Asian Cosmetic Surgery - San Francisco

How Long Do Double Eyelid Surgery Results Last?

2011-06-06T09:58:00.001-07:00

A: It depends on technique and expertise

This is a very good question as it means you probably already know the 2 main types of surgery for the "double eyelid" procedure. Regardless of technique, we would want the procedure to last your lifetime, but this does not always hold true as we cannot stop the aging process or external events outside our control.

The incisional method is still the "gold standard" as it allows the surgeon to have full control and access to the anatomy (levator, tarsus, orbicularis, etc) to precisely place sutures. It allows the surgeon to address any ptosis and any needed skin and/or fat excision. It is the most "permanent" way to create the fold.

The non-incision/minimal incision method does not allow the surgeon to have access in the same way. The procedure is designed to "trade" the scar and exposure for slghtly faster recovery and minimal scar. In certain individuals, this procedure is adequate; but in others, skin, fat, levator, etc need to be addressed and the non incision method may not even be the right option for you.

It is important to see a plastic surgeon with significant expertise in Asian eyelid surgery before you embark on this face-altering path.

Asian Rhinoplasty

2011-02-27T22:37:00.000-08:00

Asian rhinoplasty is most often performed to address the dorsum of the nose with augmentation and to shape the tip to be smaller and more refined. This is usually accomplished by adding a silicone implant to the dorsum of the nose and by further refining the tip by trimming the tip cartilage and with additional sutures sutures that will hold the tip in a tighter position.

I mainly use the open rhinoplasty approach, which requires a small incision around the base of the nose, and in the inside. This approach allows for the most control of the tip and easy access to the dorsum for placement of the implant. The scar is nearly invisible after only a short time. There is usually a minimal to moderate amount of swelling, which resolves significantly within seven to 10 days.
A balanced dorsum and tip can be achieved with a very natural appearance. Far too often, I have seen patients with excessive augmentation and tip work that is not harmonious with the face. It is usually obvious that the patient has had rhinoplasty, which is not one of my goals. The result should be natural and balanced with minimal signs of additional work done.

Rhinoplasty techniques have improved significantly. Silicone implant is not always necessary for augmentation. . Often times I can use the patient's own tissues with their own cartilage or tissue to obtain very natural results without the potential future issues of an implant. Asian rhinoplasty can be performed safely and effectively with a balanced and natural result.

Does Asian eyelid surgery cost more than a typical blepharoplasty?

2010-03-28T20:21:00.000-07:00

Asian eyelid surgery requires significant technical precision, a greater understanding of eyelid anatomy, and an understanding of what constitutes Asian eyelid beauty. These three concepts cannot be over emphacized. Setting the lid and throwing down some sutures to create a fold is not enough. There are extremely important anatomic structures in the Asian eyelid that must be addressed to create the best, most natural outcome. These structures include the orbicularis muscle, the orbital fat, the orbital septum, the levator muscle, and the tarsus. All of these structures work together and need to be precisely addressed. Because of the additional techniques and sutures required to perform Asian eyelid surgery, it will cost more.

Remember: As with most cosmetic surgery, the first chance is your best to have the best result. I do not encourage a "bargain hunting" mentality for plastic surgery as you often "get what you pay for." It's not easy to correct someone elses' mistake on your face or body.

Q: Can eyelid surgery be done without anesthesia?

2009-12-11T08:35:00.000-08:00

Can bleph eyelid surgery be done without anesthesia? If so, how does it work?

A: It depends on what you call "anesthesia."
As you can see from all of the responses, most surgeons have recommended "local anesthesia," which is a form of anesthesia, simply not the type in which you go to sleep. I recommend local anesthesia, which requires placing anesthetic with a small needle in and around the area for surgery. Placing the anesthetic can be uncomfortable, but generally well tolerated. The advantage is that you can participate in opening and closing your eyelids. This can be a critical part of the operation.

--Asked on Realself.com

Q: Possible levator muscle injury from eyelid surgery?

2009-12-11T08:32:00.000-08:00

A: Levator muscle and repair in upper lid blepharoplasty
You are now 2 weeks out from the surgery and by this time, you eyelids should have accomodated to each other. If you still have signficant ptosis at this point, it is likely that the levator muscle or attachment to the tarsus is not functioning fully and will likely not resolve with further waiting. In other words, the transient effects of medication, brusing, swelling, etc, should have mainly dissipated.

There are a number of possibilities that are causing your eyelid asymmetry at this time, but removing too much fat is likely not one of them. My advice is for your to wait and be patient a while longer (minimum of 3-4 weeks). If you require further treatment, the levator may be explored, tightened, or "advanced." By this time, you will also see that the scars on the lateral incision will have healed much further.

(From RealSelf.com)

Asian Double Eyelid Surgery

2009-02-24T01:01:00.000-08:00

This is an extremely technical operation that requires significant precision and skill. I liken this operation to microsurgery as the sutures and precision required to create symmetry and the functional crease with the levator aponeurosis to be of equal value. I perform this operation under high magnification and place sutures as precisely as I do with blood vessels that are less than 1 mm in diameter.

The double eyelid operation is one of the most popular procedures performed in Asia. It must be performed keeping in mind the natural aesthetics of the Asian eye, not merely to Westernize the eye.

I spend a lot of time with the patient setting the height of the new lid crease. This is a highly personal choice by the patient, which must be followed precisely during the operation. It is important to remember that the lid height can always be shortened, but at a later date cannot be lengthened. This means that I pay great attention to the patient's aesthetics about lid height and whether more or less lower lid show is desired. Some patients desire a very natural, smaller crease, whereas some patients desire a much higher, glamorous lid height to place more makeup. These lid heights can vary between 5 mm to 9 mm.

What is Asian Cosmetic Surgery?

2008-11-29T14:19:00.000-08:00

Asian Cosmetic Surgery is plastic surgery that understands the anatomical differences of Asians and the different standards of "Beauty" that come from this understanding. This is a subtle, but very fundamental difference that can make an outcome good versus bad. Even though the exact same operation may have been performed between two individals, (Example: Asian versus Causasian) the expectation and the judgement of outcome can be entirely different. At its core, plastic surgery is the same, but in its different forms, there can be real and subtle differences.

For example, the eyelid operation (blepharoplasty) that is commonly performed on many Asians to create a more "Western" appearance (creation of a supratarsal crease) must keep in mind the different anatomy and expectation of the lid and crease position. Too often, I have seen the position of the lid and crease in a position that does not bring out the "beauty" of the eye. Instead, it is more a stylized attempt at trying to create a Caucasian eyelid on an Asian. Asian eyelids have specific charateristics, unique anatomy, and natural lines that should not be dramatically altered.

Performing Asian Cosmetic Surgery requires specific training and understanding of these ideals. I have personally spent time as a Visiting Professor at Seoul, Korea's top Hospitals and Plastic Surgery practices, where Asian Cosmetic Surgery is considered the best in the world. I have learned from these superb surgeons and also lectured to their residents on topics in Plastic Surgery. These experiences, combined with practicing in a multicultural city like San Francisco, have allowed me to hone my skills to treat Asian who desire cosmetic surgery.