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Eye Bags Removal Treatment, and What Causes Having Two Kinds of Eye Bags
Eye Bags Removal Treatment, and What Causes Having Two Kinds of Eye Bags

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

A woman has two layers of eye bags and wants to know how to treat each type.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon practicing in Manhattan and Long Island for over 20 years, deals with this situation every day. He first explains to his patients the cause of the bags. In this woman’s situation, one of her bags is from the eyelid margin or the eyelashes to an area before the second bags begin. That space that became puffy is actually a muscle called the orbicularis oculi. This muscle is activated when someone smiles and has the tendency to bulge when it contracts. Dr. Prasad doesn’t really recommend doing anything for it because it’s a muscle needed to support the lower eyelid. He periodically does a trial of a neurotoxin like Botox® which is non-surgical to see if it contracts less. However, he can’t relax it too much otherwise the patient is at risk for the lower lids sagging.

The puffiness under that area despite the use of creams is due to lower eyelid fat prolapse. From this woman’s photos, it is clear that there is a bulge of fat that has moved forward. The procedure for that is lower eyelid blepharoplasty. If there was a non-surgical option then blepharoplasty would not be one of the top 5 most popular cosmetic surgical procedures. In addition, a lot of devices are marketed to try to non-surgically treat this area and people try to camouflage this with all kinds of injectables. Unfortunately, at a certain point, none of those things can really make a difference because the anatomy is very straight forward - it’s fat that’s pushed forward. MRI studies have actually shown this to be fat that has increased in volume. It generally runs in families, and Dr. Prasad has had the privilege of operating in 3 generations of the same family.

Dr. Prasad’s recommendation would be to do a transconjunctival blepharoplasty. He would address the fat pockets from the inside of the eyelid to avoid any external scar. At the same time, he reduces the puffiness and creates a contour either through the removal, sculpting and repositioning of fat so that it looks like patients never had the bags to begin with. The fat pockets don’t come back. He performs this surgery under local anesthesia with LITE™ IV sedation in his Joint Commission-certified facilities.

For over 20 years, Dr. Prasad has worked on developing systems and processes so that people would not have an aversion to surgery. He does everything to make people comfortable. Lower eyelid surgery can be complex. Unfortunately, many people do have some complications. As a specialist, he gets to fix those complications. He sees patients from around the world to have these procedures revised whether it’s residual fat or fat transfer that have to be removed. Patients also have lower lid retraction where the eyelid was pulled down, and ectropion where the eyelid everted out. In spite of all those potential complications, it can be a remarkably satisfactory surgery when performed well and in good hands. Every surgeon has to deal with these issues no matter how good they are and how much experience they have.

Dr. Prasad recommends that she meet with qualified, experienced cosmetic surgeons and have a physical exam. She must determine the kind of doctor she feels has the level of expertise, knowledge and experience that she trusts to have her eyelid surgery performed. Otherwise, she will be spending a lot of time and money on things that are not likely to work.

Why Puffy Eye Bags Can also Cause Hollow Eyes, and Treatment for Both Problems
Why Puffy Eye Bags Can also Cause Hollow Eyes, and Treatment for Both Problems

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

For more information on platelet-rich plasma (PRP), go to:

http://prasadcosmeticsurgery.com/injectables/platelet-rich-plasma/

For more information on fractional CO2 laser, go to:

http://prasadcosmeticsurgery.com/prasad-medi-spa/laser-light-treatments/microfractional-co2/

A woman has volume loss under her eyes and dark pigmentation causing them to appear sunken. She wants to know recommendations for her under eye area.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon practicing in Manhattan and Long Island for over 20 years, can tell by looking at this woman’s lower eyelids are sunken. This area is also known as the tear trough where people are most concerned about hollowing. Above this area is the orbital space where patients may experience lower eyelid fat prolapse. It appears that she has a bulge of fat that is making the adjacent area look hollow. Dr. Prasad assesses this by doing a physical examination where he asks the patient to look up to see if there’s any fat pushing forward.

Beside the tear trough area is where the bone and the cheek meet called the eyelid-cheek junction. This is where it’s very common to lose volume caused by being athletic, genetics and losing volume as you get older. Sometimes, we refer to that as the V deformity or the loss of volume at the eyelid-cheek junction.

Dr. Prasad does a systematic approach when treating patients. If they have lower eyelid fat prolapse, depending on the degree of fat prolapse, he can either choose to do something conservative such as a hyaluronic acid filler like Restylane, Juvederm or something in that family. These fillers are placed in the tear trough to reduce the obvious transition between the puffy under eye bags and the relative hollow underneath. If the fat pockets are more prominent, then he would usually recommend lower eyelid blepharoplasty. In a younger person who doesn’t have extra skin or there’s no other indication to go from the outside, he would typically perform a transconjunctival blepharoplasty.

Dr. Prasad always educates his patients that the eyelid skin is the thinnest skin of the body. Factors such as stress, environmental exposure like sun and smoking can cause this area to thin, look very ashen, irregular and very crêpey. To help skin quality, he uses a material that’s derived from the patient’s own blood called platelet-rich plasma. Platelet-rich plasma refers to the cells called platelets and the plasma that goes with it in the absence of red blood cells and they are responsible for wound healing. From the technology already established in orthopedic and oral surgery, it was discovered that placing the patient’s own growth factors under the skin results in stimulating new collagen and improving quality of skin with more blood supply. In fact, he developed a method of hair loss treatment combining platelet-rich plasma with a material called acellular matrix or extracellular matrix. In select people, he would also consider a laser such as a fractional CO2 laser.

These options would help patients understand their situation more. Dr. Prasad suggests that this woman meet with qualified and experienced surgeons who can help guide her. Not all doctors have the same level of expertise in a given area so she has to identify in her level of comfort a doctor who has the level of expertise that she can trust.

