Fitness Club

Q: My upper lids droop over my eyelashes and I would like to have them fixed. I have seen two plastic surgeons, one who agreed that he could help me with my upper lids, another who told me I’d have to have a brow lift as well. My brows are fine with me and I do not understand why a brow lift would be necessary? Why would a surgeon recommend a procedure I did not ask for?

A: You really should go and have another talk with your plastic surgeons – if one recommended a brow lift, he should have explained why he did so. Rarely would we suggest a procedure about a body part not brought to our attention by a complaint originated by a patient. For example, we would never comment about very large or small breasts if a patient came in to discuss an abdominoplasty (i.e. “tummy tuck”).

The two exceptions I can think of relate to chin implants and brow lifts, but in such a situation, I sure would hope that the patient left the consultation with an understanding of why we are recommending the brow lift or chin implant procedures! Patients with weak chins who come in complaining of a large nose or a droopy neck cannot get a great profile without addressing the weak chin because the chin, nose and neck all contribute to the profile. Likewise, if a patient complains of heavy upper eye lids, we have to analyze the balance between the eyelid and brow position.

As a plastic surgeon, our duty is to lay out the options for a patient and each person has to choose the procedure(s) that will give them their desired results. In a pure upper eye lid blepharoplasty, the thin skin excess of the lids is removed but the distance from the lashes to the brows is not changed. In patients with low brows, removing the thin, excess upper lid skin may not be appreciated unless the thicker tissues just below the brows are raised as well. This is not to say that every low brow must be raised when doing an upper lid procedure, but the patient has to understand that only the thin, upper lid skin excess will be removed, that the thicker brow hooding will be unchanged, and that the distance between the brows and lashes does not change with an isolated blepharoplasty.

If a patient desires a more open – eyed look, this will only be accomplished if a brow lift is added to the eye lid procedure. Not only will the eye area look more open following a brow lift, but during a brow lift, the frown lines between the brows will be minimized because we can remove some of the muscles that cause these frown lines, called the corrugator and procerus muscles. And finally, occasionally I’ll see a patient with hooding caused by low brows who thinks they would like an upper eyelid blepharoplasty, but when I gently elevate the brows, I can see that this patient does not have an excess of thin, upper lid skin, just low malpositioning of the brows and I will recommend to this patient that a brow lift be performed without a lid procedure per say.

A brow lift is a minimally invasive procedure. In the endoscopic brow lift, a few half inch incisions are made behind the hair line, allowing the instruments to be inserted. The tissues are freed from the bone, the muscles sculpted, and the brows raised a few millimeters. The brows are fixed in their new position with a variety of devices. The incisions are rarely perceptible after healing has taken place. Occasionally, a brow lift will be performed as an isolated procedure, but more commonly it will be combined with a minimally invasive midface or thread lift, an eyelid procedure or a standard face lift.

If you have any specific questions about cosmetic procedures, you should see a qualified, board certified plastic surgeon to review your options and have additional questions answered!

About the author of this article:

Dr. Bunkis,MD, FACS of Orange County Plastic Surgery is a Harvard trained, Board Certified Plastic Surgeon and has 30 yrs of surgical expertise. Call OCPS at 949-888-9700, email your questions to info@ocps.com or visit our website for more information.

Related posts:

