Archive for the ‘Blepharoplasty / Eyelift / Eye Lift / Dark Circles / Eye Bags’ Category

Can fillers like restylane cause blindness if injected into the tear trough?

Wednesday, July 14th, 2010

Fillers (like restylane, perlane, radiesse, juvederm by Dr Young in Bellevue near Seattle, WA) in the tear trough can theoretically lead to blindness but there are precautions that you can take to prevent it.  The veins around your eyes and nose and center of the face are valveless and do not prevent particles from traveling back into the deeper tissues like your eyes and brain.  It is possible to cause the particles that are injected with fillers to go back into the eye to cause blindness.  But this is extremely rare.  You can take some precautions to prevent this though.  When you inject, you should not apply to much pressure with injecting.  Also when you inject it you should never be in one place and your needle should always be moving and distributing the filler evenly.  This prevents a load of filler being place in one spot and in the case that you are near a vessel the one spot is not being filler aggressively and possibly back into deeper structures like your eye. Also local anesthesia prevents the vessels from being injected by constricting the vessels so that it is less likely for the filler to get into the vessels. This is a video on fillers around the eyes.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Will it be hard to close your eyes after Eyelift / Blepharoplasty / Eyelid Surgery?

Tuesday, July 13th, 2010

Sometimes after Eyelid Surgery / Eyelift / Blepharoplasty it can be hard to close your eyes. This can be due to the local anesthesia that can numb the muscles that close your eyes. Also the swelling around the eyes can make it difficult to close the eyes depending on where the swelling is located. Oftentimes, you have eyelid skin that is taken with an eyelift / Blepharoplasty.  This decreased amount of skin will also lead to the decreased ability to close your eyes right after the procedure. Your physician should make sure not to take to much skin.  It is always better to be on the more conservative side of skin removal.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Reversing Asian Blepharoplasty and double eyelid crease is difficult but can be done

Thursday, July 1st, 2010

You can reverse Asian Blepharoplasty and double eyelid crease formation (Dr Young Bellevue, near Seattle, Washington).  You are correct that fat injections can be a part of this. But this all depends.  If there is too much skin taken, a skin graft could be needed and the cosmetic outcome could be less favorable in this situation.  Lowering the crease requires elevating the scar and then resetting the crease to a lower height, and then requires fat grafting to the area above the new crease or a tissue graft.  You need experience in this though and there is a learning curve based on my experience. Here is a video on asian blepharoplasty.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Ptosis in the left eyelid that could be from a previous Asian Blepharoplasty to create a double eyelid crease

Thursday, July 1st, 2010

This was a question a lady asked me after she received a double eyelid crease with her Asian Blepharoplasty procedure.  She felt that her crease was too high and she lost her ethnicity.  She also felt that her left eyelid was lower which made her left eye smaller.  She thought that there might be a ptosis in that eye.

Here is how I answered her question:

Ptosis in the eyelid is correctable and you can lower your crease after Asian Blepharoplasty.   Sometimes doing an Asian Blepharoplasty will reveal a ptosis that wasn’t as apparent before the procedure because the Asian Blepharoplasty can remove the skin that over hangs the eyelid margin that can hide a ptosis.  Ptosis surgery can be done by a doctor that does a lot of Asian double eyelid surgeries.  It just entails shortening the muscle that elevates the eyelid margin called the levator aponeurosis.  This is the same muscle that you have to work with to create the double eyelid crease in Asian Blepharoplasty.  Some choose to wait to do the double eyelid asian blepharoplasty after the ptosis surgery.  In my hands, I have confidence in getting a good result doing them at the same time.  Revision asian blepharoplasty to lower the crease is a difficult procedure.  It entails releasing the scar, and then adding fat into the area to block the readhesion of the crease and recreating the new eyelid crease. Here is a video on asian blepharoplasty.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

My right eye is larger than my left. The lower eyelid is lower on the right which makes it look larger than the left eye.

Thursday, July 1st, 2010

This is something that a person asked me to correct for her.  She has a right eyelid that was larger than the left to a minimal degree. It appeared that the lower eyelid of the right eye was lower in position making the right eye appear larger in general.

This was my answer:

This would be difficult to correct the asymmetry in your eyelids through blepharoplasty.  It seems that your lower eyelid in the right eyelid is lower than the left.  It would be possible to take some skin from the left eye to lower that and this would have to done very carefully.  The risks that this could not be exactly what you are looking for is relatively high. As most of the experts have mentioned, most surgeons would likely stay away from this situation.  You would have to accept the risk that it might not be completely what you are looking for.  Given that your eyes are already pretty, a surgeon would less likely want to do anything.  One thing to remember is that surgery is never as natural as what God created for you.  At least this is not the case at this time.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Eyelid weakness after Double Eyelid Surgery and a hard lump after this surgery?

