I didn’t like the way I had to keep lifting my brows to smooth out my eyes! I take good care of myself and felt the eyes where in need of some updating. I schedule my upper eye lift with Dr Carraway. I drove myself and had local anesthetic. Easy Peasy! Can’t wait for the final results! Updated on 23 Aug 2019: Pretty swollen. No pain I didn’t feel anything during the procedure but I know that I am quite a bleeder. My surgeon needed to go back-and-forth between each eye as he cauterized the bleeding. He told me he did all the stitching at the end. Updated on 24 Aug 2019: No pain. Felt some mild stinging and took a Tylenol. Quite bruised. I did go walk on the treadmill at the gym for 45 mins. I also slept with saline soaked gauze on my eye to try and help with swelling and bruising. Updated on 24 Aug 2019: No pain. Still very bruised and swollen but back at the gym doing cardio. I saw what looks like an opening of the incision on my right eye and when I sent my surgeon the picture he told me to just not pull on it and it would be fine. I continue to sleep at night with saline soaked gauze. No icing and don’t seem to have time during the day to truly rest my eyes. Stitches came out on Thursday. The third day after the procedure. The surgeon put some tape at the corner of my eyes and said I could continue to work out as long as I don’t sweat too profusely or squint! I return to work on Friday. I won’t be wearing makeup until I’m sure everything is good. My follow-up with the surgeon is in a month. Updated on 26 Aug 2019: It was my 2nd day back at work and my first real hardcore day back at the gym. I feel great. Still some swelling and lots of bruising- but I do bruise very easily. I scratched a bite on my arm and it’s bruised! I’m still sleeping elevated and doing the saline soaked gauze at night - though I don’t really know if there are any benefits at this point! Updated on 8 Sep 2019: I feel fine. I still have some stubborn bruising that won’t go away. When I run my finger along my upper right lid I do feel some lumps but from what I read from other reviews that is normal. I don’t believe the lumps are visible to the eye. Updated on 13 Sep 2019: Very happy with how my eyes look. I can feel some lumps under my right eye when I run my finger across the lid. But they don’t seem noticeable to the naked eye. The stubborn bruise under my left eye is almost gone. My postop appointment is coming up soon
15 years ago I had rhinoplasty. My nose looked great for about two years and then started growing. I had a second rhinoplasty. Unfortunately - I'm not sure what went wrong - but the skin on the end of my nose was really damaged immediately after surgery and I developed a scar. The skin that was covered with surgical tape turned red and was dying. I theorized that the nose clamp was held too tightly and cut off the blood supply. The scar was filled with filler and I just accepted it. However, as the years went on my nose started growing a little ball on the tip and was misshapen.... and the scar bothered me more and more. I went to see Dr Caraway about fixing that scar and seeing what he could do about the bump. Even as I'm swollen and taped up I already feel that anything would be a huge improvement! I was awake during the procedure, but relaxed and numbed up. Dr James Caraway has an amazing bedside manner, took his time, and explained everything to me. I will keep posting pictures as I heal. I'm extremely hopeful that there is a huge improvement. Updated on 8 Mar 2017: I was pretty groggy and hazy yesterday afternoon. Might have done it too much with going to the grocery store before going home! It was bleeding along the incision line and had blood coagulation so I covered the area with another piece of tape so my coworkers wouldn't have to look at it! I'm calling the doctor today to ask him about the bleeding. Updated on 10 Mar 2017: I'm not to work out which has me bummed, but the nurse took out the side stitches today and left the three across the top. I'm supposed to have the other three taken out on Monday. She said I'm healing nicely but still swollen Updated on 13 Mar 2017: I see the doctor for a follow up next week. So glad to have those stitches out! I already see an improvement. Pretty sure I still have some swelling. I was told I could ease back into working out. Updated on 20 Mar 2017: I still seem to have a little bump on the left side of my nose. It is hard and sore to the touch. During surgery he said he cut off what basically looked like a little bump of cartilage. I'm hoping it's just swelling and I don't have to go through this again!
