Dr. Commons and facial surgery.
Before a plastic surgeon can embark on a surgical procedure about the eyelids, there must be a clear definition of what will constitute beauty in each specific patient. Eyelids differ in men , women, different races, different ages, different facial types, etc. Let us undertake first a thought process of what should be attained in the 55 plus or minus year old female of general non Asian eyelid anatomy. Later we will discuss Asian patients, males, and on and on. We will discuss in this essay only upper eyelids to be more specific because it is the upper eyelids that differ most between the mentioned groups. Upper eyelids in the non Asian female of 55 tears or so must have the following characteristics. The upper lids ideally should have a open natural alert look. The upper eyelid crease should be about 10 mm from the lash line. The crease should display a beautiful flowing natural curve from the inner canthal area to 10 mm to 13 mm beyond the lateral canthal area. Ideally no puffiness is noted in this upper lid at any point along its length. On the other hand it is preferable that the lid not have a too deep hollow look. The surgeon must be prudent in his removal of fat, In fact great thought must always be given to the removal of any fat about the eyelid area because of possible hollowness later. The upper eyelid ideally rests above the pupil but below the upper border of the iris. The upper lid closes easily in a blink or at rest or sleep. The function must always be normal and function must be a foremost consideration of the plastic surgeon. An enhancement of the beautiful upper eyelid as well as the lower eyelid is the presence of long attractive eyelashes. Latisse, an eyelash enhancer made by Allergan is a product that really works and works consistently and extremely well for nearly everyone. To attain the above beautiful eyelid the surgeon must have extensive training and exert great thought and planning. A surgeon that is boarded by the American Board of Plastic Surgery is ideal. Just the perfect amount of skin must be excised in exactly the perfect incision. The orbicularis oculi muscle must be examined and properly adjusted. The fat must be assessed and properly adjusted. A beautiful flowing subcuticular suture must be used for closure that can be removed by a single pull out effort. The sutures should be removed by the 5th day. The procedure should be quite easy and a joy for the patient. Return to work or play should be possibly after a week. A desire for significant confidentiality can make this 2 weeks. This factor varies.. In my next essay session I will discuss the lower eye in all ages, and races, and sexes, because the lower lid is somewhat more universal in its nature. Nevertheless there are difference that must be addressed and the different looks possible must be discussed with the patient.
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