Friday, June 11th, 2010

This eyelid weakness after Asian Double Eyelid Surgery is a very common occurance and will get better or at least should get better. Your doctor would know best what was the status during your procedure. This weakness is due to the fact that your eye muscle that opens up your eye is the same muscle that you use to create the eyelid crease.  So you need sutures that are attached to this muscle.  These sutures can place the muscle under tension and make them temporarily weak. This is really common.  The other scenario is less than desirable and can occur if there is any damage to the muscle that opens up your eye.  If this is the case you could need a more formal repair to repair that muscle.  This would require a more complicated surgery.  This is much less likely.  The other situation is when the levator or eye muscle that opens up the eye is placed under too much tension when creating the eyelid crease.  This can occur when the crease is set too high on the levator.  You can go on my blog to read about more of this and this is found on my website.  When this is the case it will take longer for the muscle to recover.  Sometimes it won’t recover and the levator needs to be released from the fixation and refixed. This situation is more rare fortunately. The hard lump will get better with time. Sometimes steroid injections can help this get resolved more quickly. Your physician can determine this as well. Here is a video of an asian eyelid surgery.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

What is the relationship of the eyelashes with the eyelid and Asian eyelid?

Friday, June 11th, 2010

Eyelashes can be affected by asian eyelid skin. When you lack a double eyelid crease, the extra skin can lay over the eyelashes and can affect the way they are positioned.  When you do a double eyelid crease procedure, the skin can be positioned higher and this can allow the eyelashes to rise up higher.  Also there are ways to attach the levator muscle to the skin and orbicularis muscle to elevate the eyelashes to a different degree with Asian double eyelid surgery / eyelid crease formation surgery.  Sometimes this relation of the eyelashes with the eyelid is natural depending on the person’s anatomy and what they inherited. Here is a video of an asian eyelid surgery.

Thanks for reading,

Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Does ptosis repair (for a droopy eyelid) and Asian Double Eyelid Surgery need to be done in a staged fashion?

Friday, June 11th, 2010

Some doctors feel that you should repair the ptosis and then do the double eyelid surgery 6 months later. Ptosis Correction with Asian or Double Eyelid Creation can be done in stages but also all at once in my hands.  This has not been a problem for me.  After reattaching the levator to the tarsus in the best position, I then attach the levator muscle to the orbicularis muscle or skin or whatever technique you use for the double eyelid crease.  This has been okay to do for me in my hands.  I think some people stage this procedure because they feel that they will have some better control of the results.  But I think if you can do it in one procedure why not.  You can always stage a revision if the results are not as desirable.  But usually one surgery is possible to correct them both with out needing more surgery in my experience.  Here is a video of an asian eyelid surgery.

Thanks for reading,

Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Do you have visible scars with eyelid / blepharoplasty surgery?

Friday, June 11th, 2010

Visible scars are unavoidable whenvery you do a procedure that requires an incision.  But with upper blepharoplasty / eyelid surgery the incision is usually placed in your crease so they are not visible when you eyes are open.  With the eyes closed the incision is usually very minimal to imperceptible.  Here is a video of an eyelid surgery.

Thanks for reading,

Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Double Vision should be seen by your doctor after Blepharoplasty as well as by an ophthomologist.

Friday, June 11th, 2010

Double Vision should be seen by your doctor after Blepharoplasty as well as by an ophthomologist.  There could be many reasons for this.  It does depend on the timing after the procedure.  If it is the day of your procedure or the day after, this could be from the swelling and local anesthesia.  Sometimes local anesthesia can have longer affects on the eye muscles. Swelling can also affect the way the eye is positioned so that there is double vision.  The key difference is whether the double vision is from the way both eyes are positioned meaning that when one eye is looking based on one position and the other eye is looking based on another different position.  This can be due to swelling and the eye muscles being temporarily weakened.  Sometimes it is due to muscle damage that can occur with upper and lower eyelid blepharoplasty.  This can resolve on its own over several months.  But could require eye muscle surgery that must be done by a qualified ophthomologist.  If it is double vision only when the one affected eye is open then it could be due to something related to the lens of that one eye.  Sometimes through blepharoplasty the changes brought about changing the eyelid skin leads to differential pressures to the lens that can lead to visual changes that can be interpreted as double vision.  This issue can also be followed by your doctor or ophthomologist as well. Here is a video on lower eyelid blepharoplasty.

Thanks for reading,

Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington