Treating Puffy Eye Bags, Wrinkles around the Eyes, Dark Circles, and Hooded Eyes Separately

A 39-year-old woman has suffered under her eyes for as long as she can remember. He asks for advice on what he can do with them

Dr. Amiya Prasad, a cosmetic plastic surgeon who has served in Manhattan and Long Island for more than 20 years, says there are a few things she needs to see besides looking into her eyes. She also does a lot of facelifts so she sees not only her perspective as an expert in the eyes but also as an expert in facial rejuvenation. Because she is disturbed by the look of her eyes, she is sometimes so focused on this field that she misses the details of the whole face that contribute to the overall look. When Dr Prasad looks into one's eyes, he sees a middle face also known as a sublimar or cheek area. He also sees the eyelid junction of the eyelid because not only will he see swelling under the eyes, but he will also see the loss of volume on the cheek.

The upper eyelids appear to have extra skin and some fine wrinkles, while the lower eyelids have swollen and delicate skin. There are more wrinkles when there is muscle activity such as smiling.

In the practice of Dr. Prasad, routine for upper eyelid blepharoplasty to reduce excess skin and sometimes carve the fat under the eyelids, orbital fat and sub-brow fat. She also does a great job of minimizing eyelid glosses to allow for a natural look and rejuvenation. Hooded upper eyelids tend to make people look sad and tired as they dominate the natural form of the eye.

These lower eyelids have lower eyelid fat prolaps. Lower eyelid prolaps mean that the fat usually around the eyes pushes forward like a hernia and causes swelling. When there is a relative depression, the amount next to it makes the depression look deeper. Dr. Prasad recommends lower eyelid blepharoplasty. There are two ways to perform lower eyelid blepharoplasty: one is an external one called transcutaneous blepharoplasty which is meant to have a slit under the eyelid, the other is a transconjunctival blepharoplasty that comes from the inside of the eyelid. From personal experience Prasad, he likes to do transconjunctival blepharoplasty because he tends to maintain the natural shape of the eyes. It allows the maintenance of lower eyelid support structures such as the muscle orbicularis muscle and tendons. Low eyelids are complex as there are several key structures required for the balance of the lower eyelids to maintain a good eye shape. Often, people have lower eyelid retraction or ectropion where the eyelids are removed and they come for revision surgery.

When the patient has fine lines and wrinkles, Dr. Prasad has two methods. One is a fractional CO2 laser that combines ablation or removal of the upper layers of the skin as well as the generation of the upper layers. It also generates heat energy into the dermis or spine of the skin for tightening. He also uses regenerative medicine technology called plasma-rich platelets (PRP). Platelet-rich plasma is derived from the patient's own blood which is basically the same technology used in orthopedics for joints and wound healing. It is used for the skin to stimulate new collagen, blood supply and improve skin quality.

During the consultation Prasad, he always showed his patients the possibility of hollow after this type of surgery. It is not caused by too much fat under the eyes but about the presence of loss of volume on the cheeks due to facial aging. Loss of volume cannot be treated in eyelid surgery. He recommends procedures such as fat removal, implant implants or injections such as Radiesse, Restylane or hyaluronic acid fillers to balance them.

Dr. Prasad suggested that he meet with an experienced cosmetic surgeon who has extensive experience with eyelid surgery. She truly believes in her vast experience in all areas of cosmetic surgery as it enables patients to achieve better outcomes. When a doctor has experience in specialization, it is a matter of fitting the patient's aesthetics and the aesthetics of the surgeon to get the desired result.

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