Lower Blepharoplasty with Negative Vector Orbit?
I met with 3 different board certified plastic surgeon in Canada regarding lower bleph.
I received 3 different answers.
1- This surgeon said it would be a big mistake to have surgery because of negative vector.
The solution: fillers. 2- A traditional lower bleph with a bit of skin removal.
3- Lower transconjunctival bleph with facial laser resurfacing.
This is all so confusing.
From my pictures, does it appear I should avoid surgery due to negative vector?
Could it cause lid retraction or sunken eye?
Thank you for your question!
Well you have dealt with the realities of getting several opinions when you go for different
doctors about eyelid surgery.
And that's a very important message is that surgery is not generic.
And people who shop on price or get convinced by very interesting infomercials very often
live to regret their decisions because they make these decisions thinking that every surgeon
does a procedure the same way because it all has the same name.
So the question which you are most concerned about is the relative risk of problems related
to negative vector.
So let's just define the term negative vector.
Negative vector basically means that the cheek bone relative to the projection of the eyeball,
the front of the cornea is back.
Therefore, the cheekbone is back and the eye is forward.
And so, being a specialist in oculofacial plastic surgery and being someone who does
a lot of revisional work and a good percentage of my practice is about that, I can tell you
that it is a risk but it is a risk that can be managed.
When you have a called negative vector, when you do a procedure where the lower eyelid
is being operated on going from the outside and doing something to reduce the fat pockets,
you have to balance everything because the position of the lower eyelids is very dependent
on multiple factors.
The lateral canthal tendon, the position of the lower lid retractor, the tone of the skin,
the orbicularis muscle, there are a lot of technical issues.
So I can tell you that although it's a risk, it should not stop you from doing the surgery.
It's just that you have to find a doctor who has a lot of experience with eyelid surgery
and has the ability to anticipate the issues that can happen and can deal with them.
Sometimes, like a general plastic surgeon who does eyelid surgery may be able to deal
with some minor complication or just things that happen in the surgery but they may not
be able to do things which are at a higher levels.
Now someone like yourself, now that you are doing the research, you have the opportunity
to find someone who can provide that level of care if you need it.
So when I look at a face like yours, I think not only of the eyes but I think of the face
as a whole.
I happen to also be board certified in facial cosmetic surgery and I do a lot of facelifts
and cheek implants and lot of things to help with facial aging.
So, when I look at you, I just don't look at the eyes.
I look at the face as a whole and when you talk about a negative vector, a common strategy
that I would use is not to address the eyes but address the midface, address the cheek
area.
Consider adding volume whether it's with a filler or something more long-term which is
a cheek implant or a submalar implant.
So these are the things that are worth considering and the most important for you is to be confident
about whoever you go to be able to help you achieve the look that you desire.
The key is very much communication and understanding the desired goals and be prepare to deal with
any of the things that can happen regardless of who does the surgery.
I hope that was helpful, I wish you the best of luck and thank you for your question!