How Sagging Jowls are Treated with Face Lifting Procedures and Facial Fillers
How Sagging Jowls are Treated with Face Lifting Procedures and Facial Fillers

A 40-year-old woman has jowls that bother her a lot. She wants to know if she needs a facelift.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, says that this is a very common issue particularly for a lot of women in their 40s. He explains that there are two aspects of facial aging: one is descent or sagging, the other is volume loss. Facial descent means that the skin and soft tissues are sagging or drooping, which ispartially responsible for the jowls and the little band of skin below the chin which has resulted in a loss of angularity. The other part is volume loss which is gradual diminishment of bone, muscle, fat, skin and soft tissue.

For years, there have been debates between non-surgeons and surgeons about the better procedure for facial aging. Before deciding a procedure, Dr. Prasad often asks patients to do a simple test by lifting the skin upward and seeing what happens to their jawline and neck, often referred to as a "mirror lift". This moves tissue upward to see if it improves the jawline and neck. If it does, a significant element of their concern, specifically the jowls, is related to some descent.

Usually, when someone has this type of situation and they are relatively young, a limited incision face lifting procedure can be considered. In Dr. Prasad’s practice, he does these procedures under local anesthesia with LITE™ IV sedation. It’s still not a shortcut procedure because deeper tissues specifically the layer called the SMAS or superficial musculoaponeurotic system, needs to be addressed in order to maintain the position of the skin. Unfortunately, a lot of doctors advocate deep plane and other lifting procedures. However, an experienced cosmetic surgeon who does a lot of facelifts will customize these procedures based not only on the external physical exam but also what they see when doing surgery. A lot of decisions have to be made in real-time during surgery depending on the quality of the tissue and the effectiveness of the movement. Dr. Prasad thinks that repositioning sagging tissue is probably the most optimal way to restore a youthful appearance when there is descent.

In Dr. Prasad’s practice, he also uses fillers to restore volume. Sometimes he does this when patients don’t have the time yet to do a facelift. In the meantime, he does things to soften the appearance of the jowl using fillers like Radiesse. He routinely places it in an area that is right in front of the jowl called the mandibular notch. Adjacent to that is the area called the mesolabial fold which is often referred to as the marionette line. These areas benefit from augmentation or replacement of some of that loss of volume. Ideally, the sequence would be to lift and then add volume. When the face is thin, there are opportunities in different areas to restore volume. Dr. Prasad’s approach is to always be conservative. He wants to restore just enough so that artistically, the balance of the face is maintained.

Dr. Prasad thinks that she would benefit from meeting with experienced cosmetic surgeons. In his practice, he offers everything from advanced surgery to skin care products and everything in between. He is able to customize a plan for each patient. With 20 years of practice, he always tries to figure out ways to create the right solution for the right time to match the person’s desires and budget.

For more information about face lifting surgery, please visit our website:
http://prasadcosmeticsurgery.com/prasad-face-eyes/facelifts/

To learn more about injectables, please visit:
http://prasadcosmeticsurgery.com/injectables/

Radiesse:
http://prasadcosmeticsurgery.com/injectables/radiesse/

Why the Fat that Causes Eye Bags Won't Go Away with Weight Loss
Why the Fat that Causes Eye Bags Won't Go Away with Weight Loss

A woman lost weight and says she has awful eye bags and lost the youthful volume in her cheeks. She wants to know the best and most affordable method in solving her issues.

Dr. Amiya Prasad, a specialist in facial aging and cosmetic oculofacial plastic surgery practicing in Manhattan and Long Island for over 20 years, deals with this type of problem every day in his practice. He approaches this situation by first defining the problem and discussing the different options based on the level of long-term benefits as well as affordability.

Bags under the eyes are the result of lower eyelid fat prolapse. Lower eyelid prolapse means that the fat that is normally around the eyes has pushed forward and results in puffiness under the eyes. Under eye bags or the fat around the eyes is the last fat in the body to go away when someone loses weight. This is common in people in malnourished situations where much of their body’s natural tissues in addition to muscle are broken down, so Dr. Prasad warns against trying to lose more weight to get rid of the fat that causes eye bags.

The approach to the lower eyelid fat prolapse is to perform lower eyelid blepharoplasty. This can be done in two different approaches: one is from the outside called a transcutaneous approach and another is from the inside called the transconjunctival approach. For most of Dr. Prasad’s patients, he performs from the inside of the eyelid called transconjunctival blepharoplasty to avoid an external incision. The decision on approach is based on physical examinations. The lower eyelids are deceptively complex and many plastic surgeons end up having the lower eyelid pulled down or retracted and sometimes even everted. The lower eyelid has a lot of critical anatomic structures that need to be in balance in order to get good results.

When Dr. Prasad evaluates the lower eyelids, he also looks at skin quality and texture. He would consider procedures such as fractional CO2 laser as well as the use of platelet-rich plasma (PRP)derived from the patient’s own blood in order to stimulate new collagen and to improve the skin quality.

The apples of the cheeks are an area which is referred to as the malar fat pads or the submalar space. When someone has lost volume in this area, Dr. Prasad performs different facial rejuvenation surgeries such as face lifting, cheek implants, etc. He tries to decide how much volume was lost from weight loss and from sagging or descent. When the face descends when one gets older, plumping it out might not look so good because the skin doesn’t have the tone or the resilience to hold that volume. In the mid facial area, augmentation can be performed with a facial implant such as a submalar implant, or a filler such as Radiesse or Restylane. Dr. Prasad also tends to use platelet-rich plasma to further enhance the volume in this area. He would also do fat grafting which is taking fat from one area of the body and place it into this area to augment it further.

In terms of affordability, Dr. Prasad comes up with different scenarios for his patients. As long as the patient understands what those scenarios and the costs are, he tries to come up with a structure that is affordable but is also satisfactory. A lot of people buy lower price options and they end up wasting a lot of money. High quality and cost do often go hand-in-hand. This is an investment where patients will reap the benefits after a long time. As long as the patient communicates with their doctor, they should be satisfied.

