With every cosmetic surgery, no matter how skilled the surgeon, there is an element of risk.
Approximately half of the Asian population have a crease in the eyelid (with a lid position that varies), while the other half does not (known as single eyelids). Some patients of Asian heritage would like to create or enhance the crease on their upper eyelids. Alternatively, some Asian patients already have an upper eyelid crease and simply want to reduce sagging skin on their upper eyelid, much like a Caucasian eyelid procedure.
Detailed discussion of these elements of the procedure is a major factor in success. As a surgeon, it is important to stay true to the ethnic features of the eye and not try to “Americanize” the eyelids—which can result in an unnatural look. Appearance, symmetry, and functionality are all very critical aspects of upper eyelid surgery. I understand that ethnicity plays a critical role in the characteristics of the face and will create a treatment plan based on your individual needs.
The following will give you some additional information on Asian eyelid surgery. If you would like to schedule a consultation to talk about this procedure, please contact Sistine Facial Plastic Surgery.
Eyelid surgery: over and under correction
As one might imagine, it is usually much easier to correct an under corrected or less aggressive surgery then it is to correct an overly done or aggressive surgery. Once tissue or skin is deficient, revision surgery can become more difficult, requiring reconstructive surgery. Fat grafts (in which fat from other areas of the body are transferred into the upper or lower eyelid) may be required. In patients who have had multiple surgical procedures, it is sometimes best to refrain from operating at all due to a high risk of there being no improvement or an even worse result. Each case is evaluated in depth to determine the best possible outcome for the patient.
During an under corrected blepharoplasty surgery, one can more easily make corrections and remove additional skin and tissue to attain the desired result. This is why Dr. Leong favor being more conservative rather than being overly aggressive. However, when operating a second time, it is even more important to stay conservative and leave an ample amount of tissue and skin.
Revision blepharoplasty surgery can result in higher rates of complication, so it is important to avoid rushing into surgery and consider whether your expectations are realistic. Attaining perfection is nearly impossible and the risks of revision surgery are higher. Once excess scar tissue has formed, manipulation becomes more difficult. In addition, recovery time may be increased, multiple surgeries may be needed, and the result may be limited.
Another serious complication from eye surgery includes blindness from the blood accumulation in the back of the eyes. Hemorrhaging may occur after visual impairment and the sensation of pain. If any of these symptoms occur, it is vital to be seen by a doctor right away. Removing the stitches or creating a slight tear in the tendon might release the accumulation of blood gathered in the back of the eyes. The goal is to take the tension off the eyeballs and repair normal blood flow. If all else fails, detaching the socket bone may help. If blood continues to accumulate behind the eyes, a blood clot may form which can change the appearance of the eyelid. Once incised, this blood clot may be removed to encourage recovery and healing.
Possible complications after lower eyelid surgery
Under eye bag removal is a common request of many patients, but there are a number of potential issues that could lead to a problematic or unsatisfactory lower eyelid result. This includes eyelid retraction (when the skin hangs below the eyeball), entropion (eyelid position turned inward) and/or ectropion (eyelid position turned outward).
Lower eyelid retraction can occur when too much skin and/or tissue has been removed from the lower eyelids or because the patient had significant facial drooping and/or hollowness. To correct lower eyelid retraction, a number of different methods may be used such as cutting off scar tissue, performing a cheek lift, an ear or fat graft, canthoplasty or an orbital implant. When using a lifting procedure such as a cheek or mid facelift, it is important to note that results may only be temporary due to the aging process and loss of gravity over time.
Entropion occurs when the eyelid folds inwardly near the eye. Causes may include previous trauma, aging and loss of muscle strength. Since the eyelashes brush up against the eyeballs, the eyes may be red, delicate and easily irritated. More serious problems may occur if the condition is not treated properly. Eye infections, a scratched cornea, mucous discharge, visual impairment and/or ulcers can all damage and reduce the effectiveness of the eyes. Wind or light may become extremely sensitive to the eyes. Your doctor will decide which surgical technique would work best to repair your eye condition.
Depending on the severity of your eye deformity, your procedure may occur in the hospital or in the office. If an incision is required to tighten the lower eyelid, a hospital visit may be required. On the other hand, if sutures are used to non-surgically tighten the eyelid area, your surgery will most likely be done in the office. Regardless of the location, surgery to repair entropion is a relatively minor procedure with a quick recovery time.
Ectropion occurs when the eyelid folds away from the eyes, making it difficult for the upper and lower eyelid to close properly together and protect the eyes. Since the skin sags and exposes more of the eye, the eye tends to dry out more often. The eyes can also become red, tear more easily, develop mucous and crusting, damage the cornea and eventually lead to vision loss. Causes of this condition may include trauma, a prior surgical procedure, aging, a facial nerve disorder, or skin cancer. Surgery performed by a board-certified facial plastic surgeon or ophthalmologist is required to repair a turned-out eyelid and restore its proper function. Most patients experience immediate relief and little down time.
Revision rhinoplasty: making the right choice
In conclusion, blepharoplasty revision surgery can be a challenging procedure with an array of risks, but it offers a substantial improvement at the hands of a skilled and educated surgeon. It is important to voice any concerns you may have with your previous surgeon, but if you feel that you are not on the same page with your doctor and are unhappy with the technique and results, you may want to consider finding another reputable doctor in your area. Reading patient reviews, reviewing blepharoplasty before and after photos, speaking with past patients and researching credentials are all important steps in selecting the right doctor.
Paul Leong MD FACS
The Facial Specialist
Dr. Leong completed his medical degree at the Yale University School of Medicine. He then dedicated the next seven years honing his skills specifically in head, face, and neck surgery at the University of Pittsburgh—a university consistently ranked among the top five otolaryngology programs in the country. Dr. Leong continued to develop his surgical skills through a fellowship in Advanced Oncologic Surgery of the Head and Neck at the Pittsburgh Medical Center. This was followed by yet another fellowship in Facial Plastic and Reconstructive Surgery at the Oregon Health Sciences University.
What is the cost of revision blepharoplasty in Pittsburgh?
The price for revision blepharoplasty will differ from state to state and is also dependent on the skill level of the physician. An in-office revision upper blepharoplasty in Pittsburgh can range from $3,500 to $6,000. Revision lower blepharoplasty is often done under general anesthesia so that price can range from $4,500 to $7,000 including anesthesia and facility fees.
These prices will vary for each patient due to the complexity of the procedure since everyone has a unique anatomy with different amounts of fat, tissue, and excess skin on their eyelids.
Contact Sistine Facial Plastic Surgery
To learn more about blepharoplasty revision surgery or to schedule a consultation with Dr. Paul Leong to talk more about this treatment, please contact Sistine Facial Plastic Surgery today.