Q: I am developing deep folds on the sides of my mouth and my eyelids have extra skin that make me look tired. I have attached a picture so you can see my concerns. What type of plastic surgery will get rid of these problems?
A: Thank you for your inquiry and picture. There are two comments that I can make based on your pictures. First, you have a thin and lean type of fat. As a Caucasian, this makes your skin thin and extremely prone to wrinkles particularly around the mouth area. Such wrinkles around the mouth, known as smile lines outside the corners of the mouth, are virtually resistant to any treatment other than temporary injectable fillers. There is no surgery that can provide a cure or any long-lasting treatment for that resistant wrinkle problem. It is resistant because the one thing that would help in not making them continue to develop is to stop smiling or moving your mouth…not only an impossible but not a good social habit to develop.
From an eyelid standpoint, you have deep set eyes (again due loss of fat around the eyeball area or, in your case, you may have never had it to start with) with some moderate skin redundancy of both upper and lower eyelid skin. The real issue is whether the skin on your upper eyelids needs to be removed (eyelid tuck or blepharoplasty) or whether lifting of the eyebrows is better. You can determine that by doing a simple lift test on your eyebrows and see what it does to the skin on your upper eyelids and the new brow position.
For all of these reasons, I don’t think computer imaging is helpful in making these facial aging treatment decisions. It would be better to come in and sit down and go over the options that are available…and see what they can and cannot do.
Dr. Barry Eppley