Lower Blepharoplasty - Des Moines, IA

So far everything is going as planned considering...

So far everything is going as planned considering i try to be as patient as possible. I posted a question about being 5wks post bleph and assymetrical. So far i received some shots for swelling/bumpiness around incisions and about 3 days after those i saw a huge improvement. I just have to keep from freaking out. MY doctor is excellant and has been supportive thruout and since the surgery. I saw him about 5wks post op, and i'll go back in few months in jan. '12. But so far i have freaked out about 3 times, and the doctor and nurse and the dr's comments i've received here were all correct. That it is still too soon to tell, that i'm still swollen, that it may take 6mo's before completly healed and to try and be patient. Easier said than done. So far things look better and better each day and week. They are much better than they were. I will continue to trust the dr. and nurse. Plus, if i'm very unhappy i can always have other things done. For ex. the tear troughs.

Had been getting some severe headaches in and...

Had been getting some severe headaches in and around my eyes. Thought it could be related to surgery but Dr. said no. Was more likely sinus infection. Went on some prednisone pack and it seemed to help but still dull ache once in a while.
Eyes are ok. Still healing i guess. Been very depressed lately when look in the mirror. the lighting in my bathroom doesnt do me any favors. It seems as though the right eye has a puffy lid close to the eyelash line and both eyes seem to be sunkin in more. My dr. thinks they look good, so much better than before. The puffiness is gone but they were more symmetrical before. Now they're assymetrical and the circles below them (where lid and cheek meet)are very pronounced, especially when i smile. They are worse than they were before. The nurse told me they would improve. I'm wondering if maybe i should have went with a tear trough filler to begin with. Its just weird. How different they look. Its like i traded in one problem for another. I guess its been only about 7 weeks now, and i know, its still healing. But it just seems that the more the inflammation goes away the more raccoon like my eyes. I guess they call that hollowed out. I dont know. So i'm trying not to look to much in bathroom mirror. the brighter the lighting seems to help, but i still feel like i cant go without my glasses, which was the whole reason i wanted to get the bleph done to begin with. So i could wear my contacts more.

Its Dec. 29. About 2.5 mo's since lower bleph. ...

Its Dec. 29. About 2.5 mo's since lower bleph. will post pictures at exactly 2mo's and today. Today i noticed on the side of eye where incision is it has indented in. Very upset about this. Called Dr. and nurse told me that its from the shots he gave me and they will pop out again. I havent had any shots for inflammation since Nov. 17, so i'm not sure it would take this long to have a reaction. Now the rings under my eyes are more noticable than ever and not just on the inner side but on the outer side now too, especially noticable when i smile. Let me know what you think. Going to dr. in Jan. for reeval.

Lets see its 1/11/12. and i'm really noticing the...

Lets see its 1/11/12. and i'm really noticing the dents at the sides of my eyes. They actually show the orbital bone more which almost completes an entire ring under my eye. Thats not what i wanted.the nurse said they'll pop back out, but i received them back in nov. its been a while. Its like instead of bags and rings, now its just reversed and theres more darkness and defined rings. the left eye is better than the right, i think. I've been very depressed. Wrote in several questions and answers always the same-be patient, wait, may need filler. i dont know why he didnt readjust the fat while he was in there. I dont get it. Is he just trying to suck more money out of me. I'm not married with a husbands salary too. I saved a long time for this. I guess its better than before. Its just hard to look at myself in the mirror. Especially when i smile. I feel like I cant smile anymore because it pronounces the dark circles even more. I've posted a few questions which show pics. One doctor told me it was hard to evaluate since the b4 pic i'm not smiling & the last pic i am. Well, sorry, but i dont want to go thru life not able to smile anymore. I didnt do this to make me uglier. Obviously not having a good day. I'll keep you posted.

