Saint Louis Facial Plastic Surgeons

10 Months Post-op Facelift. Unable to Involuntarily Blink Right Eye.

This is a follow-up of my previous question here.

You do appear to have symptoms of facial nerve injury on your right side, either due to the surgery or possibly unrelated (viral, Bell's palsy, etc).

Some ongoing recovery is expected over time. As the previous surgeon mentioned, professional eye care is extremely important to prevent eye infection due to incomplete blinking causing dryness of the cornea.

When your recovery plateaus, if need be, a small gold weight can be implanted into the right eyelid to allow much more normal involuntary blinking. In the meantime, a small amount of injectable filler performed by an experienced surgeon can simulate the same effect, allowing a 1 minute office procedure to give you complete eye closure while your condition finished healing. If there is still weakness, then the filler can be dissolved and a gold weight placed. If the weakness resolves 100%, simply dissolving the filler will do.

Laxmeesh Mike Nayak, MD

Saint Louis Facial Plastic Surgeon

Do I Need Revision Otoplasty or Is It Not Worth It? (photo)

I did otoplasty 1.5yrs ago.My doctor did what I asked him to: pinned the ears back but I wanted them to show a little bit,I didn't want people to notice the otoplasty. Strangely,I look in some mirrors and I like how my ears look and in others I don't like them.I don't know why I still have this issue with my ears. Is it worth it to do a revision otoplasty? Will this 'weaken' my ears long term?I do Jujitsu and don't want this to be comprmise training. I attach photos.Please give me your opinion

I agree with the previous posters - you have a very nice, very natural result. I doubt revision surgery will improve an already excellent result, and you may encounter unexpected problems. Enjoy your great result.

Laxmeesh Mike Nayak, MD

Saint Louis Facial Plastic Surgeon

Why is Fat Transfer a Low Rated Procedure on RealSelf?

Fat transfer or grafting has slid into one of the lowest rated plastic surgery procedures on RealSelf. Under 40% of consumers say fat transfer was "Worth it". Why is this the case?  Is there something wrong with the procedure, patient selection, doctor technique?

I think the reason fat transfer has low "worth it" ratings is because fat transfer is actually of very limited utility in facial plastic surgery. In my personal experience, fat transfer produces very predictable results in the tear trough, moderately predictable results in the anterior and lateral cheek, and almost no long term results in the lower face. It is also not a valuable treatment for skin wrinkles or creases - it is good for "volume" filling only.

When fat transfer is used as a single procedure, and the patients' entire satisfaction is based on the result, I think disappointment is likely. When fat is used as a "finishing touch" to blepharoplasty or facelifting, focusing on the tear trough and cheek, I think overall satisfaction is high.

In short, I think most of the dissatisfaction with fat is because patients (and inexperienced surgeons) are asking too much from a procedure of relatively limited utility.

Laxmeesh Mike Nayak, MD

Saint Louis Facial Plastic Surgeon