Blog

Incision Eyelid Surgery

Incision eyelid surgery at 5 days, 12 days and at 1 month

5days post operative

12 days post operative

1 month post operative

Patient had intermittent folds which benefitted from permanent crease placement with an incision approach to make the crease symmetric while maintaining the natural crease size the patient desired.

This patient’s left eye is slightly smaller than the right. This is caused by a weakness in the left eyelid opening muscle. She was using her forehead to elevate the eyelid, causing the brow to be slightly elevated. After the muscle tension was corrected to match the other  eye, note that the brow is relaxed and in a slightly lower position (in the after picture). A small amount of skin was removed to accommodate the slight drop in the brow.

Face and Neck Lift with Upper and Lower Eyelids Surgery

Jaw Angle Augmentation with Implants and Sliding Genioplasty

Both procedures were performed through an intra oral route.

Intraoral Jaw Augmentation

Oblique View

Side View

The purpose of the surgery is to give a more masculine jawline and chin.

Notes on Jawline Shaving

Using a direct view from behind the ear, a precise amount of bone can be removed for an ideal jawline contour. This is an improved view compared to the traditional approach of resecting the bone from an intra oral approach, in which the bone is removed mainly by feel, due to visual limitations.

For additional photos of actual bone segments, click here:
http://www.flickr.com/photos/63242188@N06/sets/72157626924419082/

These photos were taken from three consecutive patients on three consecutive days. Note the significant amount of bone that was safely removed.

“Revision jawline reduction through an behind-ear approach”

To see the photo, please click this link:

http://www.flickr.com/photos/63242188@N06/5793573345/in/photostream/lightbox/

Much more significant bone can be removed through this route compared to going through the mouth.

Here is an example of how bone would be removed if done through an intra oral route.

http://www.flickr.com/photos/63242188@N06/5794403590/in/photostream/lightbox/

It is more difficult to get a whole piece out, and usually is done in small pieces.

Jawline shaving


All Natural Chin Augmentation

Sliding genioplasty augments the chin using your own tissue, not an implant.

Before and After Chin Augmentation

Before and After Chin Augmentation

Before and After Chin Augmentation

One year after Sliding Genioplasty

Before and After Photo (1year)

All Natural Chin Augmentation

By: Dr. Charles S. Lee

All natural chin augmentation is also known as a sliding genioplasty.

Chin implant is a traditional choice for correcting a small chin on profile. An incision is made under the chin or in the mouth for this procedure.

The materials that are used can be Silicone plastic if placed inside the mouth or Porex if placed from an incision under the chin.

Advantages of the chin implant include the simplicity and straightforwardness of the procedure and it uses local or sedation anesthesia only.

The disadvantage is that it only corrects horizontal deficiencies and deficiencies under 10mm that are in one direction only.

Problem chins where implants will not work:

• Chins requiring large advancements – more than 10mm.

• Long chins or chins requiring reducing the size

• Short chins requiring additional vertical height

• Lip incompetence – lip has trouble closing. “Stippling” is apparent.

In these situations, bone movement is required (sliding genioplasty).

How is it done?

• General anesthesia

• Intraoral incision

• Lower border of chin exposed, avoiding nerve of sensation

• Bone segment is divided

• ***Chin can be shortened and advanced -or- lengthened -or- centered and advanced -or- as how the chin should suit the patient.

After surgery, patient can have:

• 3/10 scale of pain – bone has no nerve ending

• Mild discomfort from drain, removed on day 1 or 2

• Bandages for 5 days

• Recovery one week off with both weekends

Durable Suture Technique

This patient is an ideal candidate for the suture method crease formation. The skin is thin, without excessive amount of skin or fat. There are no major asymmetries or weaknesses in the upper eyelid, which would interfere with this technique of crease formation surgery. If any of these factors are present, then an incision method is indicated. This patient is very early after surgery but is able to return to work at four days.

Preoperative.

Day 4 after surgery

Another patient that underwent Durable Suture Technique

Eyelid Crease Recreation

This case demonstrates that when excess upper lid skin is removed, a crease needs to be recreated even when a crease already exists.

This patient had a well-defined double eyelid crease and requested removal of excess upper lid skin.

A skin-only removal was performed, preserving her relatively large, preexisting crease. At 5 months after surgery, their is no significant visible crease, although the excess skin has been removed.

