I am trying to decide if lower blepharoplasty (fat repositioning) or tear trough rejuvenation with Restylane is best for my problem? I have fat prolapse on my right side resulting in a more puffy appearance above the tear trough and on the left have more extensive hollowing. I am just lost as to which gives best results. I am getting married in August & concerned with complications / recovery of the surgery but wonder if ultimately it is the better option? I have also been told that my mid face area seems to be attributing to the overall problem?
Answer: Restylane vs. surgery The photograph is not completely telling because you are looking up and a bit to the side, which accentuates the bags under the eyes. Your eye configuration is one of a prominent eyeball (globe); hand in hand with a large eye is often a very visible fat bulge below the eyes. The most effective way to treat a bulge below the eye is with a transconjunctival blepharoplasty. That way the danger to the lower eyelid is very low. If you try to build up the areas surrounding the bulges with temporary filler, even if you don't have a complication, you will likely be much poorer (the amounts needed will be significant) and in my opinion I would not recommend that course of action, especially from an aesthetic standpoint. Aesthetically, you can do the math and see how bulging your lower eyelids would be if everything were brought to the level of the lower eye bulges... not very attractive. Sometimes a small amount of lighter HA filler is excellent at producing camouflage of the bumps without breaking the bank, a good compromise if the patient doesn't want to have surgery and doesn't mind frequent treatments. Typically these treatments would need to be repeated every six months in this area. It is indeed possible to adjust the lateral canthus to reduce the appearance of a prominent globe with the aid of a limited incision cheeklift. It is also possible to elevate the midface slightly through a cheeklift. But again, lots of surgery. Many articles and chapters on our website drbrent.com under Articles. Fat transposition surgery usually requires an incision below the eyelid and division of the arcus marginalis. For the small amount of fat you have, I wouldn't recommend that approach. Relatively invasive and complication prone in the wrong hands. I would rather see you have a transconjunctival blepharoplasty and later do small amounts of filler below the eyes. Restylane and Juvederm are heavy fillers and can in some patients cause edema around the eyelids that is long-lasting (Juvederm more than Restylane), so if you have an important upcoming engagement, do you want to take that chance? There are lighter fillers such as Prevelle which are less risky. And Radiesse, Artecoll, and any semipermanent filler are in my opinion a terrible idea because of the potential for untreatable lumpiness and chronic inflammatory complications in the future.
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Answer: Restylane vs. surgery The photograph is not completely telling because you are looking up and a bit to the side, which accentuates the bags under the eyes. Your eye configuration is one of a prominent eyeball (globe); hand in hand with a large eye is often a very visible fat bulge below the eyes. The most effective way to treat a bulge below the eye is with a transconjunctival blepharoplasty. That way the danger to the lower eyelid is very low. If you try to build up the areas surrounding the bulges with temporary filler, even if you don't have a complication, you will likely be much poorer (the amounts needed will be significant) and in my opinion I would not recommend that course of action, especially from an aesthetic standpoint. Aesthetically, you can do the math and see how bulging your lower eyelids would be if everything were brought to the level of the lower eye bulges... not very attractive. Sometimes a small amount of lighter HA filler is excellent at producing camouflage of the bumps without breaking the bank, a good compromise if the patient doesn't want to have surgery and doesn't mind frequent treatments. Typically these treatments would need to be repeated every six months in this area. It is indeed possible to adjust the lateral canthus to reduce the appearance of a prominent globe with the aid of a limited incision cheeklift. It is also possible to elevate the midface slightly through a cheeklift. But again, lots of surgery. Many articles and chapters on our website drbrent.com under Articles. Fat transposition surgery usually requires an incision below the eyelid and division of the arcus marginalis. For the small amount of fat you have, I wouldn't recommend that approach. Relatively invasive and complication prone in the wrong hands. I would rather see you have a transconjunctival blepharoplasty and later do small amounts of filler below the eyes. Restylane and Juvederm are heavy fillers and can in some patients cause edema around the eyelids that is long-lasting (Juvederm more than Restylane), so if you have an important upcoming engagement, do you want to take that chance? There are lighter fillers such as Prevelle which are less risky. And Radiesse, Artecoll, and any semipermanent filler are in my opinion a terrible idea because of the potential for untreatable lumpiness and chronic inflammatory complications in the future.
