Thank you for your question.
You’re 52 years old and you submitted several good photos from different angles of your
face.
And you express in your question that you’re 52 years old and that you’re concerned about
your eyelids and your tear troughs and you want to get a general plan on how to address
your appearance.
Well I can certainly share with you my perspective.
I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic and
reconstructive surgeon.
As an oculofacial plastic and reconstructive surgeon, my original specialty prior to training
cosmetic surgeries was in eye surgeries so as you can imagine, I do a lot of cosmetic
surgery for eyelids, in the cheek area and work around the eyes.
And I’ve been very active in advocating a natural look and I think that it’s very
important particularly for men to retain a natural look.
So one of the things that I would first mention to you is that when you ask and open a question
like this, you’re basically asking what is the surgeon’s aesthetic sense about your
look and what would be ideal.
And most of the time, it really is or I should say all the time, it really is about conversation
and dialogue with a doctor.
So although certainly I can point out to you different things as opportunity to help you
look better so much depends on what your priorities.
Yes, you express concern about your eyelids and tear troughs so let’s begin with that.
When you look at your face, what impression would one have when someone looks at you?
I think it is reasonable to say that someone looking at you would say you’re tired and
this is what I’ve been hearing for 20 years in practice.
I’ve been practicing in Manhattan and Long Island for over 20 years and when it comes
to people, I would always say that they are tired of looking tired.
So when you think about what is in your face that makes your eyes look tired, part of it
could be the upper eyelid hooding.
Yes, there is volume loss under the eye in the tear trough area but I think you can also
pre-shift from the three quarter views of your face.
There is also a lot of volume loss in the cheek area.
In my practice, what I do first for a patient like yourself is go over the different things
we can do but I would probably advice a combination approach for you.
Let’s start with the upper eyelids.
Yes, what we can do is conservatively remove a bit of skin just to show off a little bit
of the eyelid but I would caution you that in men in particular, it’s very important
not to take away too much skin.
This is one of the telltale signs that someone had eyelid surgery.
A lot of times in our field, we refer to it as feminizing effect.
I would actually go further, I would actually say it actually has an aging effect.
If you take too much skin or fat, a person doesn’t look better particularly men when
there is nothing in the upper eyelid if they never had balance of a natural trait for that.
Now, in the lower eyelid, in the tear trough area, there are more than a few opportunities
and of course physical exam would elucidate whether or not there is any under eye fat
prolapse as far as hollowing the tear trough.
In our practice, we routinely combine hyaluronic acid filler like Restylane with platelet-rich
plasma (PRP) to improve both the volume in the tear trough as well as the skin quality.
Platelet-rich plasma (PRP) is derived from your own blood and usually it helps stimulate
collagen and blood supply and help skin quality.
Now, it is very important to actually understand my next point is that the cheek area really
supports and frames the eyes.
So when I look at somebody, I don’t just see their eyes.
I see the cheek and the rest of the face.
I’m also board in cosmetic surgery.
I do a lot of face lifts, volume augmentation in the cheeks, chin implants and etc.
So when I look at someone like yourself, I also think of structure.
And the structure in your face, when you look at it, it kind of flattens out.
There is a lot of fat volume loss as well as some bone loss.
So we would use a method to actually place a volume from the cheek area to help give
you more support around the eyes.
So there is truly an art in doing this.
This procedure, when it comes to eyes, is performed in our practice under local anesthesia
with LITE IV sedation and then we avoid general anesthesia and you are able to recover a lot
faster.
This has been a winning formula for us for over 20 years.
I do this for a lot of people.
Actually, we’ll do injectables at the same time.
So essentially, they go in for one thing, they go a lot of things together and at the
same time, they are not adding any down time in addition to their procedure.
So I would recommend that you meet with qualified and experienced cosmetic surgeons and learn
about your options.
I promise you, when you meet 5 doctors, you will get 5 different opinions.
So what you have to do is get a sense and feel and resonate with your doctor that you’re
considering and once you feel like there is a good connection, well follow with your plan.
So I hope that was helpful, I wish you the best of luck and thank you for your question!