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Bulletin Board for
Patient's Questions and Answers
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Reconstructive 
Hand
Cosmetic
Congenital Breast
Head & Neck
Skin
Cancer
Microsurgery
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Ptosis (drooping of upper eyelid) Facelift / Neck lift (rhytidectomy)
Facelift surgery (rhytidectomy)
Ptosis of the eyelid (drooping of the upper eyelid)
Ectropion (Drooping of the lower eyelid) Recurrent ectropion after multiple cancer resections and then skin cancer excision with Mohs' chemosurgery and full thickness skin grafts. Eyelid Reconstruction
The Aging Face
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Cosmetic Eyelid Surgery (Blepharoplasty)Subj: Re: eye surgery Dear Dr. Bermant, Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. Sounds strange to me, have not seen similar problem. Hope it gets better. Let me know if you find out what happened. I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures. Michael Bermant, MD Subj: Re: Crepeyness under eyes Dear Dr. Bermant, You responded to my question of last night about under-eye crepeyness by saying that depending on the situation, eyelid surgery might be indicated. I'm curious to know how surgery on (or above) the lids might affect the area under the eyes. L Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. Lower eyelid surgery affects the area under the eyes. You need a consultation to properly educate yourself on your options, E-mail has a very limited value. I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures. Michael Bermant, MD Subj: Re: Upcoming bleph Dear Dr: I'm 47 and having upper bleph only the day after Christmas and will have 10 days to recover before going back to work on Jan 5. Will I be sufficiently presentable? My mom (who blows everything out of proportion) says I won't be able to walk after and have to be waited on for several days...is this true? Thanks. Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. Good question for your surgeon. It depends on what you consider "sufficiently presentable". It also depends on your problem, how you heal, what your surgeon plans to do, and your surgeon's skill / technique. I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures. Michael Bermant, MD Subj: Re: Eye surgery Graves Dear Doctor, Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. Grave's disease patients are at greater risk for blepharoplasty but also age like the rest of us. This aging can make the eyes look older and "tired". Eyelid surgery on such patients can result in: lagophthalmos (eyelids not closing totally) Any preoperative asymmetry becomes more obvious after surgery. Any eyelid surgery should be deferred until orbital inflammation and lid positions have stabilized. Since some patients develop protruding eyes, the tissue that seems like extra eyelid skin, may be needed for standard covering of the eye. Any surgery should thus be very conservative if not discouraged. I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures. Michael Bermant, MD Subj: Re: Double-fold in upper eyelid. Dear Dr. Bermant, I am an extremely self-concious 29 year old and have for many years been bothered by a "double-fold" in my upper eyelids (in other words, I have two creases in my upper lids rather than one). I have no knowledge of the correct termanology for such a condition (if there is one), and have unsuccessfully seached the web for information about it. Although it does not inhibit my vision, for purely cosmetic reasons I would like to have a procedure done to remove the "second folds." I would be grateful for any information which you could provide about this condition and any available treatments for it. Many thanks, Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. Although the double upper eyelid is considered a sign of beauty in the orient (Mandarin eyelid) it can cause concern for westerners. Surgery to improve this is called blepharoplasty. It depends on the actual problem as to what degree corrective surgery is successful. The skin from the upper lid is usually attached to the lifting muscles in the double fold upper eyelid. Cutting out this skin and getting it to heal without scarring back down can be tricky but frequently is successful. I have my patients massage their lids after initial healing to minimize such problems. The surgery is done under local anesthesia. I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures. Michael Bermant, MD Subj: Re: blepharoplasty Hi, Can you tell me, generally, what is the difference in recovery
time between having blepharoplasty with the incision done below
the lashes and the incision internally? Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. Blepharoplasty surgery can be both for trimming redundant fat, extra skin and tightening the tone of the lid itself. Internal incisions can be used for both the extra fat and slight tightening the tone of the lid. It cannot address extra skin. Laser treatment can help with the extra skin. External blepharoplasty can handle all three problems. The type incision needs to be discussed AFTER an examination and evaluation. On the pages already posted the incisions are external due to the massive skin and tone problems involved Recovery is a function of what surgery was done, not just the incision. Both external eyelid and internal eyelid mucosa heal fast. Work on the eyelid muscle and lid tone have a much more variable recovery time. This part of your education is much better done during an in office consultation after an examination and evaluation. I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures. Michael Bermant, MD Subj: Re: Can't close my eyes I had a foehead lift and bblepharoplastyy on the upper
and lowe rlids over 5 weeks ago. All is OK except that my eyes
open up to 8 millimetres after I have gone to sleep, and if I
do not apply anti-biotic cream inside the eyes before giong to
sleep my eyes swell and are abrased badly next day. Will this
pass on its own or should I do smoething? Please type in my e-mail
add instead of replying diesectly, as my server is hopleess. Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. The eyes have a delicate balance for closing. Brow surgery and eyelid surgery can upset this balance. Eye protection is very important. If you are getting enough loss of protection at night to cause irritation in the morning - Let your doctor know as soon as possible. When upright gravity will help to a certain degree. When awake the sphincter muscles can compensate to a certain degree. Asleep and on your back compensation can break down. Too much brow elevation or too much upper lid shortening can keep you from closing you eyelids. Swelling from surgery can also contribute to this problem. The problem can be so bad that some are unable to close their eyes even during the day. The problem can be very minimal such that with time it will correct itself. Check with your doctor. If you were my patient, I would want to know about your concerns. The doctor who has worked on you has a much better insight as to what the chances are that the problem is temporary or if there are other concerns. I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures. Michael Bermant, MD Subj: Re: I live in France and am planning to have a blepharoplastie I live in France and am planning to have a blepharoplastie done on my lower eyelids. It took me 10 years to make the decision and am very relieved that I have decided to go for it. My surgeon says that after the belepharoplastie, and after the eyes have healed, a decision will be made whether to have laser treatment. I see elsewhere on the web that there are doctors that do the whole procedure by laser: "fat removal" and superficial smoothing. What is your opinion. All laser or incision + laser? Thank you for your answer (I am 52 years old): Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. It depends on what your problem is. Laser is a good resurfacing tool and best for fine wrinkles. As a "knife" to cut the skin, there is little advantage to an otherwise very expensive tool. Laser surgery will not handle a major excess of skin, nor help with eyelid muscle drooping, nor lax eyelid supporting structures. Eyelid surgery with or without lasers handles all of these problems except for the fine wrinkles. Although I can do both, I prefer the knife for general blepharoplasty surgery and reserve the laser for resurfacing problems. In some cases that means only laser, others only knife, and in others both methods. Again depending on the problem such laser surgery is done at the same time as the blepharoplasty, and in other cases reserved for a second operation. I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures. Michael Bermant, MD Subj: Re: Not quite a face lift... I am 30 years old. My facial skin is in good condition except for "bags" under my eyes. I have had these "bags" since I was a teenager. I feel that these make me look older than I am. Is there anything that can be done to get rid of or lessen their appearance? Also, if there is something that can be done what complications may arise, how long would it last and at what estimated monetary cost? I truly would appreciate any information. Thank you! M.G. Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. Many individuals want to get rid of that "tired" look that such bags give. There are many possible treatments for "bags" under the eyes. Blepharoplasty surgery, face lift, and laser resurfacing are just three of the options depending on the problem. You really need an in office consultation and evaluation to define what is the problem that needs solving. Then risks, benefits, and alternative methods of care can be discussed. Cost depends on what needs to be done. Take a look at several of the cases on my website to see examples of eyelid surgery for "bags" in the blepharoplasty section. I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures. Michael Bermant, MD |
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