This review is for a surgery I had in 2011 by Dr. Carraway. I was 27 at the time. In 2008 I had a fat grafting procedure done by a "surgeon" in Houston, TX. He (Eser Yuksel) voluntarily placed fat below my eyes while I was sedated. I lived for 3 years with huge lumps under each eye, as I was too scared to let any doctor fix my eyes. A doctor from another region highly recommend Dr. Carraway to me after witnessing his work on the eye area. To this day, I'm so grateful for finding Dr. C. My eyes look like they've never been through a botched surgery, and have since the very beginning. The scar was placed just 1 or 2 millimeters below my lash line, and nearly invisible. I only wish I found him sooner. Thank you Dr. Carraway, thank you.
Words cannot convey how happy I am with Dr. Carraway and his staff though I will try. I was referred to Dr. Carraway by Dr. McDaniel for revision surgery of my chin which was another local Dr's poor result. I am grateful for that referral because a year later, I am fully healed and my chin looks great! Dr. Carraway is a excellent surgeon who genuinely cares about his patients as well as his work. He has the experience and skills to figure out what needs to be done and do it right. He listened to my concerns and we communicated very well. He has a keen eye for symmetry and fine details and goes to great lengths to create the best result. He is a wonderful man who exudes positive, healing, energy. I highly recommend him.
I had a rhinoplasty done about 12 years ago. I liked the results very much but over time one side had gotten a little concave, there was a 'ski slope' look to my profile on one side and the cartilage had shifted so that the tip had a strange sharpness on one side. My original plastic surgeon who I love did a tip revision only, with no grafting done. It's still very early and while I am sure my nose is better than it was, I am worried it still looks projected. He says this is swelling and will subside over time. I would love feedback - any one else have an experience like this where the actual results didn't present accurately at first? Even if my nose doesn't get any better I guess I am better off now than I was before and give it time. Updated on 7 Jul 2015: So now I am 12 days post operation and I definitely think the tip is receding. The nostrils are not symmetrical but honestly I can live with that. You can't see it from the front view at all (unless I look up at the sky!) My husband has a perfect nose and his nostrils aren't symmetrical either so I'm not going to sweat it. No one knows how this feels unless they go through it themselves - anxious and hopeful you will get the outcome you had hoped for! Good luck to everyone else out there (: Updated on 7 Jul 2015: I tried to get some other shots with smile too for a better angle - I do think swelling is subsiding and making a difference in projection (at least I hope! lol) Updated on 13 Jul 2015: got a new hair cut too which helps (: It's getting there and I do think staying positive, being kind to yourself and being thankful for what we do have is really important through this process! But sooo glad I went ahead, took the plunge and got this revision. Updated on 2 Aug 2015: I am still happy with the results and some mornings I wake up and think it does look like more swelling has gone down. The soreness at the tip and columella have subsided. I also have come to grips with the fact that the nostrils aren't even when I put my head back. I don't know they will ever be even, but I am ok with this. I have read so many stories of people miserable with their results and going back again and again. I would caution against this - just remember the perfect little nose will not fit every single face! Good luck again to everyone hope your journey is going well!
I recently had facial surgery with Dr. James Carraway. The surgery was done in part to correct a prior neck/jaw surgery which had resulted in some disfigurement. As I'm only in my 40's, I especially did not want to appear to have had facial surgery, and was worried that my face might looked pulled after surgery. I can happily report that, as promised, my face looks natural, younger, the prior surgeon's work was largely corrected, and I do not at all look like I've had surgery. My face in no way has a pulled appearance like I have seen on other women. Because my surgery was corrective, Dr. Carraway not only had to correct some of the original problem, he had to correct a prior surgeon's work, which is much more difficult. Even though my result was outstanding, the result obviously wasn't as perfect as it would have been if Dr. Carraway had been my original surgeon and he hadn't had to correct someone else's work and the scar tissue that had formed. Again, even with some remnants of the prior surgery visible, I had an outstanding result.
