Dr. Kossler is the best! She is so compassionate and kind and is an exceptional surgeon. She was able to repair my eyelid when 40% of it had been removed so that it looks and functions normally. I am forever grateful to her.
I have wanted this surgery for years but hesitant because of my health issues. Dr. Kossler and her team were professional and easy to work with. She was always available and answered every question. I am so please with the results. I get complements often about how my eyes look great and I look bright and I well rested. She genuinely care about her patients and I couldn't be happier with the results.
I went to Dr. Kossler in the months leading up to my wedding (Sept. 2019) and honestly could not speak more highly about how outstanding she is in her work. Typically it can be scary to do things to your face right before a wedding, but I felt confident with Dr. Kossler from the minute she started sketching ruler marks on my face for precision. I initially went to see Dr. Kossler when my lip filler wasn't done properly by someone else and I had heard good things about her. Not only did she make my lips look incredible, she is also so sweet and made the experience fun. I've never in all of my years doing filler felt so beautiful -and natural- with results. She took the time to patiently inject incremental amounts to make sure it was perfect. In all, I have seen her for Botox, Facial fillers and filler in lips and became so spoiled by the experience that I don't think I could go to anyone else at this point. Well done Dr. Kossler! My wedding photos were a total success thanks to you!
Dr. Kossler was a kind and attentive surgeon. I felt very well cared for throughout the entire process and am extremely happy with the outcome. I would definitely go to Dr. Kossler again for any future eye surgeries.
I would add a star if I could. Dr. Kossler is the absolute best, and it goes far beyond her knowledge and skills as a surgeon. She is an ideal mix: she is utterly confident, but with the most wonderful bedside manner. She is patient and down-to-earth. She takes the time to describe why she's come up with a particular approach for a procedure vs. other alternatives. She is great at taking a complex medical concepts and making them understandable for the layperson. She wants to make sure you are comfortable and know what's going on (that you have "buy-in," per se, before she moves forward). My first visit with Dr. Kossler was to get her opinion on some unsightly xanthelasma growths that showed up around my eyes. This was ultimately a cosmetic procedure, as they weren't causing a functional problem, but I had let them get pretty large and obvious. She did an absolutely incredible job of removing them. The whole experience was wonderful — from pre-op to during, to the post-op care and visits. And her support team is equally warm, friendly and gives you great confidence that everything is okay. I believe there were six stitches at the outside corner of each eye, so it was not a minor thing, and this is why I chose to see an oculoplastics specialist, rather than a general plastic surgeon. Removal of one of the growths required her to cut through muscle, and I have no problem opening/closing my eyes, which I believe may have been a risk with a less skilled surgeon. Within several weeks, the scars were barely visible, as she had so perfectly hidden them in my crows feet. They're impossible to see now. Beautiful, beautiful job. I also have had my under eye (tear troughs) filled several times with Dr. Kossler over the past several years, as I have deep hollows that exacerbate my dark circles. I have seen a top-notch dermatologist for fillers in other areas (nasolabial folds, for instance) over the years. But as experienced and skilled as she is, even she won't go near the delicate under eye area. I would not trust anyone other than Dr. Kossler to handle this. During appointments for tear trough filler, Dr. Kossler has also injected filler in other areas, and Botox as well. She has an excellent eye for aesthetics, and everything always looks completely natural. Just better. Bottom line: whether you have a cosmetic issue or a more serious medical issue, you can trust Dr. Kossler without question. Her work is impeccable.
The results from my blepharoplasty upper eyelid and my brow ptosis results are amazing. Dr. Kossler did an excellent job. Dr. Kossler explained the procedure at my initial appointment , On surgery day and my recovery went just as planned. The instructions for the recovery process was provided prior to my surgery day so I was had time to prepare for the recovery. I am very pleased with the results of my surgery. I have received multiple compliments about how good I look.
I can't speak highly enough about Dr. Kossler. I am so happy I found her. My initial experience with Dr. Kossler was orbital decompression surgery, followed by eyelids surgery to fix the proptosis in my right eye caused by Graves disease which I have had for over decade. The results were truly amazing. I then decided to go with my "new look" that it was time for botox and fillers which I also had done with Dr. Kossler. I couldn't be happier with the outcome. In addition to being an extremely skilled, Dr. Kossler is also kind, compassionate, and patient. It's really obvious she cares about her patients. I would not hesitate to see her again or recommend her to anyone.
Dr. Kossler is extremely adept at addressing issues affecting aging of the face. She was able to target the key areas that were creating a hollow affect under my eyes and extreme creases in my tear troughs. She used Voluma to elevate and contour my cheeks and restylane to improve my tear troughs and dark circles. She also skillfully used Botox to improve my facial wrinkles and improve the appearance of dark circles. She literally took twenty years off of my face without me looking “filled”. She truly is skilled, conservative, and delicate when it comes to refining facial features, not just filling in the gaps.
I highly recommend Dr. Andrea Kossler. After seeing a number of doctors, I count myself lucky to be a patient of Dr. Kossler for cosmetic procedures such as fillers, botox and more. She is highly skilled, professional and balanced in her approach, with an excellent eye for aesthetics. The results are impressive!
