Facelift Revision

Lip Fillers

Double Eyelid Surgery

Brow Lift

Deep Plane Facelift

Eyelid Surgery

“hooded eyelids” can come from two different anatomical issues &mdash; and choosing the right procedure depends on identifying which one you actually have. 1. Upper eyelid excess (true eyelid skin redundancy) If the heaviness comes mainly from extra skin in the upper eyelid, an upper blepharoplasty is usually the best solution. It removes the excess skin and can define the crease, making the eyes look cleaner and more open. 2. Brow descent (especially lateral brow drop) If the outer brow has descended, it pushes tissue down over the eyelid, creating a “hooded” appearance. In these cases, a brow lift (often temporal or endoscopic) is more appropriate because it addresses the root cause. What I often see in patients like you: Most patients are actually a combination of both, with: mild to moderate brow descent (especially lateral) and some degree of eyelid skin excess In those cases, doing only a blepharoplasty can sometimes under-correct or even make the brow look heavier. My approach: The key is a detailed facial analysis, not a one-size-fits-all answer. In many patients, the most natural and balanced result comes from: conservative upper blepharoplasty + subtle brow elevation (often a temporal brow lift rather than an aggressive full lift) This avoids an overdone look and keeps the result elegant and natural. Important takeaway: The question is not “which procedure is better?” it’s “what is causing YOUR hooding?” That determines the right treatment.

Looking for a procedure to help hooded eyes. The right eyelid sags more than the other. Would brow lift be a good option, or eyelid surgery?

Would a brow lift help my sagging eyelids?

Significant weight loss &mdash; like your 80 lb change &mdash; often leads to early facial aging, even in patients in their 30s. Based on your concerns (jowls, marionette lines, neck laxity), you are describing structural descent, not just a skin issue. That distinction is key. Would a deep plane facelift help? Yes &mdash; in the right patient, a deep plane facelift is one of the most effective ways to address: early jowling deepening nasolabial folds marionette lines neck laxity Unlike skin-only techniques, it repositions the deeper facial structures, which is exactly what tends to be affected after weight loss. But here is the critical point: At 39, the goal is not to “tighten” aggressively, but to restore a natural, rested version of your face. In younger patients like you, I typically favor: a conservative deep plane approach sometimes combined with volume restoration (fat grafting) if there is deflation from weight loss What about losing another 20 lbs? This is very important. Ideally, you should be at or very close to your stable weight before surgery Further weight loss after a facelift can: reduce facial volume partially affect the final aesthetic balance That said, it won’t “ruin” the result, but it may make you look slightly more deflated over time. Neck lines These are often a combination of: skin quality platysma activity volume changes A deep plane facelift (with proper neck work) can significantly improve them, but skin quality treatments (laser, resurfacing) may be needed for optimal refinement. Dark circles under the eyes This is usually a separate issue from the facelift. Depending on the cause (hollowing vs pigmentation), options include: lower blepharoplasty (if fat herniation or hollowness) fat grafting skin treatments (laser, skincare) Bottom line: .You may be a good candidate, especially given the post-weight-loss changes .But timing (stable weight) and a natural, conservative approach are key to getting an elegant result

I'm 39. I got nasolabial folds at 21, after a 80-lb weight loss. Recently, I noticed saggy jowls, marionette and neck lines. Will the deep plane facelift erase those lines? If I lose 20 lbs, will it affect results? What do you recommend for neck lines and dark spot under the eyes? Thank you.

39, 80 pound weight loss - Am I a good candidate for the deep plane facelift? (Photos)

At 44, “hooded eyelids” can come from two different anatomical issues &mdash; and choosing the right procedure depends on identifying which one you actually have. 1. Upper eyelid excess (true eyelid skin redundancy) If the heaviness comes mainly from extra skin in the upper eyelid, an upper blepharoplasty is usually the best solution. It removes the excess skin and can define the crease, making the eyes look cleaner and more open. 2. Brow descent (especially lateral brow drop) If the outer brow has descended, it pushes tissue down over the eyelid, creating a “hooded” appearance. In these cases, a brow lift (often temporal or endoscopic) is more appropriate because it addresses the root cause. What I often see in patients like you: Most patients are actually a combination of both, with: mild to moderate brow descent (especially lateral) and some degree of eyelid skin excess In those cases, doing only a blepharoplasty can sometimes under-correct or even make the brow look heavier. My approach: The key is a detailed facial analysis, not a one-size-fits-all answer. In many patients, the most natural and balanced result comes from: conservative upper blepharoplasty + subtle brow elevation (often a temporal brow lift rather than an aggressive full lift) This avoids an overdone look and keeps the result elegant and natural.