As a mature person, I looked tied all the time, and my facial look did not reflect how I felt inside. I invested in these procedures for myself, so that I felt good about myself every day.
In 1998 I had botched blephraplasty. I had big,round eyes instead of my almond shape. All the Michgan doctors said there was no way to fix it. I was suicidal!! I'M NOT KIDDING. I looked in the book "Best Doctors in America" and found an eyelid specialist-plastic surgeon in Virginia Beach, who did a levator lengthening,(cuts the muscle that opens and closes your eyes so it drops down the lid.) It really helped a lot. I just went back to get filler + botox to help the expression when I smiled. I should have gone back to him sooner to fix that but I got so overwelmed by this problem and choose to wear my glasses because I couldn't deal with it anymore. I didn't think anything could fix the problem. I can honestly say on June 25, 2011, I look like myself again!!! It has been a LONG journey. I never thought I would ever be able to say: I don't look like a freak anymore. I would recommend 3 things: a doctor "Y" in Boston LOWERED a girl's brow ( a reverse brow lift) on this botched plastic surgery show and she looked good. I would have looked into that 1st 2) levator lengthening ONLY with Dr. C in Va because it is risky surgery in the wrong hands or 3) fillers like restylane, again I'd only go to Dr. C (or someone top notch) for that because it's needles close to the eye. Try the fillers first, then go more invasive until you find a solution. GO TO ONLY THE BEST DOCTORS-PROBABLY OUT OF STATE. Don't give up. IT IS POSSIBLE TO LOOK LIKE YOURSELF AGAIN- THERE IS HOPE TO GET BACK THE ALMOND SHAPE AGAIN!!!
When I first met with Dr Carraway - he was very kind and made all kinds of recommendations. He appeared at that time to be very patient and concerned. I returned to have the surgery that was recommended and was so disappointed in the way the nurse assisting and Dr Carraway treated me that day. They were very short with me and I felt like I was seeing a total different personality. The nurse that assisted even rolled her eyes at me and snapped at me when I asked a question. I almost felt tricked. When I returned to get my stitches out - a different nurse tended to me and she was very nice and helpful. I am overall satisfied with the actual surgery though my skin was stitched incorrectly and I have a crease where the skin over laps under my brow.
I have never really had a flat tummy, at least not that I remember. I am married to a wonderful man, and I have two beautiful girls, ages four and six. My husband is in the Navy, and I am homeschooling my first grader. So, for my body history...I am 4'11". We had a hard time getting pregnant in the beginning. I gained about 15 pounds from the emotional roller coaster of thinking/hoping to be pregnant every month (from 105ish to 120ish). Then I had the miscarriage, and gained an additional 20 pounds. Then, I got pregnant with my oldest daughter. So, I was 40ish pounds up when I got pregnant, then gained an additional 26. I nursed her and joined Weight Watchers, and lost baby weight plus 20. Then I got pregnant (1st month trying) with my youngest daughter. I gained 28, then lost it plus an additional 20 by nursing plus Weight Watchers and Atkins. Anyway, I have a c-section scar, loose skin, saggy boobs and plenty of fat. I am apple-shaped and carry my weight in my middle. Even at 100 pounds, there is a muffin-top. I am NOT at 100 anymore. :( At 105, I wear a 3/4. At 112, I am at the top end of a 6 (what I weigh now). I gained 10 pounds this summer, and can't seem to take it off. I was so good in FL over Thanksgiving, eating no carbs and running, and it took a month to lose 1 pound. I got so frustrated that I basically gave up trying to lose weight beforehand. Why ruin Christmas for nothing, right? I am pretty depressed about my weight, and am at a loss as to which diet would actually work for me these days. I would like to fit back into my size 3/4 jeans before jeans season is over. I am very alternative when it comes to health issues. A good friend and I were very active in Le Leache League together, and we nursed our babies for extended (2+ years) periods. We used to fantasize about getting our breasts lifted after we were done. Well, she went and did it last June, and I decided that I would too. When I saw her surgeon, we decided on the breast lift/augmentation and a tummy tuck. I was brought to tears (happy) thinking that I would finally not be worried about my belly fat anymore. I scheduled my surgery for January 16th. As time went on, my friend developed some complications from her breast surgery: double bubble and them falling onto her arms when she laid down. Also, I never really liked the shape of them, and I felt that her