A Guide To Eyelid Surgery Eyelid surgery which is also called blepharoplasty, involves the removal of excess fat, muscle or skin which may be present around the eyes. This will give you a more youthful and alert appearance. It is possible to do the surgery on the upper and the lower lids, either simultaneously or separately. This procedure may be [...]...Sample Interview Questions and Answers: How to Prepare For ... It’s no secret that it’s a buyer’s market out there right now for employers. They’ve got more applications than they know what to do with. You may be competing with dozens of applicants for every job opening. If you are lucky enough to be granted an interview, you better be prepared to answer some tough [...]...Some Incredible Issues That Involve Plastic Surgery It would be very unusual to come across an individual who was completely satisfied with the way they looked. Most people have at least one area of their body that they dislike but only some of those people are brave enough to take the leap to looking into plastic surgery. They are procedures that people [...]...The Truth About Liposuction Q: I had a friend years ago that had liposuction on the bottom half of her body. 10 years had passed since I saw her; I could not believe my eyes, her face and arms had gained so much weight I didn’t recognize her! Is it true when you lipo from one part of the [...]...Answers To Your Questions To Ask Before Hiring A Moving ... It is really one of the toughest decisions to make in the entire process of relocation. Whether you are moving across town, or across the country, determining whether you should move yourself, or hire a moving company, is a huge task. And there are a number of factors to consider before making the final decision, [...]...The Many Types of Cosmetic Surgery Many people are not satisfied with the way they look. Some feel hopeless because they think they are unattractive. All of these things can be solved by one thing, cosmetic beauty surgery. The industry is booming. People all over the world are looking into getting this type of correction to gain the appearance they want. [...]...Understanding the Procedures and Risks for Chin Augmentation Undergoing any kind of plastic surgery involves a certain amount of risk, and recovery. However, if you are completely set having work done, and you understand all that is involved in the procedure, you can be very happy with the outcome. Chin implant surgery is for those who are not happy with the shape or [...]...Making Your Body Look Its Best As human beings get into middle age, the body goes through a great deal of changes. They may notice that they weigh more than they once did and have a hard time getting rid of it. The skin becomes altered also, especially on the face. Those that have not properly protected themselves from the sun [...]...Looking Beautiful on a Budget – Wrinkle Repairs Q: I am in my early 50’s and I’m starting to see wrinkles. Many of my friends have gotten facelifts and Botox® injections but I’m terrified of needles and knives! Are there any over the counter products that will tighten my skin? A: Great question! You will know when you are saggy enough to warrant [...]...How To Reduce Eye Strain All of us have surely experienced eye strain and we know how much of a problem or hindrance it can be when it comes to our work or daily chores. Because our eyes are tired and we are uncomfortable, we tend to slow down a bit on what we are doing or completely stop it [...]...

A new study of the cardiovascular benefit from using omega-3 enriched margarine in patients who previously suffered heart attacks turned up disappointing results, but its design may have been flawed.

The study, conducted over a period of 3 1/2 years by researchers in the Netherlands, concluded that the rate of cardiovascular problems, including resulting deaths, was substantially the same, whether the participants were consuming additional low doses of omega-3 fatty acids in their diet or not.

The 4,800 participants were mostly men, aged 60 to 80. All were taking medications during the study period to regulate blood pressure and cholesterol levels, as well as guard against clotting.

Daan Kromhout of the division of human nutrition at Wageningen University presented the findings Sunday at the European Society of Cardiology Congress in Stockholm.

Although at face value the study may seem to suggest that omega-3 supplementation provides no heart-health advantage, that conclusion might not be warranted, for several reasons. The amount of supplementation provided may have been too little. The patients consumed an average of 18.8 grams of margarine per day, which gave them an average of 226 milligrams of eicosapentaenoic acid (EPA) combined with 150 milligrams of docosahexaenoic acid (DHA), both derived from fish; and/or 1.9 grams of alpha-linolenic acid (ALA), found in plants. These amounts are considered "low dose." Heart patients are often advised to take 1,000 milligrams of omega-3 daily.The supplementation may have been provided too late for most of the study participants. Several years had intervened between the time many of them experienced their heart attacks and the beginning of the study. However, it is the period immediately following a cardiac event when a patient is most vulnerable.Some of the patients did seem to benefit from the supplementation. There was a "borderline significant reduction" in major heart events among women who consumed ALA, as well as among diabetics in the study. The supplementation appeared to protect against ventricular arrhythmia-related events, the researchers said. Unlike taking an omega-3 supplement in pill form, the study required patients to consume margarine, so a secondary food was required -- and that typically was bread. The study did not account for the possible negative effects of weight gain or increased blood pressure from eating extra bread, critics have noted. The strength of the patients' heart-protective medications may have overshadowed any potential benefit from the low-dose supplementation.The study was conducted among a population that typically consumes a lot of fish, which naturally provides omega-3. Supplementation might be of greater benefit to people who eat more meat and less fish (typical in the US).The study was not designed to consider the potential heart benefits of omega-3 supplementation among a general population of individuals who had never had a heart attack or other serious cardiovascular problems.

It's likely that more research is warranted to provide a clearer picture of the relationship between supplementation with omega-3 fatty acids and heart health.