Well i had my 7mo. checkup today and i've been...

well i had my 7mo. checkup today and i've been kind of unhappy with the results. i had a lower bleph last oct. and i feel like i have raccoon eyes worse than before. the right eye was always worse but i looks red under the skin. dr. says thats cause i'm so fair. well i was fair when i talked to him before the surgery and he said nothing about bruising being permanent. i told him my eyes looked more assymetrical than ever. especially when i smile. dr. always takes pictures not smiling therefore you cant see the problems as well. i told him i cant spend the rest of my life not smiling. he asked if i wanted corrective surgery and i said i was afraid of surgery. he said i could have radiesse filler injections in cheek to lift it to cover the tear trough. i dont know anything about this. i didnt think it was permanent. dr. said that we'd probably do it 3 times at most and that was all i would need. i asked him if i would have to keep doing that and he said no. i read online that it could last 7 yrs at most. so i'm not sure what to believe. anyway, has anyone ever had radiesse after lower bleph for the tear trough indents. you can see the indent where lower lid meets cheek. in fact, right eye worse than left. plus i now have a tiny lid under the lash line on my right eye that wasnt visible before. the dr. didnt say anything about if he could correct that. he never even mentioned that that could be a possible outcome.

i told him he had said that he didnt do fillers because they could leave bumps because the eyelids are so thin. he said he never said that. he said injections would be in cheek to have lift to cover trough. i said why didnt we do this more conservative procedure 1st instead of bleph. he didnt say anything. he had led me to believe that i couldnt do fillers for my problem and now after surgery he wants to do a filler. i want to do it, but i'm scared to. has anyone ever had the filler after bleph. i left some recent pics. any comments or advice on what to do would be helpful. thanks

Hi. Its June 16th. Its been around 9mo's since the...

Hi. Its June 16th. Its been around 9mo's since the bleph. I notice more assymetry than before. Left eye looks better than right, but he took some tissue from right and added to left. I'm not sure why he did this because my right eye was the worst. If anything i thought he would have gone from the left to right. Anyway, i seem to notice huge lines when i smile and the right eyelid is redder under the skin due to the muscle being right there. I cant say i'm pleased. The pictures he took are in well lighted room, no shadows and i'm not smiling. Under those conditions the lower lids look ok, better i guess. But when i go home to my bathroom or normal light and everytime i smile i have huge circles around my eyes. i really wish he would have took the fat from the outside of eye and left the inner fat or transfered fat to right eye so it would even them out more. I asked him what my options were because this was not what i had anticipated nor wanted. I wanted the lines to be gone or less noticable when i smile. He said filler would be the most conservative or correction surgery to lift the skin off muscle and reposition what fat is still there. I feel like he really didnt examine my eyelids very well. We could have injected first and then contemplated surgery. He said what healing was going on now was myself, not what he did. Are you kidding me? He should have some type of knowledge of what to expect after surgery. They wouldnt be like this if we hadnt done a thing so how can he blame what they look like now on me. Now that i've had a chance to look at this website (which i wish i would have found before surgery) I can honestly say that its more of the bone from my lower eye socket and cheek thats causing the indents when i smile and NOT the lid. Granted the outside 3rd of my lower lids were puffy but not the inside 2/3rds. The outside does look better, except that now there is like a full half circle around my lower eyes and they sink in now rather than puff out, but the circle is more pronounced on right eye and basicallly the same as it was before. I hope you can understand that. Instead of being puffy and causing a circle, now theyre just hollow with a circle and discoloration on the right.
Back to the filler. He wants to use radiesse in the cheek. (which i believe he should have done all along, but never informed me that it was more the lower bony eye socket and cheek rather than the eyelids that were causing the deep lines when i smiled.) Radiesse is not permanent but it does help the body produce collagen, so he thinks that it should take 2 or 3 injections(more in the right eye than the left). Now i'm wondering if this will last. Articles on this site have said no its not permanent and i dont want to keep going back for these injections the rest of my life. I'm trying to trust my dr. I just wish we had done the more conservative injections 1st and then surgery if needed. Anyway, i've decided to have the shots of radiesse in the cheek area. He said that the only area it wouldnt touch is the corner of the eyelid. I should be getting the first shot in a month and then go from there. These are part of and included with what i paid for the surgery, so at least theyre free(so to speak) or rather i've already paid for them. I tried to get a 2nd opinion from another dr., but none of them would see me. Its like they all stick together. Anyway, he is supposed to be the best facial plastic surgeon in Des Moines, so i'm going to cont with what he thinks. I just dont think he listened to what i wanted very well, him nor his nurse. a week before the surgery i called his nurse (who takes most of the calls for him) and asked her just about repositioning the fat to fill in the tear trough area. I told her i read where you could bend it or position it in there to fill the lines. She said she'd never heard of that before. What a lie. But i trusted and believed her. Maybe i didnt explain myself right. But i said to her that i wanted the lines/tear trough indentions to be gone and she said they would be improved if not gone at all. Right after the surgery, she handed me a mirror and said "See, the lines are gone." And both my boyfriend and I couldnt believe how great it looked. Well, that was right after the surg when the swelling had started and everything was smooth. As time past and healing ran its course, the lines or circles under my eyes came back and even more complete than ever. Well, its just the fact that this is permanent. Hopefully the radiesse injections in the cheek will improve the situation. As far as the surgery being worth it. It was an up and down roller coaster of emotion. I wasnt expecting perfection, just an honest critique of my options and possible results. Its so important to make sure your on the same page with your surgeon. Sometimes i think they are so smart that they look and see what they would want to do rather than what the patient wants. This was a lot to me. I'm single and have always hated my dark circles and tear trough lines. Make sure you have a doctor that knows exactly what your wanting and try to do your research at home first before setting up anything.