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

For more information on platelet-rich plasma (PRP), go to:

http://prasadcosmeticsurgery.com/injectables/platelet-rich-plasma/

For information on facial implants, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/facial-surgery/facial-implants/

The Limits of Fillers for Swollen Under Eyes and Why Lower Eyelid Surgery is a Better Option
The Limits of Fillers for Swollen Under Eyes and Why Lower Eyelid Surgery is a Better Option

A woman thinks she has swelling under her right eye only. Doctors gave her different opinions on treatment, with one saying fillers and the other saying eyelid surgery. She wants to know the best under eye treatment.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, says that the swelling below this woman’s eyelids is called lower eyelid fat prolapse. Fillers are also useful for someone who has a small amount of fat prolapse. Dr. Prasad uses fillers to camouflage that little fat prolapse before they are ready for a blepharoplasty. He continuously sees patients who have had fillers to correct their significant fat pockets under their eyes. Their fillers have caused their puffy bags to become more pronounced. Most of these people who come for revision or some kind of correction ultimately require an injection of a material called hyaluronidase to dissolve their filler.

Dr. Prasad recommends blepharoplasty because fillers are not going to be beneficial to someone like this woman. That doesn’t mean that fillers aren’t helpful in other areas. When someone has volume loss in the cheek area, Dr. Prasad may add volume in the cheek area to correct the imbalance between the lower eyelid fat prolapse and the hollowing of the cheek. However, for herniated fat, lower eyelid blepharoplasty is the best solution.

If patients are afraid of surgery, they may be better off doing nothing than getting an injectable. However, in this woman’s situation, surgery would be beneficial. In Dr. Prasad’s practice, he alleviates the fear of surgery in his patients. His Joint Commission approved facilities are within his office and he tries to make the surgery less scary by having a more family type of environment where they know everybody and they’re comfortable, as opposed to going to a hospital or surgery center where there’s de-personalization. The procedures he does for lower eyelid blepharoplasty are done under local anesthesia with LITE™ IV sedation which means that there’s often very quick recovery. In fact, the amount of swelling and bruising is often less than people having injectable fillers. With surgery, he has a lot of control so his patients don’t look very swollen or bruised after a week.

With that said, Dr. Prasad thinks that she needs to first evaluate who the doctors she saw were and she must understand her options. It’s all about selection and making intelligent decision.

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

Facial Aging Treatments in Early 40s Depends on Individual Cases Rather Than Definite Age
Facial Aging Treatments in Early 40s Depends on Individual Cases Rather Than Definite Age

A 41-year-old woman has sagging skin. She wants to know if the best facial aging treatment options for her at a relatively young age includes a facelift, or non-surgical fillers.

Dr. Amiya Prasad, a board certified cosmetic oculofacial plastic surgeon practicing for over 20 years, says most of his patients for face lifting surgery are women over 45-years-old. The youngest patient he has done facelift for was 37-years-old and close to that was a woman who was 42. From his experience, he concludes that it really depends on what the situation is more than a definite age.

One of the goals of face lifting surgery is to restore the definition of the jawline and to lift sagging tissue from the cheek to the jawline or to the neck. When Dr. Prasad determines if a patient is a candidate for face lifting surgery, he looks at how much they can slide up the skin. A lot of women will do a mirror lift at home by pulling the skin up. If there’s a lot of slide and their jawline improves, then they may be a candidate. This lady may not need an extensive full face and neck lift, but she may be a candidate for one of the smaller scar limited incision types of facelifts. However, the one thing Dr. Prasad cannot do with photos is a physical examination.

People with similar cases to this woman may be able to explore some other options. Some patients in Dr. Prasad’s practice will do something like a limited liposculpturing and reduce fat in the jawline so that the jawline is seen more clearly. He also may address the indentation at the jawline called the mandibular notch. This is the area where there may be accentuation of the jowl. He can fill that area with Radiesse® or another filler.

This woman may be a candidate for a facelift but she really should meet with cosmetic surgeons and learn about other options. She may be able to buy some time with just fillers by filling in some relative hollows to create a smoother jawline. Many of Dr. Prasad’s patients who know they will be having a facelift in the future are often time limited or have already used vacation time. In the meantime, they can do a few things to strategically improve the appearance of their jawline. Sometimes, it involves putting fillers in the nasolabial folds or the cheeks so that they look more youthful. Facial aging, particularly in women, is very much accentuated in the lower facial area or the lower third of the face.

Dr. Prasad recommends she meet with qualified experienced surgeons who specialize in facial aging. She should learn more about her options and together with her doctor develop a game plan that works for her.

For more information about Face lifting surgery, please visit our website:

http://prasadcosmeticsurgery.com/prasad-face-eyes/facelifts/

To learn more about Radiesse, please visit:

http://prasadcosmeticsurgery.com/injectables/radiesse/

Why Choosing a Cosmetic Surgeon for Facelift Surgery Based on Price Leads to Compromised Results
Why Choosing a Cosmetic Surgeon for Facelift Surgery Based on Price Leads to Compromised Results

A woman has just finished a very stressful period in her life and is considering a facelift. She wants to know the least expensive approach but also the most effective for her.

Dr. Amiya Prasad, a specialist in facial aging and as a cosmetic oculofacial plastic surgeon for over 20 years, says that he has seen many patients who made bad decisions because they based their doctor of choice on their budget. There are lots of costs to delivering quality care which includes the surgeon’s fee, anesthesia and facility costs. Patients have to be cautious whenever someone offers them a lower price solution for something that another doctor is offering at a higher price. Cosmetic surgeons will often charge a higher price when doing a high level of quality work than doing volume procedures. From his experience, any doctor or surgeon who does volume work rarely does high quality work. The artistry of cosmetic surgery requires focus and time. If he had to do upper and lower eyelids, face and necklift and cheek and chin implants, it’s going to be a different experience for the fourth patient compared to the first. It’s very difficult to do high quality work consistently. In his practice, he is more about the quality and the boutique style in trying to perform exceptional procedures for each patient.

In this woman’s case, if she likes a doctor and she feels comfortable, then this doctor may be able to counsel her as long as she is willing to do something that may be less expensive that are satisfying the major concerns that she has. Dr. Prasad would caution her not go with price. There are many companies that have been proliferating by trying to do high volume and have very convincing marketing messages, but the quality is just not there. Patients have to figure out a way to invest the right money with the doctor they trust. He has seen patients who come from all over the world that had shortcut procedures and didn’t have a beautiful, crisp jawline and a nice, smooth neck.

