Appearance of dent on outer side of right eye after, Face lift plus upper & lower eye surgery, less than a year ago. (photo)

Question

I have noticed the appearance of a considerable size dent on the outer side of my right eye less than a year after my face lift and upper and lower eye surgery, my mouth is also slightly higher on this side of my face , please please could anyone advise why this has happened and what can I do about it? Thank you

Alejandro Nogueira, MD · Answer

There is a basic universal rule in skin surgery: incisions must NEVER cross the so called naturla Langher's lines, in your eyelids means the scar shold have a curvaceous shape to fit into your upper tarsal fold but... laterally... at its lateral extension... it must have a sinusoid shape and change from convex to concavity to lie withing the crow's feet lines.Your surgeon went straight breaching this basic rule, therefore you have the typical retraction and dent. The solution is zetaplasty, very easy and under local anesthesia.

Brian S. Biesman, MD · Answer

it appears that you have follow up volume changes from fat loss after surgical dissection. I have seen this scenario frequently and have had great success treating similar cases with injectable fillers. Best of luck

John Nguyen, MD, FACS · Answer

This is due to fat atrophy near the area of your eyelid surgery.  It is not common but can happen.  I would recommend fat grafting or fillers to correct this.  Communicate with your surgeon.  Good luck and be safe.John T. Nguyen, MD, FACS, FICSDouble Board Certified Plastic Surgeon

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for the pictures. I cannot comment on what actually happened.  This may be improved with fat grafting. It may take multiple sessions to give you noticeable improvement.

Kenneth D. Steinsapir, MD · Answer

This is the result of a mid face dissection that was part of your surgical procedures.  The dissection plane used by the surgeon to enter the midface is a plane that contains a small amount of fat.  Unfortunately, the dissection itself can damage the fat which is later reabsorbed by the body as you heal from surgery.  This crease a depression in the temple area that outlines the zygomatic arch.  I call the deformity plateau midface because the effect is the appearance of a shelf or flat spot above the zygomatic arch.  Unfortunately this tiny bit of fat also services a critical aesthetic role in the face:  It isolated the eye aesthetic area from the temple.  The brake down and loss of fat here profoundly affects the gaze contact that other have of you during conversation.  Normally the person you are speaking do looks at your eyes most of the time but also gazes at the mouth and a little less at the nose.  This effectively sets of a triangular gaze pattern that we associate with someone actively interested in conversation.  When this little bit of fat is broken down, this gaze barrier is lost.  During conversation, the person speaking without no longer follows the gaze pattern we associate with interest.  Instead their gaze is distracted into the temple area and off the face.  Individuals with plateau midface often report that they feel that people are no longer paying attention to them.

Carey Nease, MD · Answer

This looks like fat necrosis (fat cells died and absorbed) from where the outer aspect of the lower eye lift was done.  This can easily be fixed with a fat transfer procedure to fill in the hollow area.  It is a minor procedure with little recovery.  You also have very hollow temples, and filling that area would be aesthetically beneficial as well.

Katrinka L. Heher, MD · Answer

This dent seems most consistent with a mid face lift performed in conjunction with your lower lid blepharoplasty. The goods news is that a filler injection would be simple and very affective. I prefer restylane for this area and you could potentially enjoy the results for years. Good luck.

Darryl J. Blinski, MD · Answer

Yes there is a "dent". Reason not clear. But a HA filler or fat graft can improve. Fee from $400 to $1,000...

Appearance of dent on outer side of right eye after, Face lift plus upper & lower eye surgery, less than a year ago. (photo)

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