This is me after asian blepharoplasty. Does the crease look more natural?
I'm simply looking to enhance not to change my eyes. When I went into consult in Singapore, the doctor whose clinic by the way in orchard road area recommended that I also get an epicanthoplasty. I got the impression that without the epicanthoplasty, my double eyelid surgery would not come out optimal.
In terms of time for recovery and surgical process they are faster and heal quicker too. Especially the DST method where the eyelid tissue is attached to a certain part of the eyelid skin only under the surface part giving a more natural looking eyelid crease.
You see asian eyelid surgery once you have relative amount of experience, the principle is straight forward. Understanding that asian eyelid crease is a little bit lower, there has to be a fold, and the position of that crease is several milliliters lower than a caucasian crease.
This is a problem that unfortunately has evaded any type of consistent successful approach. When we look at people with malar bags, we are looking at what are the most common causes that are associated. So the first question I ask are history of allergies, sinus problems, smoking, whether or not it runs on the family.
2 aspects of smiling that challenges many people that come to us. First is the wrinkling that related to the activity of the muscle called the orbicularis oculi muscle; muscle that surrounds the eyes and is responsible for supporting the eyelid and allow you to blink.
You are 30 days after an endoscopic brow lift and lower eyelid blepharoplasty, and you are asking about eyelid retraction you described one eye being worse than the other that your doctor has advised you to massage the lower eyelid. It is important to communicate with your doctor obviously set up the procedure the best way he knew how and following up with you in 2 weeks so you are getting the appropriate attention that you would need to deal with the concern you have.
Puffy Eye Bags & Skin Laxity Treatment For Eyelid Health
You mentioned that you have bag under your eyes and you want to understand a little bit more and get a strategy. You have what we refer to as lower eyelid fat prolapse, it has nothing to do with body fat but rather it is fat that is anatomically is surrounding your eyes. There are 2 types of fat anatomically, one is called the intraconal fat which is directly behind the eye and one is called the extraconal fat which is surrounding the eye. It’s just not about relative excess skin, there is a clear anatomical structure called lateral canthal tendon.
When you are looking to get an improved appearance think about it in a context of what looks right for you and a little bit more realistic. I think trying to look like someone else is just a real set up for disappointment. But I think you can be a good candidate for double eyelid surgery procedure. Also when you think about lower eyelid being more defined you will be surprised to see that when people have their upper eyelids done, the whole area kind of opens up.
Emily Tan's insight:
Also read this:
Genetic Drooping Eyelid Corners Can Be Fixed through Lower & Upper Eyelid Surgery
First of all when you look at the outer corners of the eyes, the position of the outer corner is based on an insertion of a lateral canthal tendon and it goes to the inside of the bone (the lateral orbital rim). That position is attached directly to the bone. For patients who have had complications of lower eyelid surgery, where the eyelids are pulled down I do something called drill hole canthopexy.
Dark circles under the eye is caused by several factors; heredity (people who have genetically have dark skin, usually it is more a pigment issue), next allergies and sinuses (allergic shiners – a bruised look). And other reason is because of the skin is so thin you can actually see through the skin and see the blood supply and the muscles underneath. The puffiness represent the fat pockets under your eyes to push forward.
So the question that you are concerned most about is the relative risk of problem related with your negative vector. It basically means that the cheek bone relative to the projection of the eye ball, the front of the cornea is back. Therefore the cheek bone is in a back, the eye is forward. I can tell you that it is a risk but it can be managed.
Restoring the Functionality and Health of the Eyelids
Those suture marks are of course the results after having your lower eyelid blepharoplasty done from the outside where the incision is made and skin was overlapped (whether it’s a skin pinch, is irrelevant at this point) stitches replaced and you develop these marks. Now when someone has adequate skin, my approach would be just to excise skin that has the marks. Now you can sometime improve this area with fractional co2 laser but because the skin is so thin, that is a pretty tricky thing to consider.
But my recommendation for someone with lower eyelid fat prolapse is to do something called blepharoplasty and when there is no excess skin I use transconjunctival blepharoplasty that means taking away the fat pocket from the inside of the eyelid.
Emily Tan's insight:
You may want to read:
Why Skin Quality is Not Affected by Eye Bag Removal Surgery
At the age of 20 you made a good observation that you have bag under your eyes since you were 12. The question you were asking about is whether or not you should consider having a procedure done, and are you at risk at the crepey skin quality, wrinkles after the surgery.