Hi its a week since i had the radiesse shots in...

Hi its a week since i had the radiesse shots in both cheeks. More in the right cheek than the left since that seems to be the problem area. My dr. said it would probably take 2 or 3 shots in right and maybe 1 more in left. Dr. wanted to be conservative because he cant take the radiesse out once its in. The anesthetic in the cheeks stung a bit but was nothing i couldnt stand. After that it was easy. Didnt feel a thing, but my cheeks looked bulbous like half a golf ball on the right one. The dr. said they would be inflammed at first due mostly to the anesthetic and the the radiesse on top of that. The anes. would eventually go down and then the radiesse. Puffy, sore, tender for a few days, especially at the anes. injection sites. Then tender for a while and starting to bruise later, especially the right cheek which had more and was injected closer to the eyelid to help cover a noticable bruise close to inner part of lid. Anyway, the bruising was a yellowish, reminded me how it healed after the lower bleph. The left cheek wasnt bruised as much. Then a reddish bruise appeared on the right cheek about an inch under the eye. I'm hoping that is not permanent and will go away. Today i cant notice any bruising on the left cheek, but the right is still yellow with that reddish area mentioned before. I have enclosed pictures to show what i'm talking about. All in all i am very pleased. In fact, i go back in a month from when i had the shots so dr. can see and proceed with more if he thinks it needs it. It looks a lot better than before and less assymetrical. Now hopefully the bruising will go away.

Had another radiesse shot in the right eye on Aug...