Benelli lift was not adequate, which is what he wanted to do to mine. He revised her, and she loves them now, but I went to another surgeon for a consult. He was recommended by a lady at church who used him for face surgery. He has no books of pictures of his work to look at, so I just have to trust that he is as good as his patients say he is. He is the plastic surgeon at the local medical school EVMS. He is in his 70's, and I like that he has 40+ years of experience doing these procedures. I scheduled surgery with him on January 2, and was given a military discount, along with a slow month (December) discount. They were full already, so she extended me the discount for January 2, too. :) So, I canceled my other surgery with the other surgeon. I have had a heck of a time trying to find pictures of what breasts I want. I am petite, and have had larger (32D) breasts since I was finished growing. So, I am starting out with that, and would like to be as big as I was when nursing. I wore a 32F when nursing. Trying to figure out implant size has been challenging. I have been to the office twice to try on sizers. I am pretty sure that he is going to insert 450 cc high profile silicones. I finally found a picture to print, so we will see. I just have a fear of not going big enough, since the biggest regret of women getting implants is wishing they went bigger. The nurse said that I could go bigger than 450, but I don't know... So, my surgery is in 5 days. I am supposed to start my period sometime soon. I wish I tracked that better. Sometimes I am clockwork at 28 days, and other months it is more. I will be staying in a hotel for 3 nights with nursing care afterwards. I need to buy some pads, I guess. I think I have some of those hospital ones from childbirth left. I usually use the Diva cup, but I am thinking that I won't be able to insert or remove it post-op. I will take it with me, just in case I can. I am hoping that I start soon, so I won't be dealing with my heavy day post-op. My parents are coming up for New Years on Sunday. Dad is leaving sometime, and Mom is staying until the 13th. She will take my 4 year old to preschool and homeschool my first grader for me. She is an elementary guidance counselor, so she will enjoy being involved with her education. Updated on 31 Dec 2012: I am sorry for being long winded earlier, and about the upside down photos. I will try to edit them. I can't believe that I am actually going to do this. I have been gathering supplies and taking my pre-op vitamins. No alcohol tonight. I bought a walker, 3 zip-up compression/sports bras, my compression girdle, hoodies, elastic waist pants and zip front robes. I hope I have not forgotten anything. I hope that you ladies that just had your surgery are recovering smoothly. I hope that you ladies that are coming up this week are as relaxed as possible. I am sick with a cold, and am hoping it will subside some by Wednesday. No monthly cycle yet. Great. I am hoping that the nurse will let my husband come and visit during my 3 day stay. Anyway, I hope to update soon. Updated on 1 Jan 2013: I have been getting all of my vitamins and homeopathic remedies together to take with me. I have a combo remedy for cosmetic procedures that I started today. I have some 200C arnica that I will start tomorrow before I leave home, along with 200C staphysagria that is for pain and tissue repair. Since these tiny tablets dissolve under my tongue, I am not worried about taking them beforehand. I am taking probiotics with me, along with ionic magnesium. Magnesium is great at making one have a bm. The only side effect of increased magnesium is loose stools. I just don't want to over-do it and end up going more than a couple times per day. I will definitely take it before bed tonight. I still have this cold, and last night I had a cough. Today I have not had cough issues, yet. My period started this morning, which means that tomorrow is my heavy day. Has anyone else dealt with a heavy period on surgery day? BTW, I tried to fix the pictures, but even after I uploaded them again, they were oriented the same ways. Sorry about that. Updated on 3 Jan 2013: I had my surgery yesterday (Wednesday). I was in so much pain when I woke up. Then I.started crying because he didn't do my breast lift, he just placed the implants. I have been in a hotel since I went I left the surgery center. I have 24 hour nursing care, which is nice. I have not thrown up, but I have seen stars and almost fainted. I will try to post a picture. Updated on 6 Jan 2013: I have some catching up to do. I stayed in the hotel with my nurse for 2 nights. I have been home for 2 nights. I fainted once while at the hotel. I have not fainted since. I have been trying to drink lots of water. So, the doctor didn't do the lift because my skin was stretched