Non-Surgical Solutions that Don’t Work For Dark Under Eye Circles
There is a variety of reasons for the dark circles under the eyes in my practice people come to me a lot for this problem. So let’s learn a little bit what factors are responsible for this black circle under your eye. We will start first with genetic and heredity. That’s the most common issue. There is a certain amount of pigmentation that will stay around your eyes area if that is what you have from your family.
Allergic conjunctivitis will cause swelling and puffiness to the eye area even with reduction of fat and that is basically the challenge. If there is puffiness that related with fat prolapse, then that can be addressed surgically. But if the goal is of course to reduce puffy bags from the eyes then we should try to manage it from all angles.
Older Patients Should Know about Eye Bag Removal Surgery
You are going to be given a few different choices as far as the ideal and every surgeon comes to the table with their preferences. First of all, it would not be surprising to me if you have any issue with dry eyes. Even if your eyes are watery all the time, it is very common for people to have dry eyes and reflects of tearing.
Now without doing a physical exam it is important to at least on your own to asses if you pick on the corner of the eyelid up, if the eyelid just looks a lot better. There is a structure of the eyelid called the lateral canthal tendon.
You should be doing your due diligence first to find the best surgeon for liposuction as best as you can. Then ask him for recommendation on different types of procedure they have, such as: Tumescent lipo, laser, ultrasonic, etc.
Emily Tan's insight:
Don't go to any other clinics that I don't recommend here. Finding the right one is pretty tricky process. If you have any question about the pricing, process, risk, side effect, result, etc. Don't hesitate to contact us.
First of all you must find an experienced and trusted cosmetic surgeon in Singapore. If possible find one that has more focus on face such as eyes, nose, neck, etc. A good double eyelid surgeon must also have some certification from the medical authority and he must work in a reputable hospital.
Emily Tan's insight:
I think this double eyelid surgery can really make a huge difference on people's face because eyes are definitely the most important part that express your beauty:
With proper treatment from your doctor, you can definitely make a better looking creases and more natural eyes as well. Watch on my vimeo: https://vimeo.com/92198965
Normally Asian eyelid fold can range from 1 until 10 mm above the eyelash area although it differs from individual to individual. All in all, make a good decision before you go for this asian blepharoplasty procedure. Good luck.!!
In general if your aim is to reduce excess fat cells, then go for liposuction but for example if you have just given birth or after pregnancy maybe tummy tuck is a good option for you skin you must have excess skin hanging down from your lower abdomen.
I'm a certified plastic surgeon here in Chicago Illinois are here and have been helping people to reduce their fat cells and also make them look better.
The only thing I can advise to you before undergoing any cosmetic procedure like liposuction, it is better to understand the overall process. There will be a small incision made using a tool called cannula and normally you will be put under local anesthesia during the course of surgery. You can expect to have minor side effects such as bruising and swelling but the risk can be put very minimal if you choose the right surgeon. Normally patients can be fully recovered after 1 week of surgery and continue to exercise 2 weeks later.
It’s important to understand that wrinkles and excess skin are not always synonymous. In fact blepharoplasty, a surgical procedure is defined by the removal of extra skin of addressing fat pockets, puffy bags, will not make a significant improvement when you are dealing with the textural quality of skin. So when I look at a patient, I look at a couple of thing. First is their age and skin type
How to Alleviate Tired-Looking Eyes Despite Adequate Sleep
There is a term called micro expression. And there is a lot of unconscious communications that occurs when people meet you for the first time or friends and family who see you. The appearance of the eyes has such a dramatic impact on how you communicate to others and when people look at you and see that you have puffiness under your eyes or you have extra hooding of skin over your eyes.
It appears like your eyes are very prominent in some ways it has some similarities to someone with thyroid eye disease. What that means is that if you were to actually have a procedure like upper eyelid blepharoplasty where you take away a lot of fat, a lot of skin you can actually make your eyes even more prominent.
Emily Tan's insight:
Eyelid Surgery is More about What’s Behind the Skin
If you were come to me I would first do something straight forward where I have you look in a mirror or take photos and roll your skin inward. It’s critically important when this procedure is done the skin removal part is limited, because very often people will have excessive skin removed and what they end up doing is they actually impairs the ability of upper eyelid to close.
