Marilyn,
Thanks for your question regarding down-time related to doing multiple procedures. You mentioned facelift, fat transfer and blepharoplasty. We talk about down-time in two categories. Social downtime- when will you look OK to return to routine social functions, not necessarily be in a wedding however. Total downtime- when will you look completely healed and as good as it gets. (not including things like the scar maturing to a complete white line, ie. it may be a little red after this time period) The down-time from doing multiple procedures is dictated by the procedure performed with the longest downtime. In your case that would be the fat transfer. A facelift or blepharoplasty each has about a week of social down-time and about 6 weeks to 3 months of total down-time, again this is not really downtime, but is a good judge of when you could say take photos for something important. The fat transfer has 2 weeks of social down-time for small and medium quantity transfers (10-30 cc) and as long as 3 weeks for larger transfers. The total down-time is again 6-12 weeks.
I hope this has been helpful. We would be happy to talk about this further with you at your convenience.
Ed Buckingham
Catherine,
Sorry for the delay in answering your question. Server problems. It may be possible to easily pinch some skin from under the eyelashes without creating visible scarring, but you have to be careful because you must have enough skin left under the eye so that it does not pull the lid down. I would need to see you in consultation to assess whether you truly had excess skin or not. If you only had fat removal my suspicion is that you may need your tear trough or orbital groove filled as well. You may have had a fat repositioning procedure however and that may be fine. Hope this helps and we would be happy to see you.
Ed Buckingham
Margie,
Thanks for your question regarding blepharoplasty under local. The piece of information I don’t have however is are you interested in doing you upper or lower eyelids? I’ll just answer both. An upper eyelid blepharoplasty can easily be done under local anesthesia and we almost always do it that way. About half of patients also choose to take a little relaxation pill also. It is the patients choice. Lower eyelid blepharoplasty can be done under local, but we usually do not. Because we usually use an internal incision for our lower eyelid procedures and because the lower eyelid almost always requires some kind of volume augmentation for the orbital rim/upper cheek, it is much better tolerated under IV sedation and local anesthesia.
Ed Buckingham
Deborah,
The tear trough is basically the hollow area under the eye. It gets that name because it looks like it could be a gutter that tears would flow into from the eye. It is basically a deficiency of bony or soft tissue anatomy in the lower eyelid region that leads to a shadowing and tired appearing lower eyelid. Fillers are very effective to fill in this area as is autologous fat transfer. Fillers are the temporary solution and fat is long term or semi-permanent. Fillers are performed in the office and usually only have a little minor bruising an swelling. As little as 24-48 hrs of minor evidence of the procedure. Fat transfer is perfomed with sedation and requires a few weeks of down-time, but the results last years. Fillers for the lower eyelids last 9-12 months. Both are great options depending on your goals.
Ed Buckingham
Margie,
Dark circles under the eyes can have multiple causes and so a consultation is essential. Circles can be caused by skin discoloration from venous congestions usually due to allergy or pigmentation. Usually however dark circles are caused by shadowing from a fatty pocket that has protruded forward, from loss of cheek volume over the superior cheek or more commonly a combination of both.
The treatment for dark circled related to skin discoloration is targeted at the cause. More commonly the treatment is to take care of the shadowing. In younger patients the treatment may consist of filling the hollowing of the upper cheek with a filler such as Restylane. This is a simple office procedure that takes 30 minutes and usually lasts 9-12 months. In more significant cases cause is corrected by blepharoplasty and/or fat transfer. Usually there is a slight puffiness in the fat pads of the lower eyelids. This fat is removed and tightened by performing an incision inside the eyelid (transconjunctival). A fat transfer is performed by harvesting fat from the lower body through a tiny incision and then placing it into the face through tiny punctures. This procedure builds the cheek up into the natural position of youth and hides the lower eyelid shadowing.
It is difficult to describe in words how effective these treatments are. Photos do them much more justice. Please take some time to look at our site, especially the before and after photos. I believe you will have a much better understanding.
Ed Buckingham