already with the implants. I was upset at first, but am glad now. The skin is tight with all of the swelling. I have a history of getting stretch marks, and the last thing I want are long pink stretch marks on my new boobies. I have not taken a shower yet. When I do, I will take pictures. My biggest complaints have been back pain from lying down, headaches and not sleeping well. I can't take ibuprofen and acetaminophen isn't cutting it. Caffeine helps in the morning. The Resteril the doc gave me to sleep isn't strong enough to last more than a couple of hours. DH will call the PS today and try to get some relief. I have pooped twice. The nurse at the hotel wasn't in a hurry because she didn't want me to have to use those abdominal muscles. I took my ionic magnesium Friday night and had an easy bm with no straining Saturday morning. I hope all who had surgery this week are healing nicely. All of you with surgery coming up this week, you will do great! It is all worth it. :) Updated on 8 Jan 2013: So. I learned that we should NEVER take Imitrex while recovering. I was in more pain from that than when I woke up from anesthesia. I am so swollen now. The Demerol did not touch this pain. Today is the first day that my hubby will be gone for a full day of work. My mom is here with me, though. I have been feeling pretty good today so far, other than the swelling. Happy healing, Ladies! Updated on 11 Jan 2013: I have not posted because I guess I didn't want to acknowledge my negative thoughts and feelings. I researched breast implant sizes for months beforehand. I kept hearing everyone say that the biggest complaint afterwards was ladies wishing that they went bigger. So, I had this fear of not going big enough during the months right before surgery. Back during the summer when I had my first consult, I was afraid to go too big. I didn't want people to just see boobs when looking at me. I looked at thousands of boobs online and finally found a picture to take to the surgeon. He told me that he could make me look like the picture with 375 cc. I told him to go with 450 cc. Again, I was afraid to go too small. He gave me 425 cc hp implants, and I think that they are way too big. I should have trusted him. If you are in doubt, trust your surgeon. I am hoping that my boobs are super swollen and that they will shrink considerably. He plans on doing the breast lift in a few weeks after the swelling goes down. I have lots of bruising from the Lovenox injections he had me taking for the past week. I took pictures today. I am not thrilled with my breasts. They are not the shape that I wanted, but I am praying that after the swelling goes down and after the lift, that they will be what I had hoped for. I am also still bruised and swollen all over my tummy. Oh well, now I will just wait it out. I just hope that my experience helps someone else. Updated on 13 Jan 2013: Back on Thursday I went to a post-op appointment. They removed the lipo stitches and snipped other stitches, but left them in. They applied tape over the incisions. I had some swelling above my incision, so they folded up a surgical towel and put it underneath my CG. He showed me how to massage them. I am supposed to warm them up for 5 minutes, and then move the implant in the pocket in all directions. I go back on Monday to get all of my stitches removed. I will also call and see if I can get my compression garment altered tomorrow. It is too loose to be doing any good. Last night I went to Target and bought a few stretchy non-underwire regular bras. I am so tired of not really knowing what my new boobs look like under clothes because the compression bras flatten them out. I still think that they are big, but they aren't as obnoxious as I was thinking. I decided to quit taking my Demerol last night. I didn't take one before bed. I have just been taking ibuprofen since. There just seems to be pressure on my breasts, now. I wonder if that ever goes away. I still get a little pain when I lift my arms. My TT incision doesn't bother me at all. My mom left today. I drove her to the airport myself. Driving was a little uncomfortable. I didn't help with any of her bags. I actually wore jeans and a normal shirt today. I didn't notice people staring at me, so my boobs must not be that big. My loving husband took next week off to help me get back into the swing of things. A friend is bringing us dinner tomorrow. I suppose I am going to have to start cooking again sometime. Happy healing to everyone! Happy waiting to everyone else. Updated on 17 Jan 2013: I was wearing the soft Playtex and Hanes bras I bought at Target instead of my compression bras for a few days. I have been doing too much, and switched back to my compression bra to ease the pain. I babysat a 2 month old infant on Tuesday morning for 3 hours. DH