If all you want is to correct the lower lid bags, that is all you should get done. However some surgeons want to provide you with a comprehensive rejuvenation which may or may not be your desires. You as the patient need to express these concerns to your doctor. I am sure he will understand.
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Just eyelid surgery or "The Works"
Thanks for your question. It sounds as if you were presented with quite an exhaustive package of surgical and non-surgical options to address what would appear (from your photos) to be a very straight forward upper and lower blepharoplasty procedure. I'm not doubting that what you were offered by that "very well known surgeon" would lend to a great result, but if you wish to address your eyelid aging, it would appear that you can certainly do so with blepharoplasty alone. You don't have to travel far to find an experienced Plastic Surgeon, Board Certified by the American Board of Plastic Surgery who can provide that service at approximately 50% of the cost you were quoted.
My advice....look around before commiting to what sounds like more than you're looking for. F
Blepharoplasty or more?
Hello and thank you for your question.
This situation is not unusual. My suggestion is to approach it step-by-step.
What are the things that worry you? How much money do you have? Surgery to the lower deals with that lid droop, but sometimes that can be addresses by fillers, depending on exactly what your problem is.
Droopy upper lids or hoods can be addressed with upper lid blepharoplasty.
Some Plastic Surgeons use far transfers, and some do not, preferring to use fillers and/or surgery.
There are a few choices, and Plastic Surgeons will differ slightly with their approach- after all, our graining as a specialist is about changes or adjustments to tissue, which is the origin of the word "plastic' in Plastic Surgeon. And there is rarely only 1 approach to these changes/
In my opinion, you can never replace a face-to-face consultation with a Plastic Surgeon with an online opinion. The price of a consultation is worth it to get to a point where you are making the right plans for you with the right Surgeon for you. After all, this is surgery- treat it with respect.
I hope this has been of some value and wish you well.
Without a formal exam in peson, it is very difficult to say what would be best for you. It sounds like they offered you a lot of things.
The face ages in many ways. Proposed ways to rejuevnate around the eyes includes many facets
What is important is to sit down with your surgeon and go over priorities of what you are looking to treat as well as budget. Budget includes not only financial, but the time you can take off for recovery. Blepharoplasty treats excess bags and skin around the eyes. Some of us like to use the fat from the eyelids and transfer that into hollows instead of removing fat from the eyes then taking fat from elsewhere to inject back into other areas around the eyes. The skin is also a consideration. It can be treated at the same time with treatments such as fractionated lasers or a number of months later. Fillers also can help, but that depends again on budget, timing and overall goals.
Surgery can include one, part or all of the above.
Blepharoplasty or the works
The question for me is what you want to see improved. If it is just your eyes, then you are a candidate for an upper and lower blepharoplasty. If you want a little lift to your cheeks, you could also do a filler as opposed to fat injections which would be slightly less expensive. I would suggest you get another consultation from a board certified plastic surgeon to compare.
Blepharoplasty or more
You may want to check back with the doctor to see if they really recommended all the procedures or just presented a set of alternatives . I prefer a more conservative and stepped approach. If you prefer to not have surgery, it looks from your photo like injectable filler may give you a very nice improvement without the immediate need for surgery. Not all surgeons are comfortable injecting filler so close to the eye though. If blepharoplasty is the best option then I usually perform the surgery first and add filler after only if truly needed. It doesn't appear from the photo that Fraxel is absolutely needed along with the surgery but again this depends on what is seen during the exam, your goals and the blepharoplasty technique being used. I prefer to perform most lower eyelid surgery through the conjunctiva with a laser to minimize bruising and may do fat transfer to prevent the need for filler. You might consider another opinion so you are completely comfortable before proceeding . Oculofacial plastic surgeons are generally the most experienced treating this area but make sure the surgeon has extensive experience with cosmetic procedures.
Blepharoplasty alone should be fine
Your question raises a philosophical question - Are we treating the doctor or the patient? Admittedly, looking at the photos posted is not as good as seeing you in person, but from what you describe as your main concerns - hooding of the upper lids and lower lid bags - an upper and lower lid blepharoplasty should be adequate. While it is true that from an "ideal" standpoint the additional procedures may achieve a pleasing result, they should not be necessary to achieve your goals.
Under eye bags
Depends on what you are looking for. If just your under eye bags, then they can be helped with a surgical procedure, if you are looking for a quick fix, then fillers can be placed (see my instagram for examples 'drmadnani') to soften the look under the eyes. More permanent options would be to consider a lower blepharoplasty procedure. I usually perform these under local anesthesia and takes about an hour. Good Luck.
Do I need blepharoplasty or the works?
This is a very personal question. It does not sound like anything that was recommended to you was unreasonable. If your eyes concern you, then an upper blepharoplasty and a lower blepharoplasty with fat transposition are a reasonable approach. I am not a big proponent of fat transfer to the undereye area but you can consider that versus an off the shelf hyaluronic acid filler for undereye and cheek volumization if you choose.
Stephen Weber MD, FACS
Denver Facial Plastic Surgeon