Dr. Prasad suggests that she doesn’t do anything in haste and think of what her priorities are. She must look at her budget and defer the procedure until she can afford it so that she can get it done the right way. Unfortunately, when people have cheap cosmetic surgery and they get bad results, they end up having multiple times the cost to correct the procedures. The reality of life is that a person can never get something cheap that’s equal in value to something that's expensive. She must go back to the plastic surgeon or cosmetic surgeon who she likes and discuss her issues and concerns. She must develop that relationship so that she can start in her healing process after her long, stressful period.

For more information about face lifting surgery, please visit our website:

http://prasadcosmeticsurgery.com/prasad-face-eyes/facelifts/

How to Achieve Symmetry in Eyelid Ptosis Surgery
How to Achieve Symmetry in Eyelid Ptosis Surgery

A woman has unilateral ptosis. She wants to know the procedures that would achieve symmetry in both eyes.

This is a situation that is very well known to oculplastic or oculofacial plastic surgeons. These are surgeons who are trained first in eye surgery though ophthalmology and then specialized in surgery of the eyes. Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon practicing in New York for over 20 years, explains about his process and how he makes decisions about whether or not to operate on one eye or to operate on both eyes.

In terms of making the decision in operating in one eye or two eyes, Dr. Prasad measures the upper eyelid height, called the margin reflex distance, which is the distance from the eyelid margin to the light reflex of the pupil. He also tests the muscle function which is the amount of movement that the eyelid makes when looking down and up. Then he does a test for Hering’s Law, a physiologic manifestation of how the brain sends a signal to the upper eyelids to open. He lifts the eyelid that’s more droopy and looks to see what happens to the other eyelid. Very often, when the droopy eyelid is lifted, the other eyelid will actually droop.

For people who have congenital ptosis, it is not unusual for the ptosis to be manifested in both eyes, but it can be more significant in one eye. In such cases, Dr. Prasad makes the decision with the patient to operate in both eyes because it is not advisable to lift one eye and then the other eye drops. During surgery, Dr. Prasad lifts the eye less in order to try to get the symmetry. In addition, he lets the patient sit up to make sure that the height, contour, shape and maximized symmetry are achieved.

As for the eyelid crease if there’s more soft tissue and fat on one side versus the other, then Dr. Prasad will do a blepharoplasty or remove some extra skin and fat to try to maximize the symmetry. If she wants fullness in the contra lateral eye that has less volume, then procedures such as fat transfer or even hyaluronic acid filler can be entertained. However, Dr. Prasad tends to discourage that because getting the eyelid height, contour, shape, balance and symmetry is already a significant challenge. A small percentage of patients may have the eye too open or over corrected, or even too low or under corrected - it’s always about customizing to the individual situation.

Dr. Prasad recommends that she meet with experienced oculofacial plastic surgeons. He doesn’t think that general plastic surgeons who are boarded by the American board of plastic surgeons are interested in doing this. He thinks she’ll find oculoplastic surgeons who are comfortable and more than qualified to do this surgery.

For more information on ptosis correction surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/eyelid-ptosis-surgery/

Causes of Swelling after Asian Eyelid Surgery & How an Eyelid Specialist Reduces Recovery Time
Causes of Swelling after Asian Eyelid Surgery & How an Eyelid Specialist Reduces Recovery Time

A female is 3 months post-op and her eyes are still swollen. She wants to know if this is normal.

Oculofacial plastic surgeon Dr. Amiya Prasad explains that surgical healing involves the areas where the surgeon has done surgery whether it’s a simple laceration closure or a more complex surgery. This recovery timeframe which can take up to a year. Incision healing and swelling are not correlated. Swelling is caused by a variety of reasons, one being reactive swelling or swelling that occurs after surgery. Another cause is fluid stasis where there’s fluid just sticking around in the circulation or in the lymphatic system.

Wound remodeling is a dynamic process that takes place on a cellular level. The results of any surgery can take as long as a year for any patient to fully appreciate. Fortunately, this doesn’t mean that patients can’t look good after surgery. In Dr. Prasad’s practice, when he does Asian eyelid surgery, most of his patients get back to work in a week and most of them can look pretty good within a month. There’s a mild degree of swelling which he checks at 3 months, and again if the swelling persists, but in his practice swelling rarely lasts that long. He has developed a process to minimize the active swelling in procedures such as Asian eyelid surgery using the non-incisional method or the excisional method. He also does more complex procedures such as ptosis surgery where he works on the levator muscle and advances it and it is a longer procedure. In these procedures, he still gets his patients to look pretty good faster, but swelling and other factors can take a little time.

Dr. Prasad thinks that she must communicate with her surgeon who she must have chosen based on her research on the level of his experience, and he will be able to guide her on what to expect. 3 months is still a little premature to anticipate or to project that this is the appearance she’ll have beyond a year. It’s important that she make observations. At the same time, she must keep an open line of communication with her surgeon so that she can be evaluated, examined and understand where she’s heading.

For more information about Asian eyelid surgery, please visit our website:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/asian-eyelid-surgery/

Why Sudden Puffy Eye Bags with Existing Medical Conditions are Best Treated Non-Surgically First
Why Sudden Puffy Eye Bags with Existing Medical Conditions are Best Treated Non-Surgically First

A relatively healthy 33-year-old healthy with anemia, colitis, and petrositis has sudden under eye bags. She wants to know the appropriate measures for her minor eye bags.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon specializing in this area for almost over 20 years, says that many people come to him with different variations of a story like this woman. Bags under the eyes represent lower eyelid fat prolapse which means that the fat that is normally around the eyes pushes forward. Most of the time, even with a clinical history of sinus issues, allergies, sinus surgery or other factors that can cause facial swelling, there is still often a hereditary factor. When people first notice under eye bags in the absence of a history like this woman’s, they always mention that they have some good days and some not good days. As time goes on, they tend to have puffiness that is always present.

