Evan H. Black, MD

Not only do endoscopic (and other types) forehead lifts help create a more open appearance to the eyes and brow area, this procedure also does a wonderful job of relaxing the crow's feet and glabellar lines. In fact, the crow's feet lift is one of the huge benefits to the endoscopic forehead lift, especially when the lateral/temporal pockets are lifted and treated in the specialized way that our technique offers. The endoscopic forehead lift really is a procedure that delivers what it promises. 

It is hard to tell from the photos, but it is possible that this represents forehead lipoma or a bony growth called an osteoma. The lipoma is softer moves with the scalp, whereas the osteoma is firm and fixed to the bone of the skull. These types of lesions can both be removed with much success. Best wishes for a good outcome if you decide to proceed with treatment. 

If you have isolated enophthalmos (sunken eye) due to the fracture, this can often be corrected by adding volume to the orbit with an implant (Medpore, mesh, foil, bone graft, other). It is important to consider the vertical position of the eye as well. If the cosmetic disturbance is minor, one should also consider avoiding orbital surgery due to serious potential risks (double vision, numbness, and very rarely vision loss, just to name a few). With an experienced orbital and/or craniofacial surgeon these risks are minimal but this is not a surgery that should be undertaken lightly. Best wishes. 

From the photos, you appear to have significant orbital fat "bags". These can be removed and/or transposed and you should get a great result. There is no need to have a skin incision with this procedure as it can be accomplished from the inside of your lower eyelid. Smile lines and muscle are supposed to be there. If muscle and skin are iremoved under the eye in a young person like you, there is a higher chance of a complication in which the eyelid becomes lower. 

If you are awake during a procedure, you will experience sensation. The injection of the local anesthesia is accompanied by a mild or moderate stinging and burning. This can be lessened by choice of anesthesia mixture and injection technique. After that, the area should be completely numb, but sometimes more anesthesia injection is needed. For a true drooping eyelid "eyelift" (ptosis repair) there is a pinching or pressure sensation as the eyelid lifting muscle is tightened. For upper eyelid skin removal, this is usually not an issue. These sensations are all very well tolerated by the vast majority of patients and should not be cause for significant concern.

Hi Thad1995It looks like you have lower eyelid retraction, or low position of the lower eyelids. This condition can be seen in thyroid disorders so you should have that checked if the reason for your retraction is not known. This condition can be corrected with lower eyelid surgery. Spacer grafts, or implants surgically placed inside the lids are a common an minimally invasive way to significantly help this problem. Mid-face advancement techniques can be performed in some cases.

If you are taking about 30C dilution of arnica to be taken by mouth, it cannot hurt or help you. This is diluted to 1 part Arnica to 1x10 to 60 power parts water (yes, 1 with 60 zeros). So no actual arnica can be found in an "Arnica" pill. It is just a sugar pill and placebo effect. Check out the research on Homeopathy and how it is supposed to work. Most scientists find it absurd. Enough people seem to believe in it though, that it is a multi billion dollar industry!

Endotine (brand) fixation device should absorb in about 12 months. If they have not, or if you are having problems at the site of Endotine placement, they can and should be removed.  We generally do not have many problems with "Endotines". We do not recommend the other "Ultratine" device. 

Endoscopic forehead/brow lifting using modern techniques and by an experienced surgeon should give a result that is very long lasting. Proper fixation methods will provide a nice, natural looking brow. The expectation should be that the results are permanent but of course the aging process will continue. 

Dear Steadyby, Looking at your photos, it seems that there is asymmetry of the brow and forehead along with the eyelids.  This can account for some of your concern.  Certainly, the lower lid surgery can be performed at the same time as an upper lid revision or brow adjustment. A discreet incision along the lower lash line may be required, but would be very difficult to see once you have healed. Wishing you all the best, Evan Black, MD, Oculoplastic Surgeon, Southfield, MI