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Lower Blepharoplasty Vs Restylane Under Eyes?
I am a woman in the early 40s. Below my eyes, it has gotten noticeably puffy. I was recommended
a lower bleph to remove the fat under my eyes and that hospitalization is required. When
I was hesitant to do that, I was recommended upper skin. I like both ideas. Can both be
done? I was also recommended via email to get Restylane by another surgeon. After reading
all of the review seems like there is a 50/50 chance for a mishap. Any advice will be greatly
appreciated. Thank you!
Thank you for your question!
Your journey in trying to find out what's the best thing to do for your eyebags is a
very common experience. I will reflect first on what your journey is so far where you suggested
to have your bags removed but there was a concern about you being hospitalized. Then
you have your option of having your upper eyelids done and another surgeon recommended
via email for you to have Restylane under your eyes.
Well, I looked at your photos and I can share with you some clear thoughts about my experiences
when people come to me in situations like yours. First of all, there's a whole lot of
confusion out there about the best approach to rejuvenating eyes. There are more options
but the options are tools and tools are as good as the doctor who uses them. And so,
as oculofacial plastic surgeon, I can share with you on how I practice in Manhattan and
Garden City, Long Island.
Essentially, what I do with someone like you is I first look on what is going on in the
big picture. And when I look at your face, I feel like your upper lids, there is excess
skin and in your lower lids there's a good amount of fat prolapse, what we refer to as
herniated fat. Now, in the past couple years, injectables have been used to try to camouflage
the appearance of herniated fat. And every week in my practice, people come in who find
me for a resolution because they end up getting Restylane and Juvederm under the eyes to try
to hide the fat and they end up with more swelling that makes the fat pockets even bigger.
So I think with the appearance with your lower eyelid bags, you are really a good candidate
for lower eyelid blepharoplasty. Now, I'm first going to address the hospitalization
concern. In my practice, we do our procedures in our own private facilities in both of our
offices. We are joint commission certified. And I did this for a couple of reasons. And
one of the reasons is, of course, safety. Doctors like to practice in facilities like
hospitals or service centers because there is an added level of safety amongst other
things such as sterility. But the key thing is that you want to know the procedure that
affects your physical health. So what we did is, we created the facility and the systems
so that a person can come to us and have the procedure as if they have gone to a hospital
facility and we do everything under local anesthesia with light IV sedation. That basically
means getting a little liquid *** through the intravenous and being relaxed but it doesn't
mean you have to go to the hospital. So the hospital concern is eliminated. Essentially,
they come to our office and the type of personalized care that we do is really something that a
lot of patients give a positive feedback for. So I would suggest the same for you because
what we do for someone like you is do the upper eyelids and lower eyelids under local
with sedation and you are not in the hospital and you go home the same day and you do some
basic after care such as applying ice or cold compresses to your eyes. So I think that would
be the ideal solution for you.
Now, that doesn't mean you won't need any kind of fillers or any kind of things that
help volume afterwards and there's a basis for that. I wrote a book called, "The Fine
Art of Looking Younger" and I teach my patients everyday from the basic principles I discuss
in my book which is facial aging involves volume loss. And when there's volume loss,
we're talking about bone, muscle and fat. So it's like our faces are getting a little
bit smaller and so fillers and other injectables do have a role in helping us look more youthful.
So, the first step I think for you is a surgical step done in a way that's comfortable for
you and allows you the quicker recovery which is typical of what we do in our office. I
think that once that's done, I tell my patients that we kind of do another assessment because
when the eyes look really good, people will naturally look at other things to make their
face look even better. And really nice eyelid surgery looks natural. Most people wouldn't
know that you did something but you look like yourself.
So I think I would not recommend the Restylane at this time. I think it would not give you
the type of improvement that you are looking for but rather find a surgeon that you are
comfortable with and a facility in which you feel comfortable having the cosmetic more
definitive surgical procedure done and take it from there.
So I hope that was helpful and thank you for your question!