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Bulletin Board for
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Reconstructive 
Hand
Cosmetic
Congenital Breast
Head & Neck
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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: Lower eyelid surgery On the average, at what age do you recommend lower eyelid surgery being performed outside versus inside the lid? I am 49 and am considering the lower eyelid surgery. I have probably what is considered average for my age bagginess. Inotherwords, I look my age. Also, at what average age do you consider the elasticity of the skin to be a factor in this decision? Any info would be appreciated. Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. The type surgery depends on the problem. Blepharoplasty for excess skin of the lower lids is best done with an external incision. Minimal excess skin with an internal incision needs to be addressed with something like laser resurfacing. Without an examination and evaluation, I could not comment on your case. 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 Dr. Bermant 1.I am interested in know about the fees of blepharoplasty. Thank you Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. There are many types of blepharoplasties, lower lids alone, upper lids alone, both upper and lower lids, with or without laser resurfacing, deep planer blepharoplasty with malar pad lift (among many others). Each type of surgery has a different price. My office staff can give some preliminary prices. The best way to determine the cost of surgery is through an in office evaluation and consultation. First find out what needs to be done. Our office consultation is designed around the patient's educational experience. We can then understand what you are asking us to do and we can give you a price quote. 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: Re : eyelid Dear Dr. Bermant Having just experienced my first cosmetic surgery I am unsure
as to how pleased I am about the results. Can you advise me of
the extent of improvement I can expect. I suffered with real
baggy eyes top and bottom at the moment they are healing but
still look baggy to me. Will this improve with time or is this
it. !!!! This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. A good question for your doctor (or for me if you were my patient!) Eyelid surgery does evolve over time. However it usually goes from a tightened state to one that is less swollen and looser. Tissue does change with healing and if you were my patient I would be unhappy that you felt the need to ask another doctor this question and not let me know about your concerns. Without seeing you, I really cannot comment about the specifics you ask. 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: bleph Hello Doctor, Thanks in advance for your consideration. Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. Thank you for your kind comments. Problems of the upper lid may include extra skin, drooping of the brow or lid, and a bulging of fat from around the eye. Each problem has different solutions that can combine into a blepharoplasty operation. Upper eyelid surgery can reduce excessive bulging of tissue (usually a relaxation of the material holding the fat in the orbit). This reduction is commonly done with removal of the fat as well as other manipulations. Excessive removal of fat can leave a hollowed out look. Without seeing a patient, I cannot comment about a specific possible problem or potential solutions. 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: bleph comp I had upper and lower eyelid surgery on July 2. Coming
into recovery, my family noted that my left lower lid was pulled
down. In recovery, my blood pressure felt ("through the
floor" the nurse said) and I had vomiting after I regained
consciousness. While vomiting the left lower incision bled a
sheet of blood down my cheek. This lid is very low, pulled down
and the incision is thick and lower on my face than the other
side. Also, the eyeball itself is very red on the bottom. My
Dr says that this is due to swelling and will resolve itself,
but I am worried. I want to understand why this eye is so much
worse than the other 3 incisions. He says that there was nothing
different about it surgically. Also the upper right lid has a
droop in it. Although my doctor is board certified, are these
normal complications? The incisions are not at all symetrical
either. Like on the upper left, the cut goes straight into my
nose, on the right upper, it curves down following the eye shape.
The lower incisions are jagged: up and down jags as it moves
across my face and then the left one is way lower on my cheek
than the right which more closely follows my eyelash line. I
am planning to have a full facelift after I lose 15 more pounds,
and I am concerned about making a good choice of physician. I
need some advice about whether these complications may be indicative
of a less-than-desired skill level in my physician. Or are these
issues outside surgical control? I know that my vomiting didn't
help things, but I did exert vomiting pressure on all my eyelids,
not just the one, so I don't understand. Thanks for your help.
Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. Bleeding after surgery CAN happen. Coughing, and vomiting can raise some one's blood pressure and a tiny vessel that had been stopped during surgery just let go. It takes very little after surgery bleeding to cause much swelling and bruising. Bruising of the white surface of the eye turns bright red as this blood in the superficial tissues easily gets oxygen. No surgeon, no matter how good can have such complications. I (as do all good plastic surgeons) take extra time to minimize such bleeding and am glad to not have seen such a problem for many, many years. I try to make my incisions symmetrically but some tissue deformities just need a sculpturing modifications that result in incisions that seem different. I cannot comment on your case, I have not examined you. Your questions are better directed to your surgeon. 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 Thank you very much for your response. Subj: Re: eyelid surgery makeup Hi, Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. Each doctor has his / her own preferences when patients may start wearing makeup. It also depends on the type of surgery and healing. I advise my patients individually depending on many factors. For my patients, I prefer the wounds to be sealed before they apply makeup. Early application must be done carefully as the wounds can be very weak. Other factors include patient's vision, dexterity, and needs. We have a staff aesthestician to help our patients learn what they can do for themselves with camouflage makeup. Good luck with your doctor's visit. 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: eyelid surgery I would appreciate any information as to the possibility
of the eyelid not completely covering the eye after surgery.
I have heard of such cases and wondered what the chances are
of that occuring. How long does the surgery take? Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. Depends on the problem being treated, type of eyelid surgery, and how the surgery is performed. There are just too many different types of "eyelid surgery" to make a sensible comment. In certain types of eyelid surgery however there can be an early after surgery difficulty in eyelid closing over the eye that tends to go away when the swelling goes down, and eyelid function is restored. In other cases, like eyelid ptosis (drooping eyelid), the lid is elevated such that eyelid can get out of the way for vision. Some failure for closure can be predicted in certain ptosis correction cases and is one of the options discussed about that type of surgery. There are many other possibilities, but in standard blepharoplasty surgery eyelid closing is usually not much of a problem. 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: eyelid surgery Dr. Bermant writes:
Subj: Re: Post Blepharoplasty 9/1 I have been reading your bulletin board with interest. Do you recommend either aloe vera or vitamin E (or anything else) to be applied to the eyelid area after the initial 48 hours after a blepharoplasty? I have had mild bruising from this procedure. Thanks. Dr. Bermant responds: This should not be construed as medical advice. I am a Board Certified Plastic Surgeon. You should check with your own doctor. I do many types of blepharoplasty eyelid surgery and design the after surgery wound care for the specific patient. My patients have specific clear after surgery instructions and long term scar care information. Certain types of closure benefit from specific care. Early eyelid wounds are very weak and can be disturbed with too much manipulation (again depending on closure technique). I can easily help my patients, because I know what I did and have evaluated that patient. I would not like a doctor telling my patients what to do after surgery by me. 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: Post Blepharoplasty Many thanks. My surgeon said do nothing after the stiitches come out (today). Others dissolve. But I had seen something on the internet mentioning vitamin E and/or aloe vera. Again, thanks for your time. |
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