I’m 44 years old and have heard mixed things regarding a brow lift vs upper blepharoplasty. I’m wondering which one will be more beneficial for me? Overall I’m looking to have my eyes look more open, a more defined crease and the hoods gone.

44, looking to eliminate hooded lids - Endoscopic brow lift or upper blepharoplasty? (Photos)

Thank you for your thoughtful question and for sharing your photos. It’s not uncommon for patients to notice recurrent facial laxity several years after a SMAS facelift. While facelift surgery provides long-lasting rejuvenation, it does not stop the natural aging process. Over time, changes in skin elasticity, ligamentous support, and especially loss of facial volume can contribute to the return of jowls and neck laxity. Based on your description, both a revision facelift and a lower facelift may be appropriate options, depending on the extent and location of the aging changes. A lower facelift primarily addresses the jawline and neck, and it can be effective when concerns are limited to these areas. However, if there is also midface descent or a desire for a more comprehensive and longer-lasting result, a revision or deep plane facelift may provide superior rejuvenation by repositioning the deeper facial structures. The perceived loss of the benefits from your previous fat transfer is also common, as some of the grafted fat may resorb over time. Additional fat grafting or other volumizing techniques can be combined with facelift surgery to restore facial harmony. Ultimately, the best approach depends on a detailed in-person evaluation, including assessment of skin quality, residual SMAS support, and volume loss. Consulting with an experienced, board-certified facial plastic surgeon will help determine the most appropriate and personalized treatment plan. Dr. Pedro Literas Facial Plastic Surgeon

Hi, I had a Smas facelift 4.5 years ago and a fat transfer, I am aware that neither is permanent but I literally feel like I never had it. I do not blame my surgeon for I think He is great but I'm feeling like I am still chasing the problems I started with. I am doing microneedling, and botox and filler and have been for years now. I lost all the fat and my skin is droopy, ugh! Is a full repeat facelift the answer or a lower facelift do the trick.

Facelift redo - do I need a full lift or would a lower facelift be a good choice? (Photos)

Thank you for your question. Visibility of temporal implants can occur, particularly in patients with thin skin or limited soft tissue coverage. The prominence you are noticing is often related to the edge of the implant rather than a complication, and fortunately, several effective treatment options are available. Hyaluronic acid fillers can be used to camouflage the implant’s edge and smooth the contour. When performed by an experienced injector, this is a safe, minimally invasive option that provides immediate improvement. However, fillers are temporary and may require maintenance over time. Autologous fat grafting is another excellent alternative, offering a more natural and longer-lasting solution. Fat provides soft tissue padding over the implant and integrates well with the surrounding tissues. In cases where the implant is significantly prominent or malpositioned, surgical revision, including implant repositioning, edge modification, or even removal, may be considered. A thorough in-person evaluation with a board-certified facial plastic surgeon is essential to determine the most appropriate treatment based on your anatomy and aesthetic goals. Dr. Pedro Literas Facial Plastic Surgeon

My facelift included temporal implants. Unfortunately, my skin is quite thin and the top ridge of both implants is highly visible. Is it possible to add a little filler near the top of the implant to smooth it? What options do I have for correcting the problem?

