it be wise to get two surgeries a month apart?

From an anesthetic standpoint, it’s best to separate two general anesthetics about a month apart. If you’re going to perform both of these two procedures, it’s probably best to do the nose first and wait at least a month or two, and then undergo the brow bone reduction just due to the local swelling. When performing the rhinoplasty procedure, give some consideration to placement of a small chin implant to augment your chin, forward for a better facial balance and proportions, especially with respect to the projection of your nose. Digital computer, imaging of both your nose and chin from the side profile would be help on the education process.


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