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Eyelid and Eyebrow Surgery

The eyes are the first features noted when people meet. And having puffy, sagging or wrinkled eyelids can convey a false image of being tired, sad or old. Luckily there are many techniques that can reverse these physical signs. The actual technique(s) chosen depends on what combination of deformities is present. Are the eyebrows too low producing an appearance of excess skin over the upper eyelashes and hooding or hanging of skin towards the outermost part of the eye? This condition is treated with one of several browlift procedures. In addition to the descent of skin below the eyebrow, is there excess skin in the upper eyelid proper? And are these conditions associated with puffiness from fatty protrusions? Upper eyelid surgery (blepharoplasty) with removal of skin and fat is the treatment for this. Of course, it is critical that the eyebrows are in their proper position above the orbital rim before eyelid surgery is considered. To perform an upper blepharoplasty when a browlift should have been performed will result in pulling the eyebrows even lower and producing a small, contracted appearance in this area.

Finally, when considering deformities of the lower eyelid, we look at the degree of puffiness or hollowness, wrinkling, pigmentation, laxity and vertical descent below the orbital rim. Puffiness is easily handled by fat removal from the back or conjunctival side of the lower eyelid. On the other hand, occasionally fat has to be pulled forward from within the orbit to fill out hollowness of the lower lid. Laxity of skin usually requires minimal excision, though resurfacing using the LASER or chemical peeling agents can sometimes be sufficient. And resurfacing is certainly the treatment of choice for wrinkling and most pigmentation problems. Finally, vertical descent of the lower lid below the orbital rim may require more extensive procedures such as a midfacelift which pulls the entire cheek upwards.

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Blepharoplasty 1
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Being centrally located, the nose should blend harmoniously with the other facial features and not draw attention to itself.
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Neck Lift

The necklift is a procedure to tighten and better define the jawline and the areas below it. In some instances, this effect can reach all the way down to the collar bones
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Face Lift

Surgeons use the term "facelift" to describe any procedure on the face that results in a tighter, more youthful appearance.
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Revision Rhinoplasty

The operation consists of correcting areas of asymmetry and deformity resulting from a prior surgery.
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Eyelid-Brow Lift

The eyes are the first features noted when people meet. And having puffy, sagging or wrinkled eyelids can convey a false image of being tired, sad or old.
>> More


The lips should be full and wide with the upper lip slightly rotated, revealing the lower portion of the front teeth.
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The Telltale Signs of a Bad Rhinoplasty

Having revised thousands of rhinoplasties, I have noticed certain features common to all.

Even a structurally symmetric, aesthetically pleasing nose can be a poor result if it is out of proportion with the other facial features by being too small or too large. However, the real clues to a poor result are the asymmetries, malpositions, disproportions and decreased function that are seen. We can see collapse of the side walls and/or nostrils producing a “pinched look” or asymmetry between the two sides. The bridge can be too low or too high, and the tip can be overly rotated or not rotated enough. There can be too much “nostril show” from aggressive cartilage resection causing upward migration of the nostril rims. Or too much nostril show from failure to raise the columella (area between the nostrils). Also, irregularities or distortions in the nasal tip can occur which can present technical challenges to the revision surgeon. There can be deflections or angulations of the tip or the entire nose. As mentioned above, nostril asymmetries are particularly common with one nostril appearing higher or wider than its companion. Finally, there can be a worsening of breathing , especially if a reductive rhinoplasty was performed. Making a nose smaller has to be accompanied, many times, by measures to assure that the airflow is not compromised. This means correcting any septal deviations and/or turbinate enlargement, as well as maintaining adequate openings through the nostrils and the areas above called the internal valves. I’ve included photos of a nose showing most of these deformities with the subsequent post-operative results, after I corrected them.








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