Given her current medical situation that’s still evolving especially with anemia being a factor, Dr. Prasad thinks that it is reasonable for her to consider a non-surgical option such as the use of a filler like a hyaluronic acid. In his practice, for under eye pockets that are very early and minimal, he does perform the application of hyaluronic acid such as Restylane and places it into the tear trough area. This is to soften the transition between the puffy bags and the valley underneath the eyes which make the puffy bags look puffy. Sometimes, some doctors will be a little overzealous and try to fill in the area and then the results look terrible. She should also be mindful that hyaluronic acid fillers can also cause swelling so the approach should be relatively conservative if she is going to try that first.

In Dr. Prasad’s practice, he commonly combines hyaluronic acid fillers with platelet-rich plasma (PRP). Platelet-rich plasma is derived from the patient’s own blood and it is the concentration of the healing and growth factors necessary for wound healing. It helps improve the skin quality and acts very well in synergy with hyaluronic acid.

With the issue of this woman’s medical history still influx, Dr. Prasad thinks conservative measure are probably best explored rather than moving forward directly with surgery. At the same time, it is probably her benefit to not do any kind of intervention and observe whether or not the fat pockets are consistently there for weeks at a time. This will give her a sense of the constant nature of the fat pockets being present.

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

For more information on platelet-rich plasma (PRP), go to:

http://prasadcosmeticsurgery.com/injectables/platelet-rich-plasma/

How Upper Eyelid Blepharoplasty Can Reveal or Cause Eyelid Ptosis
How Upper Eyelid Blepharoplasty Can Reveal or Cause Eyelid Ptosis

A woman had upper blepharoplasty 2 weeks ago and one eye looks smaller than before the surgery. She wants to know what kind of revision surgery can be done to get the results she was hoping for.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, says that based on this woman’s photos, she has ptosis. Ptosis means that the upper eyelid is lower and closer to the pupil. In an evaluation, surgeons have to determine if the patient’s ptosis is pre-existing meaning that prior to surgery, the eyelid was low and there was asymmetry between the two eyes. If the eyes were equal and the upper eyelids were symmetric, then the surgeon has to determine if it was due to injury during the surgery or due to a sequence of swelling and trauma. If that is the case, then the ptosis can resolve on its own. If there’s a lot of swelling, it is called traumatic ptosis.

Ptosis is one of the most common procedures Dr. Prasad does. He usually allows a little amount of time after the initial surgery to determine if the eyelid height is stable. This timeframe is based on observation during several week gaps between visits to determine if the ptosis is improving during that timeframe. If it is not improving during the first to 2 months, then he can move forward with doing some type of revision surgery. He tries to avoid operating on tissue that is swelling. Unfortunately, having the asymmetry can be very distressing and so he customizes his approach for each individual patient. He often sees patients come in for revision surgery from other doctors with their pre-operative photos and he can actually make a comparison to determine what the situation is.

Dr. Prasad thinks it is important that this woman still communicate with her primary surgeon who did her original surgery original. She must review her photos and discuss with her doctor what to anticipate and expect. No one knows her anatomy better than the original operating surgeon. If she feels that her doctor is comfortable and confident about the ptosis, she can wait it out. If it is beyond a certain point, she can probably conclude that the ptosis is not going to get better and a ptosis repair might be necessary.

Ptosis repair in Dr. Prasad’s practice is performed under local anesthesia with LITE™ sedation. He actually moves the muscle that lifts the eyelid called levator muscle and adjusts it. He lets the patient sit up during surgery to maximize the symmetry and to make sure that the eyes look balanced with the gravitational aspect being in place. It’s a more complex surgery than most general plastic surgeons are familiar with. It’s very unique to oculofacial plastic surgery so patients don’t want to rush a procedure like this. Every ptosis surgery has a risk of needing more surgery as the eyelid can be too high or can be too low afterwards. If this woman’s situation is a manifestation of swelling at the cellular level or at the level of the tissue behind the eyelid, then it can potentially get better on its own. Dr. Prasad thinks that within the first 2 months, there is no harm in waiting. She can even wait much longer than that like 6 months or longer and have the ptosis surgery performed. Seeing how much this woman is very concerned, most likely, expediency maybe the best solution for her.

For more information about eyelid surgery, please visit our website:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/

For more information about ptosis correction surgery, please go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/eyelid-ptosis-surgery/

Facial Aging - Why Facelifts Do No Not Replace Volume Enhancement
Facial Aging - Why Facelifts Do No Not Replace Volume Enhancement

A 57-year-old woman received Botox® and Juvederm a few months ago, but wants to know about procedures that are more permanent.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, board certified in facial cosmetic surgery, body, and breast surgery, deals with everything from head to toe. Facial aging is one of the popular areas he focuses on. He explains that facial aging is composed of volume loss which means loss of bone, muscle, fat and soft tissue. There is a role for volume replacement using fillers, fat transfer or surgical implants such as cheek implants or chin implants. The other facial aging issue is descent or loosening of the tissue, including: the skin, and the soft tissue framework under the skin called the SMAS or superficial musculoaponeurotic system. When tissue descends there’s a role for some type of lifting procedure. The goal of any lifting procedure is to restore the natural anatomic relationships.

When a patient comes to Dr. Prasad’s office with multiple problems, he first asks them the things that bother them most. Prioritizing problems helps him strategize a treatment plan. A procedure with a more permanent result would be a surgical procedure. A surgical procedure does not mean a patient never has to consider doing fillers, injectables or treatments such as Botox® or Dysport because a facelift may restore anatomic relationships, but it doesn’t restore volume loss. This woman has an opportunity to have some restoration of her jawline and the soft tissue that is descending. There’s also some loose skin under the neck and some banding which is called platysmal bands.

