Blepharoplasty
Deep Plane Facelift with Facial Fat Grafting, Lower Blepharoplasty and Fractional CO2 Laser ResurfacingRestoring Lift and Lost Fullness at 61Before and After
For this 61-year-old patient, Beverly Hills plastic surgeon Suzanne A. Trott, M.D., F.A.C.S. combined an upper, mid and lower facelift with transconjunctival lower blepharoplasty to remove lower eyelid fat, microfat grafting to the nasolabial folds, marionette lines, jaw, temples and under eyes, and fractional CO2 laser resurfacing of the skin. Each procedure has a specific responsibility. The facelift addresses tissue position and facial contours. Microfat grafting, a form of facial fat transfer, uses the patient’s own fat to replenish selected areas of volume loss. Together, they address both the descent and the depletion associated with aging. The fractional CO2 laser resurfacing addresses the skin itself, improving its texture and quality: changes no lifting procedure can achieve on its own. Fat grafting was mapped to specific areas rather than spread evenly. Small amounts went into the nasolabial folds and the marionette lines, where deepening creases pull the lower face down. The jaw and the temples were treated for lost definition and the hollowing at the side of the head, and the under eyes were filled to take the shadow out from beneath the lower eyelid. The lower eyelid work does two things at once. Fat is removed through an incision placed inside the lower eyelid, so no scar shows on the outside skin. Fat grafting is then placed into the under eyes to correct the hollowness that makes someone look tired. Taking the puffiness down and filling the hollow in the same operation is what makes the eye area look rested rather than operated on. With these facelift before-and-after photographs side by side, look beyond the outline of the face. Examine the lower eyelids, the cheeks and the relationship between fullness and definition. That is the thinking behind Dr. Trott’s approach to this case. The planning extends beyond how much to lift. It considers where fullness belongs and how the individual corrections will work together. The procedures are separate. The face is not.
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Male Upper & Lower BlepharoplastyBrighter, More Rested Eyes in His 60sBefore and After
This patient in his 60s is shown after upper and lower blepharoplasty. The upper eyelids no longer hood the lid margin, and the upper eyelid crease is visible again. The lower eyelids show less puffiness beneath the lash line because the fat pockets have been conservatively reduced and repositioned. The eye shape itself has not been altered; the lateral canthal angle and the overall masculine contour of the orbit remain intact. What has changed is the tired, heavy quality that excess skin and under-eye fullness were creating. The eyes now appear more open and alert, and the transition from the lower eyelid to the cheek is smoother. The incisions are hidden in the natural upper eyelid crease and just below the lower lash line, where they become difficult to detect once healed. The result is that he looks like himself on a well-rested day, not like someone who has had surgery.
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Deep Plane Neck Lift with Bilateral Upper & Lower Blepharoplasty, Lower-Eyelid Fat Transposition and Facial Fat GraftingA Smoother Neck, More Rested Eyes in Her 70sBefore and After
This patient in her 70s had a deep plane neck lift, bilateral upper and lower blepharoplasty, and facial fat grafting with Dr. Suzanne A. Trott in Beverly Hills. Her before and after photographs show a smoother neck contour and a more rested eye area. Her bilateral upper blepharoplasty included nasal fat pad removal. For the lower eyelids, Dr. Trott used transconjunctival lower-eyelid fat transposition, working through an incision inside the lower eyelid to reposition existing fat into the hollow beneath the eye. Facial fat grafting was performed to the nasolabial folds, marionette lines, and lower eyelids. This is separate from lower-eyelid fat transposition: transposition repositions existing eyelid fat, while fat grafting adds transferred fat to the areas being treated. The goal was to address neck contour, eyelid heaviness, and facial hollowing together while preserving her recognizable expression.
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Case 106047
Deep Plane Facelift and Neck Lift with Upper Blepharoplasty and CO2 Laser ResurfacingKeeping His Masculine Look at 73Before and After
With men, I pay close attention to what gives their face its character. You can improve the jawline, neck, and eyelids, but you have to understand how those changes will affect the whole face. His concern was specific, and it’s one I hear often from men: he didn’t want to lose the masculine appearance he’d carried his whole life. That concern shaped the plan. For this 73-year-old patient, I performed a deep plane lower facelift and neck lift, upper blepharoplasty, and fractionated CO₂ laser resurfacing of the face and neck. The lift addressed the sagging along his jawline and neck. The upper eyelid surgery removed excess skin that was making his eyes look heavy. The CO₂ laser addressed skin texture and fine lines. Look at his eyes and the shape of his face. He still has the features and expression you recognize. There’s more definition along his jaw, his neck looks tighter, and his eyes look more rested. That’s what I like about this result. You see the improvement, but you still see him.
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Upper and Lower BlepharoplastyBrighter, More Rested EyesBefore and After
This patient is shown six months after upper and lower blepharoplasty with Suzanne A. Trott, M.D., F.A.C.S., in Beverly Hills. The upper eyelids have a cleaner crease and less hooding, so the eyes look more open without changing their shape. The lower eyelids look smoother because the fat was transposed to fill the tear trough rather than removed, which preserves youthful volume beneath the eyes. This approach avoids the hollow look that can follow lower eyelid surgery when fat is simply taken out. Overall, the eyes look rested and refreshed, and the result still looks like her.
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Case 104569