Dear Fahad Saleem;You have bags of the eyes and dark skin, and of course, that needs an evaluation. It may be that blepharoplasty is the proper procedure, but you certainly would want to get that checked out. Be sure to see someone who is a specialist in eyelid cosmetic surgeries for that. Ophthalmic plastic surgeons are the most skilled in that field; living in New York, you will have no trouble locating one. Their focus is entirely on eyelids and the tissue surrounding, including the brow. You are an excellent candidate for rhinoplasty in these photos. The tip of your nose is too wide. The nose is long. It has a minor bump and certainly if you have been thinking about rhinoplasty for a long time and want a better profile, there is no reason not to do it. I cannot tell in these photos if you need a chin implant because the photos are a little difficult to evaluate due to the beard, but it does suggest that a chin implant may be an excellent ancillary procedure. Some cosmetic surgery homework may be in order. Here's how:The homework time you spend will be worth it. You want to do cosmetic facial surgery right – the first time. The most critical element of the process is surgeon selection. Ideally, you want a board-certified surgeon, in either plastic surgery or head & neck surgery fellowship trained, who is highly focused on the procedure(s) you want, who performs such at least weekly and who has been in practice for a minimum of ten years. Websites are the key to understanding the practice. You should see at least dozens of before and after pictures, showing the changes in the procedure you want. The most helpful sites have a variety of graphics, including photos of how you might look one or five or ten days after surgery. Look for detailed explanations of all procedures. The site should answer nearly every question you have. Generally, the top practices have the thickest, richest and most informative websites. The dedicated doctor spends much time building an educational website for your benefit. Here is another hint: Ask the practice if you can speak with one or more patients who have had the same procedure(s) you want. See their before and after photos if possible. You learn most from walking in the shoes of those who have made the journey before. Also, look for a super-specialist:Today’s medicine is an area of extreme specialization because medical knowledge doubles every 18 months, even specialists in a particular field of medicine select and concentrate on just a handful of procedures, becoming extremely familiar, efficient and adept at performing or delivering them. For instance, a cardiologist knows all about the heart, but does not operate on them. A cardiac surgeon handles heart surgeries but may ask a heart valve specialist to do operations on heart valves. That heart valve surgeon has gone beyond being a specialist and is now a super-specialist, which is a medical, (and not advertising) classification. Likewise, a cosmetic plastic surgeon who specializes in only four to seven facial procedures has become a super-specialist in say, cosmetic and functional nose surgery along with a few procedures of the face and neck. The super-specialist is more likely to have had a fellowship, an arrangement in which a younger surgeon works at the side of a Master Surgeon for a year, concentrating on and performing only a handful of procedures. The super-specialist works so efficiently, healing is faster because less tissue is disturbed going in and coming back out. The procedure is also more likely to be done correctly, the first time. In the case of nose surgery, that’s extremely important in a field where almost 20 percent of first nose jobs must be redone in a second revision surgery, owing to the extreme complexity and delicate nature of rhinoplasty which is widely known as the most difficult cosmetic surgery. Choosing a super-specialist means having something akin to an insurance policy in your back pocket.Another tip for an excellent outcome: ask for computer imaging.Here’s how it works: photos are taken of you as you are currenty and uploaded onto a special computer system that can morph your present appearance into an anticipated after picture (The technology is also known as Computer Morphing.). Such imaging is an incomparable learning tool because it provides a forum for doctor-patient agreement on the after surgery result that would satisfy you and is also a result the doctor can deliver. After all, cosmetic surgery is 100% visual. It's about appearance but without visuals and everything is left to the imagination. To anticipate a successful outcome, there must be a meeting of the minds between surgeon and patient. Why waste your time on a consultation in which the surgeon can’t demonstrate what he envisions as the outcome? Would you buy a painting without seeing it? In my opinion, a consultation without computer imaging is nearly worthless. Best wishes, Robert Kotler, MD, FACS