I had Dr. Kossler inject fillers and use Botox because I am 68 and wanted to create fullness In my face as well as soften lines. I heard that Dr. Kossler was an amazing Dr and extremely good at injections. I thought my outcome was excellent. She was an expert at creating fullness and contouring. I would definitely use her again.
Based on your photos, it appears you have mild eyelid ptosis (droopy eyelid muscle) worse on the right side with some extra eyelid skin on both upper lids. Your brows are likely symmetric at rest, however when one eyelid is more droopy than the other, that eyebrow muscle lifts to compensate for the droopy eyelid. This is likely why your right eyebrow looks higher in photo 1. The most common reason for ptosis in a young adult is contact lens use, though there are several other reasons. It is common for ptosis to be asymmetric.I recommend an in person consultation with a surgeon who specializes in eyes, typically an oculofacial plastic surgeon (aka oculoplastic surgeon). A thorough facial and eye exam can ensure the correct surgery is recommended. During your consultation, your surgeon will likely place eyedrops in your right eye which will temporarily lift the eyelid. If the left eyelid droops after the right eyelid lifts, then this indicates you would benefit from ptosis surgery of both upper lids. You also have mild extra eyelid skin on both sides, therefore, I recommend bilateral upper lid blepharoplasty (upper lid skin/fat removal) and ptosis repair. Doing eyelid skin removal (blepharoplasty) alone would not address the eyelid and brow asymmetry.
You have 2 options: Ptosis surgery or ptosis eye drops.Ptosis surgery is an extremely effective procedure with long-term results. You are a good candidate for surgery. There are several ways to perform ptosis surgery. Due to the mild nature of your ptosis, I recommend internal ptosis surgery (no visible incision). It is important to see a surgeon who specializes in eyes, typically an oculofacial plastic surgeon (aka oculoplastic surgeon), to ensure you have the most natural and safe results. During your consultation, your surgeon will place drops in the right eye (to temporarily lift the eyelid) to ensure you do not have a Herring's response, which is when the other eyelid relaxes/droops once the droopy eyelid is lifted. A thorough exam can ensure the correct surgery is selected. Your surgeon will also want to be careful not to overcorrect and to ensure the medial eyelid contour is addressed. A drop was recently approved by the FDA to temporarily lift the eyelid. It is called Upneeq. You can consider using this for temporary improvement of your eyelid position until you are ready for surgery. It lifts the eyelid by an average of 1 mm and lasts about 6-8 hours. It is not a long-term solution, but an option.
There are many options for eyelid surgery. I recommend you select a surgeon who specializes in eyes to ensure you have the most natural and safe results. Based off your photos, you have mild fat herniation (also called lower lid bags) with a dark circle (also called tear troughs) underneath the bag, and a little mid face volume deflation. You are a good candidate for a transconjunctival (no visible incision) lower lid blepharoplasty with fat transposition. The incision is made behind the eyelid and the lower lid fat is repositioned into the dark circle to fill the volume deflation between the eyelid-cheek junction. Fat removal alone, without transposition, is an option for some patients, however, I feel it will make your dark circles more noticeable and your lower lids look more hollow. I also recommend a canthopexy at the time of your lower lid blepharoplasty. Based on your photos, the corners of your eyes appear slightly downturned. A canthopexy can improve the the angle of your eyelid to give you a natural almond shaped appearing eyelid. The incision can be hidden in your eyelid crease. This can also improve tearing and your lower lid position as you age. You have several options, it is most important to find someone you trust and explains things clearly so you know what to expect and your concerns are addressed.
Thank you for the photos. The dark circles you notice are mostly due to the bags under your eyes causing shadowing, resulting in the dark circle appearance. The bags are due to fat herniating forward. A transconjunctival (no visible incision) lower lid blepharoplasty with fat transposition can reposition the fat into the dark circle to smooth out your eyelid-cheek junction. I recommend this over fat removal since your eye is slightly more prominent than your cheek (we call this a negative vector). Removal of the fat would make your dark circles look worse. Repositioning the fat is preferred. Other options you may hear about are filler or fat transfer. Fillers would help a little to camoflauge the dark circle, however the bag appearance would persist. In my opinion, fat transfer alone is not a good option, but could be considered if combined with transconjunctival lower lid fat removal. I think this is a step too much and you would do best with lower lid blepharoplasty with fat transposition.
Thank you for the photos, very helpful. Your photos show significant swelling which is common 10 days after mullerectomy. It is too soon to determine your final lid position at this time. If your surgeon was happy with your lid position on the day of your surgery then there is a very high likelihood that your eyelid position will improve as swelling resolves and fibrosis (scar tissue that is not visible under the eyelid) sets in. Patients with thyroid eye disease often have a lot of fibrosis that sets in about 6-8 weeks after surgery. This causes the surgery site to contract and the lid position to lift. If you give it more time and get past the swelling/inflammation phase your eyelid should lift into the desired position. It is common for swelling to make the eyelid look worse before it gets better. If you give it time and the lid position does not improve, then you have a couple options- ptosis surgery or ptosis eye drops (eye drops are not a permanent solution). An oculoplastic surgeon who is experienced with thyroid eye disease can discuss ptosis surgery options should that be necessary. Give it more time and speak to your surgeon for reassurance.