was supposed to be helping me, but he was sick with a cold, and I didn't want to get the baby sick. Then, I drove myself and got my CG's taken in. Now, they are tight again. She said that I should come back next week and have them taken in again. I went home afterwards, and was in pain because I overdid it. On Wednesday I went to the grocery store with the family. I was in such pain afterwards that I had to take a Demerol. I also put my compression bra back on. Today I was having an intermittent pain in my right breast. I went in just to be safe to see the PS. He said it was tendon pain. He cleared me to wear regular bras again, and he said I could go free at night. I wonder how that will feel. DH will like it. ;) Don't misunderstand. He has not been deprived in any way. He has been helping me take showers since day 3 or 4. I surprised him by asking him if he wanted to have sex during our 2nd shower. For some reason I felt safer doing it in the shower. Since then we have done it both in the shower and in bed. I hope that's not TMI. I was wearing my CG during the times in bed. Okay, I guess that's enough for now. Happy healing! Updated on 20 Jan 2013: I am stir crazy, so I went back to church last night for the first time. All went well, and we even went out to eat afterwards. I will admit that by 11 pm after finishing eating in the restaurant, I started feeling bad. It was a headache issue, not surgery issue. I came home, drank my magnesium, took my supplements and sleeping pill, and crashed. The only pain that I can complain of from the last few days is sternum aching, lipo pain on upper half of stomach, and crease incision pain when my CG zipper hits it. So, I never asked my PS about bras. Last time I saw him, he released me and said that I could do whatever I wanted, breast-wise. So, while I enjoyed the comfort of the soft, flexible Hanes and Playtex bras, I was not thrilled with the shape of my breasts in them. So, I tried on the 34DD bra that I was wearing before the MM. It is an underwire bra with molded cups that supported my saggy boobs, even though I did not fill out the top part of the cups anymore (I did at the end of nursing last baby). My new breasts are a little bigger than my bra, so the underwire don't sit on the creases. They hit a little below when sitting, and helps keep top of my CG off my incisions. My breasts are perfectly round in it. I did enjoy taking the bra off before bed, and I am really enjoying them being free. The more I go braless, the more they are growing on me. They are completely soft and I think that most of the swelling is gone. I am thinking about skipping the lift for now. They are so pretty without the scars... My PS didn't cut my pectoral muscles to insert my implants. He created the pocket by moving and separating the muscle fibers and fascia. I think that technique has shortened my recovery time. Also, I take tons of supplements and homeopathic remedies. I ordered pre and post-op vitamins from makemeheal.com. DH and I have been acting like teenagers. We've been doing it every day for awhile now. He loves the new girls, and frankly, I love the attention. Lingerie hides the CG well. Updated on 24 Jan 2013: Yesterday I was 3 weeks post op. My post op instructions say that I don't have to sleep in my CG anymore. Last night I tried it. I have mixed feelings. This morning it felt like I ripped open an incision, but I just pulled on the tape. I kind of feel unsafe with it off. My tape is beginning to curl. I cut the loose edges off after I shower. I will take more pics after all the tape is gone. My boobs are really itchy all over. I have to be conscious of scratching. I created tiny sores from scratching them. Now, whenever they are itchy I rub coconut oil all over them. That seems to really help. I also rub it on my tummy after a shower. One time I rubbed my Shea butter cream on my girls instead. I was rewarded with breaking out on my cleavage. Nice. I went to the chiropractor yesterday. Lying face down on the table was interesting. She gave me a pregnant belly pillow to put over tummy. That helped. Was just uncomfortable. I am hoping that the adjustment helps with my headaches. I hope that you all are healing smoothly. Those of you waiting for the big day, it's all worth it. :) Updated on 28 Apr 2014: I had it all redone by a better surgeon in August, 2013. My tummy is flat, now. I had a full anchor breast lift. Updated on 21 May 2014: These were taken about 2 weeks ago. I've had an anchor lift and a 2nd complete TT with muscle repair. Surgeon is planning to do a benelli to round out breasts and to open and release my left capsule. It's a little tight and pulling implant up a bit. He is planning to fix dog ears. He is planning on lipo-ing back when fixing TT scar. Final decisions on touch-ups in a few weeks.
