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Problems Post Endotine Periorbital Lift

I had an endotine brow and cheek lift (through the mouth incision) several years ago. I am 56, and had had a standard face and brow lift in my late forties. In hopes of reducing nasolabial folds, the SOOF lift through the mouth was performed, with good results; the endotine brow lift was outstanding, resulting in a beautiful, natural-looking eyebrow position.

Although the procedure was helpful, I asked if the nasolabial folds could be further improved upon, and a periorbital entrance with blepharoplasty was recommended. Pre-op, the office nurse told me swelling would be down in three weeks. The day of surgery, the surgeon said he could also lift the corners of the eye with the procedure. I was uneasy about the relative newness of Endotine, but had had such a good result with the previous surgery that I went ahead.

Post-op, my eyes had very different shapes; the scars, especially on the more slanted eye, was visible and much wider than the other side. I was concerned that this eye's sutures were opening, but the surgeon, at three days post-op, was unconcerned. A week later, he said some skin grafting might eventually improve the appearance, and that I knew that I was at a higher risk for complications, because I'd had so many prior surgeries. Should this not have been discussed pre-op? If it had, I wouldn't have had the procedures.

One year later, the eyes are still somewhat uneven, but can be disguised with make-up. The tight eye side's upper cheek bone still hurts to the touch, and the cheeks are still somewhat asymmetrical. I have, too late, read that many surgeons no longer use the periorbital entrance, due to the long healing and sorts of complications I have experienced. I have spent nearly $4,000 on fillers trying to improve the lower lid hollowness and cheek asymmetry.

I have been left with hollow temples, pulled down upper lids, and hollow eyes. What can I do at this point? I would appreciate your opinions. Thank you.

Doctor Answers (15)

Endotine facelift problems are common and hard to fix.

+5

I don't think Endotine has a useful role in facial rejuvenation.  It is a foreign body and creates unnecessay scarring and inflammation.  Your problems are very complex and possibly irreversible.  You should consult with a plastic surgeon very well versed in problems of facial aesthetic surgery.  A revisional procedure could be disastrous if poorly executed.


Atlanta Plastic Surgeon
4.5 out of 5 stars 8 reviews

Consider a Second Opinion

+3

I am sad to hear that you have had such troubles.  The issues you describe are very complex and really can't be properly addressed without a hands-on exam.  While the endotines may be causing some of your issues, there is certainly more going on here.

I would recommend that you proceed slowly and cautiously with any revision surgery.  Be certain that your healing is complete before undergoing any additional surgery.  This typically means a minimum of 6 months and usually closer to a year of healing.

A second opinion is warranted.  I am not saying that your original surgeon is incapable, it is just that it would be worth your time and effort to let another qualified surgeon exam you and formulate an opinion for your consideration.

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon
5.0 out of 5 stars 16 reviews

Lower lid reconstruction is warranted

+3

A picture will be very helpfull but it seems that you need lower lid reconstruction with canthal support. Many operations are described to handle this problem. a proper analysis and plan need to be discussed with a plastic surgeon with training in occuloplastic techniques. Feel free to send a pic to help with the analysis.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 6 reviews

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Post Endotine complications

+3

You already know you have a very complex problem, and the lower lids are not forgiving.

You had a SOOF lift and CANTHOPLASTY plus other procedures but these two affect the eyes significantly. and you have too much skin removed from the lower lid.

You need full evaluation and exam by a board certified PS and may be an expert in periorbital area for the eyes.

Samir Shureih, MD
Baltimore Plastic Surgeon

Revision eyelid surgery

+3

You should seek consultation with a surgeon with interest in the midface and revision lower eyelid surgery. Your problem is quite complex and the suggested treatment, if any, will most likely be geared toward improving the eye shape, possibly reducing lateral orbital dystopia and rounding of the lower eyelid, a common problem with subciliary procedures, and of restoring a less operated appearance to the eyes.

Your problem is best considered in the context of the entire face, and a plan made for years to come, not just for your specific issue with the eyes. Given the surgeries you have had, at this point, every major area in the face is in play.

It never hurts to have several consultations with top surgeons before deciding on your next move.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 95 reviews

Endotine problems

+2

I personally dont use endotine. I feel it another foreign thing for the body to accept. I remember the father in the movie "My big fat Greek wedding" who recommended windex to fix everything. I am a major proponent of volume replacement. Around the eyes fat placed by an expert can replace upperblepharoplasty, mid facelift, lower blepharoplasty not to mention all fillers. I recommend Dr. Little in Washington D.C as an expert in this field

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 17 reviews

Endotine lift

+2

Unfortunately you have complex complications and scarring after an approach that is lovely when it works and disastrous when it doesn't - so conservative surgeons avoid it when possible.

You should see a Board Certified Plastic Surgeon who is experienced with evaluating surgical complications of facial surgery. You should call around and see at least three. Look for someone who might be able to design for you a very careful conservative treatment plan - low risk, possible improvement in a step by step manner, e.g. massage, injections, limited surgery.

Save your money. Stop the fillers. And if you have had a lot of elective facial surgery, it's time to stop for the foreseeable future.Sorry this happened. Best of luck.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.5 out of 5 stars 21 reviews

Repairing Complications

+2

Sorry to hear of your difficulties.

As you know, fillers are temporary, a "stop-gap."

The hollow areas may do better with careful fat grafting.

It sounds like you are struggling with retraction of the lower eyelids, an unfortunate but known complication of eyelid and midface surgery. Repair is possible and may require scar release and possible grafting.

Speak with your surgeon about these techniques, his/her recommendations, and maybe get some second opinions.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 12 reviews

Revision facelift

+2

the key is the correct diagnosis of the lower eyelids and midface.get a proper analysis,formulate a diagnosis and then correct.scarring maybe an issue. fat will help with temples,so would sculptra

Cap Lesesne, MD
New York Plastic Surgeon
4.5 out of 5 stars 12 reviews

Complications After MidFace Lift

+2

The description you give leads to believe you have some form of lid retraction after your lower lid approach midface lift.  This is a described complication and a very distressing one for patients.  I have never used endotines in the midface because sutures work just fine; endotines add more expense and can be problematic.  However, I think endotines work very well for endoscopic brow lifts.  I would advise that you see an experienced Facial Plastic Surgeon regarding this issue; some complications in this area are worth pursuing surgically and others are best left alone.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
5.0 out of 5 stars 35 reviews

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