In Dr. Prasad’s practice, patients will have opportunities to consider procedures such as a limited facelift and a more extensive facelift. It is not more likely that this lady will need a more extensive face and neck lift. Since her facial structure is relatively thin, a conservative procedure is probably best for her. Dr. Prasad would try to restore a crisp jawline and define the neck. He doesn’t think that cheek lifting is the best method for her. Cheek lifting usually means some type of temporal incision using an endoscope to lift the cheeks upward or some type of procedure from the eyelid approach called a soof lift. From his experience, those procedures look very unnatural and they don’t address the underlying issue of the partial descent of the cheek when there’s also a lot of volume loss. In Dr. Prasad’s opinion, he would do a combination of a submalar implant which is a permanent implant and place that on the cheek bone to give volume rather than trying to lift it. Volume loss can be also corrected with fillers such as Radiesse, Juvederm, Restylane and Voluma.

Restoration of volume is something that is going to be a benefit for this woman. In addition, a surgical solution which is to pull all the sagging tissue back to improve jawline and definition of the neck and some of the sagging cheek will also benefit her. Dr. Prasad suggests that she find the right doctor. The ideal relationship is when a surgeon provides comprehensive solutions and providing the surgical care patients need to reach a specific objective.

For more information about Face lifting surgery, please visit our website:
http://prasadcosmeticsurgery.com/prasad-face-eyes/facelifts/

To learn more about injectables, please visit:
http://prasadcosmeticsurgery.com/injectables/

Botox:
http://prasadcosmeticsurgery.com/injectables/botox/

Dysport:
http://prasadcosmeticsurgery.com/injectables/dysport/

Juvederm:
http://prasadcosmeticsurgery.com/injectables/juvederm/

Radiesse:
http://prasadcosmeticsurgery.com/injectables/radiesse/

Restylane:
http://prasadcosmeticsurgery.com/injectables/restylane-perlane/

Temporary Swelling after Asian Double Eyelid Surgery, and Reversal of Suture Method Procedure
Temporary Swelling after Asian Double Eyelid Surgery, and Reversal of Suture Method Procedure

A gentleman just had Asian blepharoplasty 2 weeks ago and realized how much he missed his original monolid eyes. He wants to know if there is any way possible to reverse the suture method.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, says it is very common for people after Asian eyelid surgery to be concerned about an unnatural look or a lid platform that’s too high. He explains that this is caused by temporary swelling. Asian eyelid surgery, whether incisional or excision where the surgeon is removing skin and fat, has a connection made between the skin and the muscle that lifts the eyelid called the levator muscle. This causes an expansion of fluid between the eyelid crease and eyelid margin which results in a ballooning effect that makes the eyelid crease look high. Patients should anticipate that the swelling will go down and he will likely have a very natural-looking double fold.

If this gentleman really feels that he absolutely doesn’t like the result and he wants to go back to his original look, Dr. Prasad would suggest that it is probably beneficial to do it as soon as possible.

The principle of non-incisional eyelid surgery is to place sutures through skin openings on the outside of the eyelid and at critical points to engage the area of the levator muscle and the skin. This is done in such a way so that when the surgeon ties the knot, it creates a fold. That fold is responsible for creating the in-folding of the skin. In Dr. Prasad’s practice, he actually does a procedure for creating dimples where he creates a little pull in the inside of the mouth and folds it inward to create a dimple. The same principle applies to Asian eyelid surgery. Releasing those connections can be done and is probably better to be done sooner rather than later before scar tissue forms.

Dr. Prasad thinks time is of the essence for patients like this gentleman. He should meet with his doctor and have a discussion of what the realistic results will be when the swelling will resolve versus complete reversal of the surgery. He must choose what he is most comfortable with.

For more information about Asian eyelid surgery, please visit our website: http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/asian-eyelid-surgery/

Solving Extra Skin Over the Upper Eyelids to Relieve Irritation and Heaviness
Solving Extra Skin Over the Upper Eyelids to Relieve Irritation and Heaviness

A 44-year-old woman’s right eyelid is drooping more than the left that's causing a heavy feeling in her eye. She wants to know her options to fix the drooping eyelid. She is also curious if her insurance would cover her procedure.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, explains that when a patient with droopy eyelids comes to his practice, he first tries to differentiate if there is extra skin over the eyelid (dermatochalasis), or if there is drooping (ptosis). Drooping of the eyelid or ptosis is caused by a defect of the levator muscle which is the muscle that lifts the eyelid. He also looks at the brow position that could result in extra skin being pushed downward on top of the eyelid called brow ptosis.

After looking at this woman’s photos, Dr. Prasad says that her brows are relatively asymmetric which fortunately is normal. He suspects that her brows have not come done significantly so he would advise against a brow lift. If her brows are elevated even with a few millimeters, it may have a negative impact on her facial expression where she could look always surprised.

By how her eyes appear, Dr. Prasad says that the upper eyelid margin is not low enough to be affecting the pupil. She may have dermatochalasis which means extra skin over the eyelids. The solution for that is blepharoplasty which addresses extra: skin, soft tissue, fat, and anything that is impinging on top of the upper eyelid. However, there is an art of doing cosmetic blepharoplasty to look natural by not having too much skin removed. One of the most common concerns is when someone has too much skin removed and they end up having difficulty closing their eyes. As a cosmetic oculofacial plastic surgeon for 20 years, Dr. Prasad has had patients come from all over the world for revision surgery for drooping of the upper eyelid after blepharoplasty, as well as skin shortage of the upper eyelid after blepharoplasty. Blepharoplasty is not about taking as much skin as possible, it is about the art of the design and employing techniques that can allow skin to fold in properly so it looks attractive and natural.

Having practiced for 20 years, Dr. Prasad has watched how insurance companies have become very strategic in presenting themselves to patients and doctors. 15 to 20 years ago, if someone had any visual field defect, it would be covered by insurance. That unfortunately led to a lot of people who didn’t have a functional issue or problem to have it covered. Presently, insurance companies only cover procedures if they are medically necessary. In Dr. Prasad’s practice, he stopped accepting insurance altogether as he found that it was detrimental to his ability to deliver the proper care to his patients. Looking at this woman’s photo, he thinks it is unlikely that any medical director of any insurance company would consider her upper eyelids heavy enough to be blocking her vision. The general rule of thumb is, if someone else can see their pupil that means they can see out. It really takes a really low eyelid to the point of complete coverage before an insurance company would cover it.

