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Finally Happy with my Eyes
I'm 54 years old, in very good shape overall, but have been self-conscious about my under-eye bags and puffiness since my early 40's. About 8 years ago I got under-eye filler from Dr. Kapadia, and I was pleased with it for a few years. I made the mistake of going somewhere else to get more filler a couple of years ago, and over time my under-eye area became uneven and puffy looking. I had also gotten some filler over my cheekbones, and it just exacerbated the puffiness around my eyes. And overall, I was just ready to be rid of old filler.
Finally I went to back to Dr. Kapadia (because he has an excellent reputation) to figure out what I should do. He recommended dissolving the filler, then evaluating my natural under eye area so he could make a recommendation. He injected my under eye area with a conservative amount of hyaluronidase to dissolve the filler, and said to return in a couple of weeks.
When I returned, Dr. Kapadia told me that more filler would not do the trick, in fact it could make things worse since the area was already puffy; I needed surgery if I wanted to correct the baggy problem. It did look pretty horrible without the filler in it (you can see the "pre" photos), and I was eager to do something about it. I also needed another round of hyaluronidase to completely dissolve the filler.
The surgery itself took place in a hospital (he also has another, private office for these surgeries), and I was put under general anesthesia (he doesn't want his patients squirming around at all). He uses the transconjunctival approach, which involves making an incision on the inside (rather than the outside lash-line) of the lower eyelid to remove the fat pad, and the incision just heals on its own (no stitches). The surgery itself went smoothly and his team was friendly and put me at ease.
A comment on the surgical technique: I had researched the option of fat pad repositioning, which he doesn't do. Apparently fat pad repositioning is more difficult and time consuming, and more important, carries a greater risk of complications (like movement of the fat after grafting). In addition, if the goal is to prevent hollowness (which often does not occur), this can be achieved more effectively and with more precision with filler, which about 30% of his patients will need post surgery (I have to wait a few weeks to see if I need it). But surgeons appear to disagree on whether fat-pad repositioning is the best way to go, so do your research and ask your questions!
It was convenient that my surgery took place when we are all wearing masks! I had plenty of bruising and some swelling, but it healed quickly, and there wasn't too much pain other than tenderness. (I was prescribed painkillers but they weren’t necessary at all.) The recovery was relatively easy and I didn't have to hide out much, I could just pull the mask up over my under eye area. But I did have to take it easy for the first couple of days after surgery, which was made easier by grogginess from the anesthesia. I rested lots for the first 48 hours, icing on and off every 20 minutes or so for the first 24 hours, and less often the next 24 hours. I didn't ice after that.
I slept with my head elevated, but nothing drastic. I love to exercise so the ban on exercising for two weeks was not going to work. (You're not supposed to do much more that walking for 2-3 weeks to prevent serious vascular complications and to promote overall healing--the goal is not to elevate blood pressure, including bending down). I walked lots for the first week, and then used my stationary bike for extended periods of time, without increasing my heart rate by too much or sweating. After about 11 days I got right back into working out hard, and for me, that was ok. But you should listen to your doctor and make up your own mind!
You can see the pics to see how I healed. If I had to, I could have gone to work after about a week, with heavy concealer and glasses. After about 10 days nobody would be able to tell I'd had anything done if I were wearing my normal concealer (even without it they might not notice).
It's been about 2.5 weeks, and I am thrilled. It's not perfect under there, but it would probably look weird if it were, given my age. There is still a bit of swelling and discoloration, but totally manageable. It should continue to improve over the next few months, with final result in 5 or 6 months. I'll post pics later so you can see how things end up.
Dr. Kapadia and his team are great. He's very smart, sincere, and knows how to connect without making you feel like he's trying, which I can't stand. He's busy but will make time to listen to you. I have a friend who went to him for upper and lower bleth, and she is also very satisfied. I highly recommend him for filler and for surgery!
Finally I went to back to Dr. Kapadia (because he has an excellent reputation) to figure out what I should do. He recommended dissolving the filler, then evaluating my natural under eye area so he could make a recommendation. He injected my under eye area with a conservative amount of hyaluronidase to dissolve the filler, and said to return in a couple of weeks.
When I returned, Dr. Kapadia told me that more filler would not do the trick, in fact it could make things worse since the area was already puffy; I needed surgery if I wanted to correct the baggy problem. It did look pretty horrible without the filler in it (you can see the "pre" photos), and I was eager to do something about it. I also needed another round of hyaluronidase to completely dissolve the filler.
The surgery itself took place in a hospital (he also has another, private office for these surgeries), and I was put under general anesthesia (he doesn't want his patients squirming around at all). He uses the transconjunctival approach, which involves making an incision on the inside (rather than the outside lash-line) of the lower eyelid to remove the fat pad, and the incision just heals on its own (no stitches). The surgery itself went smoothly and his team was friendly and put me at ease.
A comment on the surgical technique: I had researched the option of fat pad repositioning, which he doesn't do. Apparently fat pad repositioning is more difficult and time consuming, and more important, carries a greater risk of complications (like movement of the fat after grafting). In addition, if the goal is to prevent hollowness (which often does not occur), this can be achieved more effectively and with more precision with filler, which about 30% of his patients will need post surgery (I have to wait a few weeks to see if I need it). But surgeons appear to disagree on whether fat-pad repositioning is the best way to go, so do your research and ask your questions!
It was convenient that my surgery took place when we are all wearing masks! I had plenty of bruising and some swelling, but it healed quickly, and there wasn't too much pain other than tenderness. (I was prescribed painkillers but they weren’t necessary at all.) The recovery was relatively easy and I didn't have to hide out much, I could just pull the mask up over my under eye area. But I did have to take it easy for the first couple of days after surgery, which was made easier by grogginess from the anesthesia. I rested lots for the first 48 hours, icing on and off every 20 minutes or so for the first 24 hours, and less often the next 24 hours. I didn't ice after that.
I slept with my head elevated, but nothing drastic. I love to exercise so the ban on exercising for two weeks was not going to work. (You're not supposed to do much more that walking for 2-3 weeks to prevent serious vascular complications and to promote overall healing--the goal is not to elevate blood pressure, including bending down). I walked lots for the first week, and then used my stationary bike for extended periods of time, without increasing my heart rate by too much or sweating. After about 11 days I got right back into working out hard, and for me, that was ok. But you should listen to your doctor and make up your own mind!
You can see the pics to see how I healed. If I had to, I could have gone to work after about a week, with heavy concealer and glasses. After about 10 days nobody would be able to tell I'd had anything done if I were wearing my normal concealer (even without it they might not notice).
It's been about 2.5 weeks, and I am thrilled. It's not perfect under there, but it would probably look weird if it were, given my age. There is still a bit of swelling and discoloration, but totally manageable. It should continue to improve over the next few months, with final result in 5 or 6 months. I'll post pics later so you can see how things end up.
Dr. Kapadia and his team are great. He's very smart, sincere, and knows how to connect without making you feel like he's trying, which I can't stand. He's busy but will make time to listen to you. I have a friend who went to him for upper and lower bleth, and she is also very satisfied. I highly recommend him for filler and for surgery!
Provider Review
Oculoplastic Surgeon, Board Certified in Ophthalmology
873 Worcester St., Wellesley, Massachusetts