Had another radiesse shot in the right eye on Aug 8 2012. It was better but there still was a dark area on inner Right lower lid. He wanted to put more there which would lift skin up and hide discoloration. So he did. Left side looked good. Aug 17, looked ok but still bigger red blotch on right eye. You can see it from pics below. Then I called them beginning of Oct. and told Dr. that i had a red blotch ever since he gave the 2nd shot and thought it should be gone by now. They had me come in 10/4/12 and he prescribed some Rx topical mometasone furoate cream to apply 3x's a day for 5 days and if still not gone then fill Rx for methylpredisonlone pack to use as directed. Dr. said this would decrease inflammation and area should go down. He said that he was very conservative because only about 20% collagen would remain/reproduce in that area. Well i did all of that. Cream helped some, and then pack helped some, but it is still there and hard to cover with make up. Plus now my tear trough lines are uneven. see pic. I hope this can be resolved. He said he'd see me in 3 mo's. I'm not sure why so long, but i called his office on 10/26/12 and left message with his nurse and told her of my concerns with the uneven tear troughs now and the red blotch not gone. I said i didnt know if i should wait longer or come in or if there was something he could do. I realize it had only been 22 days since cream and 17 days since med. pack but i really thought it would shrink the inflammation. She called back saying that she wasnt sure Dr. could do any more than he already has. (not too happy to hear that since he said after the lower bleph that i was stuck with him until i was happy). I mentioned that i had been online and found info that radiesse in the tear trough or cheek area was great, but shouldnt be used under the eye or lower lid etc. She didnt say anything about that. I'm trying to keep calm but it has been stressful. I had such hopes, now it looks like my right lower lid has a bug sting and is swollen but permanently. She said to maybe call back in a few weeks. I'm not sure if there will be anymore improvement. I just want the eyelids to be symmetrical. I''m not asking for perfection, but at least when they were puffy with dark lines it was symmetrical. Now the tear troughs dont match up. Help. Is there anything i can do? I'm also going to post this as a question. It probably seems a minor thing to dr's, but to patients, a little more symmetry would make a huge difference.

Had another radiesse shot in the right eye on Aug...

Had another radiesse shot in the right eye on Aug 8 2012. It was better but there still was a dark area on inner Right lower lid. He wanted to put more there which would lift skin up and hide discoloration. So he did. Left side looked good. Aug 17, looked ok but still bigger red blotch on right eye. You can see it from pics below. Then I called them beginning of Oct. and told Dr. that i had a red blotch ever since he gave the 2nd shot and thought it should be gone by now. They had me come in 10/4/12 and he prescribed some Rx topical mometasone furoate cream to apply 3x's a day for 5 days and if still not gone then fill Rx for methylpredisonlone pack to use as directed. Dr. said this would decrease inflammation and area should go down. He said that he was very conservative because only about 20% collagen would remain/reproduce in that area. Well i did all of that. Cream helped some, and then pack helped some, but it is still there and hard to cover with make up. Plus now my tear trough lines are uneven. see pic. I hope this can be resolved. He said he'd see me in 3 mo's. I'm not sure why so long, but i called his office on 10/26/12 and left message with his nurse and told her of my concerns with the uneven tear troughs now and the red blotch not gone. I said i didnt know if i should wait longer or come in or if there was something he could do. I realize it had only been 22 days since cream and 17 days since med. pack but i really thought it would shrink the inflammation. She called back saying that she wasnt sure Dr. could do any more than he already has. (not too happy to hear that since he said after the lower bleph that i was stuck with him until i was happy). I mentioned that i had been online and found info that radiesse in the tear trough or cheek area was great, but shouldnt be used under the eye or lower lid etc. She didnt say anything about that. I'm trying to keep calm but it has been stressful. I had such hopes, now it looks like my right lower lid has a bug sting and is swollen but permanently. She said to maybe call back in a few weeks. I'm not sure if there will be anymore improvement. I just want the eyelids to be symmetrical. I''m not asking for perfection, but at least when they were puffy with dark lines it was symmetrical. Now the tear troughs dont match up. Help. Is there anything i can do? I'm also going to post this as a question. It probably seems a minor thing to dr's, but to patients, a little more symmetry would make a huge difference.
Dr. Koch

Just so others know. Lower bleph does NOT remove dark circles. The distinct line between the cheek and lower lid at the junction where they meet (tear trough) is improved in my case, but not may NOT be completely gone NOR improved in others. Everyone heals differently. For me, even each eyelid healed differently which can be scary at first. It is amazing how they can change from day or week to the next and you have to be patient and trust your dr. They are the experts.

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4 out of 5 stars After care follow-up
3 out of 5 stars Time spent with me
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4 out of 5 stars Staff professionalism & courtesy
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