Dr. Roger Brill, M.D.

First, an evaluation is needed. At 32 years of age usually what patients notice is extra upper eyelid skin which may form a double fold. It may obscure upper eyelid show and make it interfere with your ability to apply makeup. There are now nonsurgical methods to considerably tighten the skin equal to a surgical result an I use Fibroblast which is new and returns the elastin tightening of the skin and may be 20-30% tighter. It gives results equal or even better than surgery as perinatal sin anti aging was achieved with doesn't happen with surgery. There is no change in color of the eyelid skin, performed with topical anesthetic, no sedation, no treatment for pain, no risk of dry eye, heals in three to four days, and looks great with no skin color change bruising and is permanent except for future aging. It is permanent anti aging and tightening of skin. Also it returns your eyelids to the same as when about 10 or 15 years younger and no scar. You can drive to the appointment yourself as if a dental appointment. It is much less expensive. If you have significant excess skin and lateral upper fullness and possibly a small amount of extra medial protuberance, then surgery would be the best treatment. This is more expensive. I have raised the lateral brow slightly as well through the eyelid incision. Conservation of orbital adipose tissue is important at this age. If she has asymmetry, or very low brows and bothers her and wants to have a different look, this can be done usually with upper eyelid incisions only but can also have a brow lift with additional small incisions added in the scalp which are behind the hairline and heal very well and unnoticeable. Remember that this patient is 32 and at this age ”less is more”. Anti aging of skin around eyes including lateral skin an lower eyelid skin should be included and can be very successful with self treatment as recommended by a plastic surgeon as prescription strength agents are necessary for permanent rejuvenation.

Yes, This is commonly done with some reduction of nasal projection but this is left to be done at the end of the procedure because it reduces some without the surgical treatment. Also, the main problem may be very wide alar portion of your nose and only needs the reduction of the nostril but also the overall proportion if your nose needs to look normal and natural