A recreation of the upper lid fold using an anchor incision technique improved the amount of visible crease, without removing much skin. Picture 3 at 6 weeks post surgery.

All Natural Chin Augmentation

What you’ll need to know about Sliding Genioplasty

Dr. Charles Lee answers RealSelf (Review Site) Customer Questions

Can Someone Tell Me Why One of my Eyes Look Smaller in Pics? (photo)

http://www.realself.com/question/eyes-smaller-in-pics

What Technique Can Be Used to Minimize Scarring Following an Eyelid Surgery?

http://www.realself.com/question/technique-minimize-scarring-eyelid-surgery

What Technique is Best to Avoid Misdirected Lashed After Asian Eyelid Surgery?

http://www.realself.com/question/technique-avoid-misdirected-lashed-after-asian-eyelid-surgery

Do I Need to Have my Nose Tip Projected More, or Possibly my Bridge Enhanced?

http://www.realself.com/question/nose-tip-projected-possibly-bridge-enhanced

Silicone Implant to Get Sharp Tip in Asian Rhinoplasty?

http://www.realself.com/question/asian-rhinoplasty–silicone-implant-achieve-sharp-tip

Asian Rhinoplasty – What’s Right for the Asian Nose Job?

http://www.realself.com/question/whats-difference-between-asian-rhinoplasty-and-western-rhinoplasty

Is Alar Rim Graft Suitable for Asian Male?

http://www.realself.com/question/alar-rimgraft-suitable

Nasal Implant Removal After Asian Rhinoplasty?

http://www.realself.com/question/can-nasal-implant-be-removed

How Safe is the Costal Cartilage Graft when Used During an Asian Rhinoplasty?

http://www.realself.com/question/safe-the-costal-cartilage-graft-when-asian-rhinoplasty

Brow Lift and Asian Blepharoplasty with Canthoplasty to Improve Eyelids?

http://www.realself.com/question/brow-lift-asian-blepharoplasty-canthoplasty–eyelids

How Long Do Double Eyelid Surgery Results Last?

http://www.realself.com/question/double-eyelid-surgery-result-last

Asymmetrical Eyelids After Blepharoplasty

http://www.realself.com/question/asymmetrical-eyelids-post-blepharoplasty

Asian Double Eyelid Surgery Recovery Time

http://www.realself.com/question/recovery-time-asian-double-eyelid-surgery

Eyelid Surgery to Look Asian

http://www.realself.com/question/Eye-enlargement-surgery-options-caucasians#421775

Does Raising the Nasal Bridge Have Essentially the Same Effect As Epicanthoplasty?

http://www.realself.com/widget/answers-full/11815?&local=1&all=1&answer_id=421771

How Does Cartilage Get Adjusted During an Asian Rhinoplasty?

http://www.realself.com/widget/answers-full/11815?&local=1&all=1&answer_id=421758

What Asian Rhinoplasty Procedures Gives the Illusion of a Longer Nose?

http://www.realself.com/widget/answers-full/11815?&local=1&all=1&answer_id=418755

Options For Making my Wide Asian Nose Smaller? (photo)

http://www.realself.com/widget/answers-full/11815?&local=1&all=1&answer_id=410009

Laser surgery for Tired Asian Eyes?

http://www.realself.com/widget/answers-full/11815?&local=1&all=1&answer_id=385470

I Have Double Eyelids but Want to Get Bigger Eyes–what Kind of Surgery Do You Recommend?

http://www.realself.com/widget/answers-full/11815?&local=1&all=1&answer_id=381142

Is Asian Eyelid Surgery an Option for Ptosis?

http://www.realself.com/widget/answers-full/11815?&local=1&all=1&answer_id=381140

Can Extended Columella Strut and Caudal Extension Grafts Be Used Simultaneously?

http://www.realself.com/widget/answers-full/11815?&local=1&all=1&answer_id=353620

Anchor incision surgery with inner corner correction

Right eye was slightly droopier prior to surgery but was able to be corrected at the time of crease placement using the anchor method. The anchor technique allows precise movement of the eyelid opening muscles at the time of crease placement. The swelling is slightly longer than the standard eyelid techniques, but the long term results justify the additional surgery.

Before Anchor Incision Surgery

Day 8 Post-Surgery

5 months after Surgery