Question: I had a blepharoplasty surgery several years ago and was amazed at how much it brightened up my face. Recently though I have begun to notice some sagging around my eyes again. Would you recommend that I get another procedure done?

Answer: I would have to personally evaluate your anatomy before I can make any definitive recommendations but if it has only been a few years since you have had your blepharoplasty I would be surprised if you have enough redundant skin to warrant another surgical procedure. You may, however, be a good candidate for laser resurfacing around the eyes since that should help reduce wrinkles and tighten some of the skin.

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Question: I had fat transferred to my cheeks about a year and half ago. I have noticed that my cheeks now seem to be sagging a bit. Is this common? What treatments or procedures are available to treat this?

Answer: I think what has happened is over the past year and a half you have lost some of the volume of the fat transfer. I personally do not feel that appropriately placed fat can create sagging of the tissue after some of the volume is lost unless an overaggressive fat transfer approach was performed that overinflated the area and then created some sagging after the fat resolved. Ultimately a personal evaluation and consultation would be appropriate but there are many ways to improve sagging of the cheek, one of which would be just to repeat the fat injections, another would be to consider cheek implants, a third would be to consider a midfacelift and finally a high SMAS facelift can also provide cheek elevation if you require improvement in the jowl and the area under your chin as well. Due to the fact that there are so many options available this is the reason why you should seek out an experienced facial plastic surgeon so that a customized treatment option can be created for your specific anatomic needs and esthetic goals.

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Question: The area under my eyes is very hollow. Is it possible to have a fat transfer in this area?

Answer: Absolutely, the area under the eyes is the most common area that I place fat during other cosmetic procedures such as lower eyelid surgery and/or facelifts. It enhances the midface volume. It can get rid of what are called tear trough deformities or nasojugal grooves and at least a small portion of the fat is going to be a permanent volumetric improvement to the area and therefore is a good value to the patient as well. I feel the fat transfer needs to be done very judiciously so that we do not create any lumps or bumps but when performed appropriately can give people a very nice esthetic improvement.

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Question: I am a 27-year-old man and would like to have some kind of face or cheek enhancement. Would submalar implants give me a more masculine look?

Answer: I would have to evaluate your specific facial features to determine whether submalar implants would be the best choice for you but typically submalar implants do not necessarily give you a more masculine look. I would argue that submalar implants are simply to improve the overall midface volume and more commonly malar implants are what most men desire to give them the stronger cheekbone structure which does masculinize the face a bit. However, having said that, many women need malar implants as well to give them the higher cheekbone that is esthetically pleasing in both men and women. I would recommend a consultation so that your specific anatomic features can be evaluated and a customized treatment plan can be created as many patients need submalar implants, some need malar implants, and some need a combination implant.

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Question: My sister was telling me how happy she was with her chin implant and recommended that I get one too. How exactly will a chin implant benefit the look of my face.

Answer: Chin implants are reserved for patients who have a relatively weak chin in comparison to the harmony of the rest of their face. If you have a relatively weak chin like your sister most likely did then you should benefit from a chin implant. A chin implant simply augments the size of the chin so that it has better harmony with the surrounding features of your face and esthetically improves the side view of your facial features. Most chin implants are placed through a very small incision under the chin but some surgeons prefer to go through the inside of the mouth. It is overall a relatively simple procedure that has very high success rates and extremely low risks of any complications or problems.

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