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What is More Invasive..a Browlift or Upper Blephroplasty?

 Andi P in Pennsylvaasks:

What is More Invasive- a brow lift or upper blephroplasty?  hich is more invasive…a browlift or upp blephroplasty? Thanks!

Image Courtesy of cosmeticsurgeryforums.com

There are a number of different types of brow lift procedures.  Most of the brow lift procedures would likely be categorized as more invasive than a standard upper blepharoplasty.  Upper blepharoplasty is a simple procedure whereby skin and a small component of muscle is trimmed from the upper eyelid, sometimes with a small degree of fat removal.  Essentially this is a simple procedure.  A brow lift can be a little bit more complex.  Coronal lifts and endoscopic brow lifts have moderate dissection components to them.  More limited brow lift techniques such as transblepharoplasty, direct brow lift or lateral temporal brow lift have a bit less dissection/invasive requirements than the old-time traditional brow lift techniques.  It is important to discuss the brow lift technique specifically with your surgeon.

David Q. Santos, MD

Seattle Facial Plastic Surgeon

Should a Patient with Botched Surgical Results, Be Required to Pay for a Revision Surgery?

msmmi in sf in Pleasanton, CA asks:

 ”Should a patient with botched plastic eye and brow lift be required to repay the surgeon for a revision?”

Photo Courtesy of RealSelf.com

Each individual plastic surgeon has his/her protocol in their office.  Common protocols include not charging for a second procedure.  Many offices and plastic surgeons require a facility fee.  Less often full price is charged.

When it comes to the need for a revision procedure, which is a little bit different than “botched surgery”, repeat procedures are common.  A certain percentage of patients who have a rhinoplasty or facelift surgery for instance, require touch-up or revision procedure.  This can be in the range of 10 to 15% of patients sometimes.  Due to the fact that this is not too uncommon, this possibility should be discussed prior to the procedure.

In the instance of a “botched” surgical procedure, a good trusted second party is needed to assist with defining the real true problems.  A trustworthy second opinion would help to define whether there truly is a permanent complication or whether there is simply something else such as not getting the results that one desires, or a wound or swelling that should get better with time, etc.  Going back to the primary surgeon, getting his/her opinion followed by a second opinion will best assess whether there is a true problem that needs fixing.

Commonly good ethical physicians will provide assistance for correcting surgical related complications at minimal or no charge.  But there is no requirement to do so.  Your best answer is to try to do the best you can with the primary physician/surgeon to see if he/she will provide correction of a true surgical complication at a reduced fee.

David Q. Santos, MD

Seattle Facial Plastic Surgeon

Options After Bad Browlift and Facelift?

Disappointed & Scarred in Los Angeles, CA asks:

“Im a 30yr old model(female-caucasian/hispanic). 6wks ago had facelift (modified volume adjusting) & lateral brow lift. My cheek elasticity was lax & brows were drooping (wanted both to be lifted & tightened). Dr is trying to convince me I look better, but Preop pics & video show very little difference & I still have same issues-lax skin & droopy brows, plus a bad brow scar (not sure why it was done so prominently knowing my line of work). Will time lift it more & make tighter? What about scar?”

My hairline was severely displaced. Now have bald spot & very visible scar.
Most importantly it is imperative to look at the time course after the procedure.  Six weeks is a long time on the one hand, but more often three months and six months is needed to really get an assessment of the final result.  Before and after pictures are viewed at these time periods and get a better sense of what really has taken place, what improvements or lack of improvements have really transpired.  This is important for the incision site as well.As far as “tightness” and “lax skin” issues or concern, the laxity itself is generally slightly improved and overall tissue should be tighter after a lift.  However the focus is not so much how things feel (with one’s own hand) but more how things look.  The best way to assess how things appear is really to look at the before and after pictures generally at the three and six month time period.  Minimal, mild, moderate or significant improvement can be easily assessed with expert before and after pictures and this is the gold standard of assessing the success of the procedure.Generally in terms of improvement with time, this is not something of improving the tightness but on the other hand there is an aspect of further diminishing of swelling that can lead to better appearance.

David Q. Santos, MD

Seattle Facial Plastic Surgeon
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