Certainly puffiness under the eyes can be further enlarged from the fact of allergies but there is no direct association between puffiness and eye irritation. The orbicularis oculi muscle supports the eyelid, when you contract it, it will create like a ridge to form and it is a normal action of that muscle.
Understanding that puffiness and wrinkles under the eyes can make you look older. Understanding first what each anatomical issue is, and then developing a strategy is very important. When you meet with different doctors you will get different opinions. So I will share with you what I typically do in my practice. Puffiness under the eyes are always there regardless of allergies, sinuses, or getting enough sleep is most likely caused by lower eyelid fat prolapse.
Many years ago plastic surgery treat this with one approach which is called transcutaneous or an incision on the outside. Bulge of the pocket skin or the convexity when the fat has removed has to follow the same surface area or relative concavity. I also have another method which uses platelet rich plasma.
So basically if you try to cover a round shape, you can’t just aggressively take so much skin. So there is a range; you can be conservative but you can’t be too aggressive. I would advise to avoid using the laser method alone.
Why Eye Bag Surgery Requires an Incision and How it Can be Done Using Lasers
No matter what option you choose, there is still going to be an incision. So what I would do for someone like yourself is the transconjunctival blepharoplasty and I also help with the skin quality by using platelet rich plasma. Platelet rich plasma is taking advantage of the healing properties of your own blood using cells that can be separated in a plasma what we call centrifugation which means spinning the blood until we separated.
You feel like you have excess skin and you’re considering a pinch blepharoplasty. You submitted a photo that is very helpful, but I will caution you about the choice of blepharoplasty to begin with. To understand what you perceive as excess skin, there is a distinction that needs to be made. I wrote a book called an art of looking younger.
Causes of Swollen Eyes Before Considering Eyelid Surgery
As an oculoplastic surgeon, I want to introduce you a condition called thyroid related immune orbitopathy or commonly referred to as grave’s disease. There are many people who are first symptoms of thyroid eye disease swelling and congestion, their eyes swell sometimes they have trouble with double vision.
Looking at the comparison between your right and left upper eyelid if you feel like there is a little bit too much skin I would typically the above mentioned procedure. When we do that, we try to customize, that’s the art of doing blepharoplasty, is that you actually try to balance out as much as possible what the amount and the volume of the skin is in one side versus the other. So it’s important to have that artistry.
This is why your skin in the Eye Area Shouldn’t be Stretched during Eye Bag Surgery
We as surgeon are not able to mimic effectively the same tone and tension as when you pull your eyelid as exaggerated as you do, there is a reason for that. There is movement in your face in this area, even if someone pulls the skin and stitches unfortunately the skin will stretch back and the scar can get widen.
I understand that from your question you’ve had had an upper and lower blepharoplasty, and you are thinking of some revision options because you feel that the lower eyelids have a certain hollowness and you’re considering procedures such as fat transfer to address the lower eyelid.
Do I need a revision for my eyelid ptosis surgery?
I can tell you that the focus on ptosis surgery is a clear super specialization. Anyone who has difficulties with patients who have ptosis normally refer their patients to someone who has the specialization in oculoplastic cosmetic surgery. I think that there could have been the opportunity where they have a clear understanding of the predictability of ptosis procedure.
There is also a buried suture technique, the advantage of it it leaves very minimal scar, and swelling post operation. So you can get back to work only after 1 hour of surgery. You'll also get the benefit of a more natural looking eyelid crease. It's reversible as well. the good thing is that this procedure folds along the natural crease and does not involve any removal of skin.
There are several checklists that you have to consider before going for a facelift procedure in Singapore. If you miss these 3 important steps then you might choose the wrong move in the future. Since this procedure is a bit costly, do a little bit of research to find the best surgeon, alternative.
Emily Tan's insight:
Your surgeon should really be consulting you about your desired goals, pre existing health condition, procedure and inherited risks from doing a facelift. This has been mentioned many times before here:
and also please bear in mind that with current advanced plastic surgery technology, patients don't have to worry about the scars that they're going to end up on their face because it's temporary and can be faded with special medical treatment.
Without a doubt, Singapore is one of the best country in terms of medical, technology field. You can also get the most out of your money if you decide to do the nose job reshaping here. I believe in Asia, they're on top 3 lists of rhinoplasty quality assurance.
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