Certainly a brow lift and eyelid surgery would increase the youthfulness of the upper part of the face. Whether you need one or the other is something we would have to see on examination. If brow ptosis or wrinkling of the forehead is a significant problem, then certainly a brow lift would be an excellent procedure. If you have eyelid skin in excess and lateral hooding caused by this excess skin in the upper eyelids, a blepharoplasty would be an excellent procedure.
Generally speaking, I recommend that people have any medical type procedures before they have cosmetic procedures to rule out any secondary complications from the cosmetic work. So I would tell you to go ahead and get the Lasik surgery and then within a month or two after, if that is successful, go ahead and have your blepharoplasty.
No. A standard blepharoplasty removes skin and/or fat and as a rule gives you less upper eyelid skin to work with after surgery than before surgery. If you are lacking in skin or have what is called lagophthalmos, I would certainly consider doing nothing with your eyes that would add to the problem such as a blepharoplasty. Correction of this problem unfortunately is not easy and usually involves skin grafts and visible scars. My recommendation is at this time that you do not do a blepharoplasty.
You absolutely would need an ophthalmologic consultation and an okay from an opthamologist before you could have a blepharoplasty. Blepharoplasty tends to cause problems with dry eyes post operatively and unless you are on the proper medication and have been evaluated properly, you could have an exacerbation of the dry eye problem.
An Asian American blepharoplasty takes a certain amount of experience due to the fact that it is important to remove the necessary skin and increase the patient’s vision while at the same time maintaining the ethnic appearance. If you have experience with this particular procedure you certainly can do what you would like, which is create a less puffy upper eyelid and still maintain an Asian looking appearance to the eyelid.
If ear cartilage is used for revision rhinoplasty, it is taken from areas in the concha bowl that should have no effect on the appearance of the ear. If the grafts are taken well and appropriately, whether it is one ear or both ears, you should not be able to see afterward that anything was done to the ear. And the ear cartilage is an excellent cartilage for work over the tip of the nose.
At 48 years old, there is most likely enough skin and the skin elasticity has been lost to the point that if you do any suctioning you also have to pull the skin back a little bit or it will just hang loosely. You can do a relatively non-invasive procedure which involves suctioning underneath the neck and a post-auricular neck lift, meaning just elevating the skin from behind the ear, which can provide an absolutely wonderful result.
Botox works absolutely wonderful around the glabellar lines, which are the lines between the eyebrows. It works wonderful on the forehead lines across the forehead as a whole. It works very good on the lateral canthal lines of the eye, which are the squinting lines. I find in all those areas we get an excellent result with Botox and it can also lift the eyebrows and give you a temporary brow lift, which is very nice.
Generally speaking, I use Juvederm in all the creases on the face. If I have extremely fine or superficial creases, I may use some Restylane, which is a little bit thinner. However, there are two or three versions of Juvederm that work at different depths in the skin and last for different lengths of time and I have gotten excellent results using them. Sometimes Perlane also works very nicely along the nasolabial lines and, again, this would be tailored very specifically to the particular problems that you have.
Otoplasty is a facial plastic surgery procedure performed by several of the facial plastic surgeons and general plastic surgeons at the Foundation for Hair Restoration and Plastic Surgery. You can see many examples of before and after photographs of this at pl4s7icf4stg2.wpengine.com. Patients who seek otoplasty often times have ears that are extended too widely.