was told only needed skin removed. While in surgery surgeon asked « did we discuss fat removal ». I said no but he removed fat anyway. I posted here a couple weeks postop because incisions were uneven. It’s now been 2.5 months. In the morning my eyes are swollen and look acceptable but at end of day it’s as if there is no fullness anymore in upper lid. I would like your opinions if possible. Do the results seem acceptable or not? Was too much tissue removed? Is there anything I can do? Ptôsis?
October 27, 2017
Answer: Post upper lid bleph You are healing well at this point. Your creases look pretty even, and the lid platform looks the same. There is no significant ptosis. When you look down you have some deepening of the central sulcus on the left. However when you look straight ahead, I would not say it looks hollow. When doing an upper bleph, I usually either trim the medial fat pad, or will move it more laterally if someone already has hollowing. Over resection of the central fat pad can cause hollowing of the superior sulcus. If you think you look too hollow, you could add some HA filler. I think you look good and would leave it alone. Before pictures would be helpful to help judge how much fat you might have had pre-op.
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October 27, 2017
Answer: Post upper lid bleph You are healing well at this point. Your creases look pretty even, and the lid platform looks the same. There is no significant ptosis. When you look down you have some deepening of the central sulcus on the left. However when you look straight ahead, I would not say it looks hollow. When doing an upper bleph, I usually either trim the medial fat pad, or will move it more laterally if someone already has hollowing. Over resection of the central fat pad can cause hollowing of the superior sulcus. If you think you look too hollow, you could add some HA filler. I think you look good and would leave it alone. Before pictures would be helpful to help judge how much fat you might have had pre-op.
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Answer: Normal eyes You have normal-appearing eyes. You posted 4 photos but it is not at all clear which, if any, are preop photos vs postop ones. All of the photos look normal. It is not unusual for patients to scrutinize their results obsessively in the weeks after surgery. Only an in-person exam can help you as a surgeon has to examine you with eyes open and closed, looking in all directions, etc. and assess the fat distribution and function of the eyelid structures. However, the short answer to your question as to whether your eyes look acceptable, the answer is yes. If you are not happy and feel your eye sockets were hollowed out by fat removal, then fat grafting might be appropriate, but that is very hard to discern from these photos.
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Answer: Normal eyes You have normal-appearing eyes. You posted 4 photos but it is not at all clear which, if any, are preop photos vs postop ones. All of the photos look normal. It is not unusual for patients to scrutinize their results obsessively in the weeks after surgery. Only an in-person exam can help you as a surgeon has to examine you with eyes open and closed, looking in all directions, etc. and assess the fat distribution and function of the eyelid structures. However, the short answer to your question as to whether your eyes look acceptable, the answer is yes. If you are not happy and feel your eye sockets were hollowed out by fat removal, then fat grafting might be appropriate, but that is very hard to discern from these photos.
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