Temporal implants - how can they be made less visible? (Photos)

Thank you for sharing your concerns. I'm sorry to hear about your experience. It is not uncommon for patients to seek revision after upper blepharoplasty and brow lift procedures, and many of the issues you describe can often be improved with appropriate treatment. Uneven eyelid scars can typically be addressed through scar revision, laser resurfacing (such as CO₂ laser), microneedling, or, in some cases, a carefully planned surgical revision to improve symmetry and eyelid contour. Forehead nerve pain and scalp numbness may occur after a brow lift due to temporary or, less commonly, permanent irritation of the sensory nerves (such as the supraorbital or supratrochlear nerves). While numbness often improves within the first year, persistent symptoms beyond this period can still be managed. Treatments may include observation, medications for neuropathic pain, nerve blocks, or, in select cases, surgical nerve release. Nerve injuries can take up to 2 years in getting better. I recommend consulting with an experienced specialist who can assess your scars, eyelid function, and sensory changes to provide a personalized solution. Dr. Pedro Literas Facial Plastic Surgeon

Hello, I had an upper blepharoplasty and brow lift in South Korea last year. Unfortunately, I believe the results were botched. A year plus later, I still have very uneven scars on my eyelids, along with nerve pain in my forehead. My scalp is also almost completely numb, and the feeling has not returned. I just want to know if this can be fix somewhere in the states?

Upper blepharoplasty scar &amp; issues. Can this be fixed?

A persistent bump after lip filler is often due to a small accumulation of hyaluronic acid or a minor fibrotic nodule. Hyaluronidase can safely dissolve the filler and typically acts only in the injected area, with minimal risk of affecting surrounding regions. An in-person evaluation is recommended to determine the best treatment. An Ultrasound of the upper lip can be helpful in order to discard other possible diagnosis like skin cysts.

There is a bump above my lip that didn't go away. It hasn't changed in size and I'm thinking it's filler? Just wondering if I get it dissolved, is there was a chance it would go down into my lip and dissolve the filler there too.

Bump above lip (under nose). Is this filler? (Photo)

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Dr. Pedro Literas MD FACS

Facial Fat Transfer

Lip Lift

Neck Lift

Plastic surgeons specialize in the full spectrum of cosmetic and reconstructive surgeries for the face, eyes, nose, breasts, and body.

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7 Answers from Plastic Surgeon Pedro Literas, MD See Education, Board Certification, and Treatments Offered.

Meet Pedro Literas, MD, a trusted Plastic Surgeon. See 7 expert answers, 6 before-and-after photos, credentials, treatments, and 0 real patient reviews. Book a consultation today!

General and Thoracic Surgery, Hospital Frances, Buenos Aires, Argentina.

Aesthetic, Reconstructive and Plastic Surgery Specialist, SACPER, Argentina.

Aesthetic, Reconstructive and Plastic Surgery Specialist, SEP, Mexico.

Aesthetic, Reconstructive and Plastic Surgery Specialist, Mexican Board of Plastic Surgery CMCPER, Mexico.

MAFAC Academy, Advanced Facial Anatomy Course, Amsterdam, Netherlands.

Doctor of Medicine with Honors, University of Buenos Aires, Buenos Aires, Argentina.

Doctor of Medicine, SEP, Mexico.

Doctor of Medicine, Sports, Culture and Education Ministry, Spain

ECFMG, Educational Commission For Foreign Medical Graduates, USA.

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Scar healing after facial plastic surgery depends on more than just the incision. In this video, I explain the three key factors:
1?? Skin Quality and Tissue Characteristics 
2?? Surgical Skill and Experience 
3?? Postoperative Care 

“Scar Healing Explained: Skin Quality, Surgical Skill, and Aftercare”

After a Deep Plane Facelift, proper early postoperative care is essential for optimal healing and natural results. In this video, I share what patients can expect immediately after surgery, including recovery, swelling, and key aftercare guidelines.

Early Postoperative Care after Deep Plane Facelift Surgery, What to expect.

Facial plastic surgeon in Los Cabos specializing in Deep Plane Facelift and advanced facial rejuvenation.
International patients choose Los Cabos for its combination of world-class care, privacy, and natural results.

Facial Plastic Surgery in Los Cabos | Deep Plane Facelift Specialist

Meet Pedro Literas, MD, a trusted Plastic Surgeon. See 7 expert answers, before-and-after photos, credentials, treatments, and  real patient reviews. Book a consultation today!

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