Helpful 2 people found this helpful
Answer: The Management Of Tear Trough Deformities It's not unusual for patients with tear trough deformities to request plastic surgical consultation. When this situation arises, a variety of treatment options exist to treat this condition. These include surgical procedures that release the arcus marginalis and the use of injectable hyaluronic acid fillers that minimize tear trough deformities.It's extremely important to individualize the treatment of tear troughs. For this reason, the specific procedure chosen will depend upon the patient's anatomic findings and aesthetic goals.It's important to realize that lower eyelid filler injections can be very effective for treating tear trough deformities, but aren't for everyone with this condition. In some patients the lower eyelid skin is extremely thin and for this reason, injectable fillers aren't always indicated. In addition, this technique only provides a temporary solution to the problem and can sometimes result in lower eyelid discoloration and nodule formation.When patients have excess lower eyelid fat, arcus marginalis release and fat re-positioning is appropriate. This procedure is associated with excellent clinical results.It's important for patients with tear trough deformities to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.
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Answer: The Management Of Tear Trough Deformities It's not unusual for patients with tear trough deformities to request plastic surgical consultation. When this situation arises, a variety of treatment options exist to treat this condition. These include surgical procedures that release the arcus marginalis and the use of injectable hyaluronic acid fillers that minimize tear trough deformities.It's extremely important to individualize the treatment of tear troughs. For this reason, the specific procedure chosen will depend upon the patient's anatomic findings and aesthetic goals.It's important to realize that lower eyelid filler injections can be very effective for treating tear trough deformities, but aren't for everyone with this condition. In some patients the lower eyelid skin is extremely thin and for this reason, injectable fillers aren't always indicated. In addition, this technique only provides a temporary solution to the problem and can sometimes result in lower eyelid discoloration and nodule formation.When patients have excess lower eyelid fat, arcus marginalis release and fat re-positioning is appropriate. This procedure is associated with excellent clinical results.It's important for patients with tear trough deformities to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.
Helpful
November 1, 2015
Answer: Filler for undereye I have good experience with fillers for the under eye area (tear troughs) and have seen beautiful results achieved. I use Teosyal Redensity II, a filler that is specifically for the lower eyelids. It can also help with any dark circles in the area.
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November 1, 2015
Answer: Filler for undereye I have good experience with fillers for the under eye area (tear troughs) and have seen beautiful results achieved. I use Teosyal Redensity II, a filler that is specifically for the lower eyelids. It can also help with any dark circles in the area.
Helpful
July 27, 2015
Answer: Combination of bleph and fillers From the photograph, you have a little fat in the lower eyelids bulging forward. You also have slight loss of your mid-face(cheeks). A lower blepharoplasty with fat transposition would shift your fat down towards the cheeks. In addition, a little extra volumizing with fillers in the mid-face would accentuate the overall look. See an oculoplastic surgeon who specializes in both procedures.
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July 27, 2015
Answer: Combination of bleph and fillers From the photograph, you have a little fat in the lower eyelids bulging forward. You also have slight loss of your mid-face(cheeks). A lower blepharoplasty with fat transposition would shift your fat down towards the cheeks. In addition, a little extra volumizing with fillers in the mid-face would accentuate the overall look. See an oculoplastic surgeon who specializes in both procedures.
Helpful
February 6, 2015
Answer: Fillers If you are concerned about surgery then I would recommend the fillers to address your tear troughs. This would fill them in and you can also add volume to other areas of your face that you'd like to have improved.
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February 6, 2015
Answer: Fillers If you are concerned about surgery then I would recommend the fillers to address your tear troughs. This would fill them in and you can also add volume to other areas of your face that you'd like to have improved.
Helpful
October 3, 2014
Answer: Eyelud surgery Those are great questions. First of all, don't even consider getting injectables in the lower lids and especially not fat injection. The tear trough that people talk about is sheer nonsense designed to get you to have injections done. What you need done is a standard lower lid bleoharoplasty to remove the excess fat that causes the puffiness. I am also familiar with this concept of fat repositioning. It is also a poorly conceived operation. Stick with what is tried and true.
Helpful
October 3, 2014
Answer: Eyelud surgery Those are great questions. First of all, don't even consider getting injectables in the lower lids and especially not fat injection. The tear trough that people talk about is sheer nonsense designed to get you to have injections done. What you need done is a standard lower lid bleoharoplasty to remove the excess fat that causes the puffiness. I am also familiar with this concept of fat repositioning. It is also a poorly conceived operation. Stick with what is tried and true.
Helpful