Question: I’m a mother of three, 42 years old and I look exhausted and worn out all the time. I know that a lot of this is due to the darkness under my eyes and I was wondering if this can be fixed with blepharoplasty?

Answer: Darkness under the eyes can certainly be improved upon with a blepharoplasty and it really depends on the reason behind the darkness as to whether the blepharoplasty will fully correct this problem or not.  In most patients, the darkness is due to shadowing because of some bulges in the lower eyelid.  These bulges are corrected surgically with a lower lid blepharoplasty and, therefore, the dark circles disappear.  Other patients have pigmentation or vascularity in the area and this is actually a discoloration of the skin and a blepharoplasty will not be able to correct this type of darkness, but this type is very easily corrected with a small amount of cover makeup.

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Question: I am a 39-year-old male and have very heavy, full eyelids as does my mother and several of her relatives.  I would like to have a Blepharoplasty performed.  I was wondering if I should wait until I am a bit older to get more bang for my buck in later years or does it make a difference?

Answer: I would have to personally examine you and evaluate your particular anatomy, but I am always recommending that patients consider surgical intervention at the first signs of concerning area simply because you will have a longer period of time where you can enjoy the result.  It would be very uncommon for heaviness and excess skin to recur after a blepharoplasty to the point where you would consider having another blepharoplasty in the future.  I, therefore, recommend going ahead and having the procedure done now assuming that you have a considerable amount of excess skin and soft tissue in the upper eyelids.  Since this is a permanent fix, you will essentially have an improvement for the rest of your life.

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Question: What sort of conditions does the necklift address?

Answer: A neck lift addresses jowls and laxity under the chin by lifting up the deeper layer of the face called the SMAS.  Excess skin is lifted with this and then removed and incisions in and around the ear are closed with sutures that are removed in a week.  It essentially does what most women do in the mirror when they look at themselves and they are showing signs of aging, and that is they grab the sides of their face and they lift a little bit and this lifts the jowls and laxity under the chin and they like what they see.  A neck lift will accomplish this same goal and can be performed in the office setting without the need for any sort of general anesthesia.

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Question: My nose has been broken three times. Is it still possible to correct it?

Answer: Yes, even though your nose has been broken three times, it is absolutely possible to correct it since we can simply manipulate bone and cartilage to bring the nose back into a more natural appearance.

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Question: How long is the cast in place after rhinoplasty?

Answer: I typically leave a splint over the nose for seven days after a rhinoplasty at which point it is removed along with any external sutures if those were placed during the procedure.  Most rhinoplasties that I perform are endonasal, which means that all incisions are on the inside of the nose and, therefore, no sutures would require removal in that case, but the splint is nonetheless placed to essentially push the soft tissue of the nose back down on the underlying bone and cartilage and this helps to improve healing and overall make the nose look better quicker.

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