Fat transfer, fat grafting, fat injections, and structural fat grafting are basically the same. This involves taking live fat cells, protecting and processing them, and re-injecting or placing them in an area where more fat or bulk is needed. Some special terms are used for marketing purposes, but it is all fat grating. In regards to safety for under eye correction, there is a greater possibility of irregularity of result with fat than with fillers. That is because it is difficult to place very tiny strands of fat under the very thin skin in the tear trough area, and therefore slight lumpiness is sometimes seen and is not desirable. However, there is a way to combine fat grafting with blepharoplasty where the fat in injected underneath the skin into the bulk of the orbicularis muscle of the lower lid. Regarding blindness, the number of cases of blindness is infinitesimally small and while it is a risk, it is a miniscule risk.
Fat grafting involves taking live fat cells, protecting and processing them, and re-injecting or placing them in an area where more fat or bulk is needed. In regards to safety for under eye correction, there is a greater possibility of irregularity of result with fat transfer than with fillers such as Restylane. That is because it is difficult to place very tiny strands of fat under the very thin skin in the tear trough area, and therefore slight lumpiness is sometimes seen and is not desirable. However, there is a way to combine fat grafting with lower lid blepharoplasty where the fat is injected underneath the skin into the bulk of the orbicularis muscle. The procedures are safe under the hands of a a board-certified plastic surgeon with experience in these types of procedures, who is conservative in his approach. It is important to discuss the various options available to you with your surgeon of choice.
Fat transfer, fat grafting, fat injections, and structural fat grafting are basically the same. This involves taking live fat cells, protecting and processing them, and re-injecting or placing them in an area where more fat or bulk is needed. Some special terms are used for marketing purposes, but it is all fat grating. There is a greater possibility of irregularity of result with fat than with fillers. That is because it is difficult to place very tiny strands of fat under the very thin skin in the tear trough area, and therefore slight lumpiness is sometimes seen and is not desirable. However, there is a way to combine fat grafting with blepharoplasty where the fat in injected underneath the skin into the bulk of the orbicularis muscle of the lower lid. My best advice to is go to a board-certified plastic surgeon who has experience with lower lid conservative blepharoplasty, talk to some of his patients, fully understand his surgical plan, and make sure that he/she understands your goals for the surgery,
For eyelid bag removal, transconjunctival surgery to remove the fat pads can be done. This leaves no outside scar. Fillers could then be used in the tear trough area to smooth things out if it is necessary. Laser is not effective most of the time against fat pad types of eye bags. However, it can be used to tighten the skin along with removal of the bags. Each person has to be evaluated in the light of what the defects are, what the surgeon’s experience is, your budget, and what you wish to accomplish in the surgery.
SMAS facelift generally is a good choice because it tightens the base on which the skin is redraped. There are some studies that show that the incidence of complications with extensive SMAS surgery are greater and some show that the SMAS tightening does not give a long-lasting effect. However, most surgeons feel that if there is a relaxed SMAS, that the patient is better off with a moderate SMASectomy with permanent closure. The SMAS can be combined with a mini-lift to give more tightness to the nasolabial folds and jowls as well as the submental neck area. This can be done and you can still look natural. The main thing is that you have confidence in your surgeon and in the advice he or she gives you.
