Your Questions
Your Questions
Q: Dr. Eppley, I have had cheek impants and a chin implant to attain a more asethetic facial balance as I had very little cheekbone prominence. But I also have benign parotid hypertrophy for about six years now which I now think attributes greatly to my facial imbalance. I would like to entrust someone to use their best judgment as to what i might need to make it more harmonious. Do you a parotidectomies will help? I also model so its really important that my face is in balance and looks good. I want a more sculpted face. I also was interested in a lateral canthoxpexy to elongate my eye shape…a more almond shaped eye? I’m attaching photos…thanks!
A: While I think there is no question the lateral face reduction by superficial parotiodectomies would be aesthetically beneficial, you have to balance that with the risks of visible scars, facial nerve injury and salivary gland leaks. This would be particularly relevant for anyone but particularly someone who models. That is a question up for further discussion. Lateral canthopexy can be effective for moving the corner of the eye out more to the side, thus elongating the eye shape. This is a much easier decision to consider.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I wrote you about orbital rim implants some time ago. I am 42 years old and am interested in rim implants or canthopey or both. Do you see any problem in having only canthopexy to reduce scleral show and slightly tilt the eyes? The thing is when I tried fillers (which didnt change my problem much at all to be honest) the surgeon said that permanenet implants feel rigid that you can feel them all the time? I really would like to simply narrow and sharpen my eye shape, just concerned that a lot of people get either a “stretched look” or nothing at all?
A: When it comes to lifting up the lower eyelid to reduce scleral/orbital show, lateral tendon procedures are not going to shorten the ‘clothesline’ and lift the lower lid margin. That is simply asking too much of the procedure. There is a good correlation between the lower eyelid margin and the underlying bone support. The lower the bony orbital rim, the more likely the lid margin may also be lower or at least have less support. Therein lies the value of orbital rim implants, raising the bony rim and helping to push up the eyelid. and its lid margin. Lateral canthopexy has as role in the placement of orbital rim implants by providing suture support to the closure of the lower eyelid incision to decrease the potential of postoperatve ectropion.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, can excess skin be removed and remaining skin lifted up and under the eye? Can the outer corners of the eyes be lifted for “sad eyes” at this same time? How is this done? I have tired and sad looking eyes that need some help as they make me look so bad. The outer part of my eyes has always been turned down since I was young and I have never liked it.
A: Traditional lower blepharoplasty or eyelid tuck techniques can remove fat that causes bags and to tighten loose skin under the eyes. At the same time, the outer corner of the eye can be changed. The position of the corner of the eye is controlled by a tendon that attaches it to the inside of the bony socket of the eye. This tendinous position can be changed to raise the corner of the eye, known as a cantopexy procedure, making it either level to the inside of the eye or higher if one desires more of an upward tilt to the eye. This can be done at the same time as a lower blepharoplasty (or an upper blepharoplasty) through the same incision.
Dr. Barry Eppley
Indianapolis, Indiana