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san antonio, TX

back with photos & questions re: facelift, bleph, fillers

I appreciate any opinons re: my upcoming facelift in late June. am soon to be 58.
i'm a little nervous. i have 2 or 3 photos in addition to these that I want you to see, so look for my next post and I will include them. .. See my under eye hollows, and under eye fat pads ( they are not that large), and badly sagging neck and upper eyelids... my forehead and brow position are OK. am overdue for fillers as you can see. i look allot better than these scary photos!

The doc. i have chosen does nothing but faces... he's also an otolaryngolist specialist ... he only does deep plane lifts with no visible scars - his work is beautiful & natural... my cosmetic Derm. highly recommends him... (he also does endoscopic mid-face lifts, but did not ask him about that since I've read mixed reports) He suggested a lower face lift, upper and lower bleph (he said i could wait on the lower bleph but suggested i do it now ) (he said he would not change my under eye shape or make it look hollow,.. he would only remove a little fat from under eyes, not all of it, and would tighten the skin there. He offered fat injections from belly into face (cheeks), but instead i will continue with fillers from the cosmetic Derm who has done my Resty. for yrs for nasio-lab folds, around mouth, cheekbones, etc.

1) do you think an upper bleph would be enough now, and then try Resty. under my eyes and orbital ridge for hollowing, and in cheeks instead of a lower bleph ? or do you think i should do a lower bleph PLUS the fillers under eyes, orbital ridge + cheeks ?

2) is Resty. safe in tear troughs where my dark circles are ?
( my skin is thin there, so the plastic surgeon said it's risky to fill with anything there ) My Derm says she does Resty in tear troughs, and in under eye hollows all the time successfully and she has to inject deep......

3) is Resty OK to fill underneath my under eye pads if I don't have the lower bleph ?
my under eye pads are under the outer part of my eyes so the skin there is Not thin....

4) how close to the eyes can you do Resty
and are there risks ?

5) they can do my blephs in the office under local with Valium OR i could do them at the same time as the facelift....Do you think it's good to avoid extra time under general anesthesia ? or would you do the blephs and face all at once ?

6) will my 'spit glands' show a little more when he does this lift ? he noticed them but said it's OK.

7) on one corner of my mouth, there is a line that goes down, unless i am smiling.
my Derm tries to fill it and lift it but it does not work... do you think the lift will help ?

8) The PS suggested botox for lines in bridge of nose between eyebrows but i have always refused it with my Derm. are there any long term studies to show injecting this toxin is safe ? is there another alternative for these lines ?

9) my area above my upper lids has always been full... i showed him old photos.. he said if i prefer, he wont remove ( as much) fat from above my upper lids... is it OK to leave fat above the upper lids and just remove hanging eyelid skin ? I would not look like me if he removed the fat. how does he know how much fat to remove ?

10) how does he know how much skin to remove from the upper lid without changing the shape of your eyes ?

Thanks for any opinion you may have. my biggest fears are : my eyes - that they might a different shape, but his before/after photos look excellent.. my other fear is that my lower lids would look done or pulled... he assures me they won't.

Even if I am not able to reply here, know that I will read everything you write and will consider what you have said, so Thanks ahead of time !

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Doctor/Professional Answers (2)   


Plastic surgeon
Miami, FL
United States
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April 17, 2013 5:23 AM

Why would you ask such detailed questions over the internet. NONE of us experts would take you seriously and we can not offer opinions on your personal requests. because we have not (more)
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Plastic surgeon
sacramento, CA
United States
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  Upcoming surgery on face
April 16, 2013 6:36 PM

I am going to be quite frank. If I saw these questions raised by one of my patients before upcoming surgery I would be hesitant to proceed. This tells me that for better or worse I have (more)
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