Dr. Prasad suggests that she identify an expert in upper eyelid surgery. Many doctors perform eyelid surgery. In the hierarchy of specialties, one would argue that a sub-specialty like oculofacial plastic surgery is a position uniquely qualified to perform this type of procedure. She certainly has many options, but must do her research and learn about cosmetic surgeons and other doctors who also perform blepharoplasty. Once she finds a doctor who she is comfortable with, she may move forward with the surgery.

For more information about upper eyelid surgery, please visit our website:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

Repairing Pulled Down Eyelids after Asian Lateral Canthoplasty (Eye Elongation Surgery)
Repairing Pulled Down Eyelids after Asian Lateral Canthoplasty (Eye Elongation Surgery)

A woman had a lateral canthoplasty, a procedure that is popular in Asian countries like South Korea. However, the outer corner of her left eye became droopy and elongated. She wants to know if the procedure can be reversed.

Dr. Amiya Prasad, an oculofacial plastic surgeon, explains that elongating the outer canthus or the outer corners of the eyes is very popular in Asia to create a longer-looking eyelid. In this woman’s situation, she has some rounding of the lower eyelid. Although the pink part of the conjunctiva is not seen, the eyelid looks low and the white of the eye can be seen. This position is often called as lower eyelid retraction and there may be some loss of integrity of the tendon.

With a physical exam, Dr. Prasad tries to determine the basis for the lower eyelid position. In many situations, it’s a combination of anatomic factors, like the lateral canthal tendon that's responsible for the position and the suspension of the lower eyelid. He suspects it’s been affected since there’s a rounding of the outer corner. In addition, the vertical support of the lower eyelid may need to be reinforced. Although she didn’t have a typical complication of lower eyelid blepharoplasty where there’s a loss of tissue resulting in contraction and pulling downward, she may still have relative weakness in this area. She may need some type of vertical support. In Dr. Prasad’s practice, he uses materials such as Enduragen which is the backbone of the skin that has been treated in a way so that it can be used as a graft. Acellular dermis may also be used for the purpose of raising vertical support as part of her strategy.

In the absence of a physical exam, Dr. Prasad can’ tell exactly what she would need. She should meet with cosmetic surgeons with extensive experience in lower eyelid revision surgery. Most plastic surgeons like general plastic residency don’t have expertise in this type of surgery as opposed to specialists such as an oculoplastic surgeon or a board certified cosmetic surgeon who has specific specialty-based experience with the eyelids. When she meets with these kinds of doctors, she’ll understand whether or not she’ll need vertical support in addition to some type of anchoring procedure to get the lower eyelid to proper position.

Dr. Prasad says she can reverse or enhance her results but it won’t likely be a straightforward simple procedure. She has to decide how important the result is to her and if the healing time and investment are worthwhile to achieve her objective.

For more information about Asian eyelid surgery, please visit our website:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/asian-eyelid-surgery/

What's Best for Under Eye Wrinkles: Lasers, Radio Frequency, or Surgery?
What's Best for Under Eye Wrinkles: Lasers, Radio Frequency, or Surgery?

When it comes to under eye wrinkles, the goal is to increase or improve the volume of collagen under the skin. One of the ways this is accomplished is by careful thermal stimulation. However, because under eye skin in less than half a millimeter in thickness, any type of heat treatment needs to be customized for the individual.

In Dr. Amiya Prasad practice, he makes use of the microfractional CO2 laser for light skinner patients, and Pellevé radiofrequency treatment for darker skinned patients. In addition to that, a concentration of platelet-rich plasma (PRP) is also given as its regenerative qualities also helps stimulate collagen formation.

For more information on fractional CO2 laser, go to:

http://prasadcosmeticsurgery.com/prasad-medi-spa/laser-light-
treatments/microfractional-co2/

For more information on platelet-rich plasma (PRP), go to:
http://prasadcosmeticsurgery.com/injectables/platelet-rich-plasma/

For more information about Pellevé, go to:

http://prasadcosmeticsurgery.com/prasad-medi-spa/laser-light-treatments/pelleve-skin-tightening/

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

Do Radio Frequency Devices Work for Hooded Eyes?
Do Radio Frequency Devices Work for Hooded Eyes?

Many of these radiofrequency devices boast about how high their temperatures reach, when in fact, more heat does not necessarily mean more tightening of the skin. Dr. Amiya Prasad has noticed that people who come to his clinic after having had such treatments exhibit skin that looks even more aged.

It is important to remember that the layer of fat present under the facial skin contributes to that volume and glow that is characteristic of youthful skin. However, because of these high heat radiofrequency devices, that layer of fat ends up almost getting “cooked” in the process, thereby speeding up the aging process of skin. It is therefore more advisable to undergo an upper eyelid blepharoplasty for hooded eyes, in order to preserve the quality of your skin.

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information about Pellevé, go to:

http://prasadcosmeticsurgery.com/prasad-medi-spa/laser-light-treatments/pelleve-skin-tightening/

For more information on fractional CO2 laser, go to:

http://prasadcosmeticsurgery.com/prasad-medi-spa/laser-light-treatments/microfractional-co2/

What's Better for Hooded Eyes: Lasers or Surgery?
What's Better for Hooded Eyes: Lasers or Surgery?

With laser or radio frequency devices, the goal is to heat the skin of the forehead and elevate the brows by slow contracture. However, people with hooded eyes often have more skin that needs to be contracted, and thus this procedure can require multiple sessions over several months. In addition to that, hooded eyes often have areas of fat which requires sculpting, and this can only be achieved through surgery. Surgery allows the surgeon to manipulate the tissues and fat more precisely, leading to better-looking results.

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on fractional CO2 laser, go to:

http://prasadcosmeticsurgery.com/prasad-medi-spa/laser-light-treatments/microfractional-co2/

For more information about Pellevé, go to:

http://prasadcosmeticsurgery.com/prasad-medi-spa/laser-light-treatments/pelleve-skin-tightening/

Can Surgery Remove Wrinkles Around the Eyes?
Can Surgery Remove Wrinkles Around the Eyes?

The only time blepharoplasty can get rid of wrinkles around the eyes is when those wrinkles are within the skin that is actually being removed as part of the procedure.

There are, however, other methods to remove wrinkles, depending on what type they are. Wrinkles are categorized into two kinds: (1) static and (2) dynamic. Static wrinkles are those lines that are present on the face even without muscle activity. These can usually be addressed with platelet-rich plasma (PRP) or a microfractional CO2 laser to build collagen and improve skin quality. Dynamic wrinkles are wrinkles that appear when the facial muscles move to show expressions. These types of wrinkles can be remedied with Botox® or Dysport.

For more information on fractional CO2 laser, go to:

http://prasadcosmeticsurgery.com/prasad-medi-spa/laser-light-treatments/microfractional-co2/

For more information on platelet-rich plasma (PRP), go to:

http://prasadcosmeticsurgery.com/injectables/platelet-rich-plasma/

For more information about Botox® Cosmetic, go to:

http://prasadcosmeticsurgery.com/injectables/botox/

For more information about Dysport™, go to:

http://prasadcosmeticsurgery.com/injectables/dysport/

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

What's the Best Cream for Under Eye Bags?
What's the Best Cream for Under Eye Bags?

Creams do not directly address under eye bags caused by lower eyelid fat prolapse. This is because the problem of under eye bags lies under the skin, in orbital fat that has prolapsed and become displaced. The only way to truly correct under eye bags is by means of surgery. Cosmetic eye creams, however, can improve the texture and colors of the sensitive under the eyes. In fact, Dr. Amiya Prasad has developed his own line of skin products to do precisely that. He recommends that instead of foraging at popular retailers for all sorts of eye creams, that patients seek out professionals with concrete knowledge of the under eye area and simplify their beauty routine.

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

Is Eyelid Surgery Safe if I have Dry Eyes?
Is Eyelid Surgery Safe if I have Dry Eyes?

As an oculofacial plastic surgeon who was first trained as an eye surgeon, Dr. Amiya Prasad has encountered dry eye cases quite frequently, and has therefore become quite familiar with the condition. Before undergoing surgery, a patient must be evaluated properly in order to determine the proper position of the lower eyelid to optimize the lubrication of the eyes. Dr. Prasad has successfully performed eyelid surgery on patients with severe dry eyes and even people with conditions such as Sjogrens syndrome, rheumatoid arthritis and thyroid eye disease.

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

For more information on upper eyelid ptosis, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/eyelid-ptosis-surgery/

When Can I Go Back to Work after Eyelid Surgery?
When Can I Go Back to Work after Eyelid Surgery?

The downtime experienced by most after cosmetic surgery can be a disadvantage, so in order to address this, Dr. Amiya Prasad and his developed a system wherein they can treat their patients effectively and quickly. In Dr. Prasad’s practice, all surgical procedures are done in his own certified operating facilities accompanied by a dedicated team of nurses who he works with consistently. After the procedure is done, immediate aftercare is given in the recovery room. This immediate attentive care given to the patient post-op plays a significant role in how fast a patient recovers, and they are usually able to return to work within 1 week.

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

For more information on upper eyelid ptosis, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/eyelid-ptosis-surgery/

For more information on LITE™ Anesthesia, go to:

http://prasadcosmeticsurgery.com/dr-prasad/lite-anesthesia-for-cosmetic-surgery/

I have Dark Skin. Is Upper Eyelid Surgery Safe for Me? I Don't want Keloids.
I have Dark Skin. Is Upper Eyelid Surgery Safe for Me? I Don't want Keloids.

It is a known fact that darker skinned people are more prone to keloid formation after surgical procedures, and while this is true, it may not always be the case especially if special care and attention is given. In an article, written by Dr. Amiya Prasad, entitled “Ethnic Considerations in Eyelid Surgery’’, he explains that keloids can be avoided when the surgeon has a deep understanding of the skin type, facial anatomy and placement of incisions on darker skinned people. It is therefore important for a patient to choose a surgeon with significant experience treating darker skinned people and dedicates ample time to properly evaluate a patient’s case.

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

For more information on upper eyelid ptosis, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/eyelid-ptosis-surgery/

What Type of Anesthesia is Best for Eyelid Surgery?
What Type of Anesthesia is Best for Eyelid Surgery?

Blepharoplasty can be performed under local anesthesia, local anesthesia with IV sedation and general anesthesia. Dr. Amiya Prasad, a practicing cosmetic oculofacial plastic surgeon for over 20 years, favors using local anesthesia with IV sedation, as it puts the patient in a very relaxed, sleepy state. This is much less taxing on the body compared to general anesthesia wherein the patient is completely unconscious and placed on a respirator.

For more information on LITE™ Anesthesia, go to:

http://prasadcosmeticsurgery.com/dr-prasad/lite-anesthesia-for-cosmetic-surgery/

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

For more information on upper eyelid ptosis, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/eyelid-ptosis-surgery/

My Under Eye Bags Don't Go Away No Matter How Much I Sleep. Why?
My Under Eye Bags Don't Go Away No Matter How Much I Sleep. Why?

Under eye bags are not directly affected by the amount of sleep one has, or whether or not they experience allergies or sinus conditions. Under eye bags are caused by “lower eyelid fat prolapse”, which is the displacement of fat that occupies the orbit (the space around the eye). When this occurs, it makes the eyes look tired, heavy and puffy. Many cosmetic eye creams claim to be able to improve eye bags, but the only way to truly address them is by means of surgery. When performing lower eyelid blepharoplasty, Dr. Amiya Prasad prefers the transconjunctival approach (inside the eyelid) to minimize trauma and scarring to the area and speed up recovery.

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

My Eyelids were Pulled Down after Eyelid Surgery. What Should I Do?
My Eyelids were Pulled Down after Eyelid Surgery. What Should I Do?

“Pulled down” eyes after a blepharoplasty procedure is a common occurrence and is often referred to as rounding, scleral show, or lower eyelid retraction. This condition is caused by tissue loss from surgery, thus leading to poor support of the eyelids. To avoid or correct this type of condition, the surgeon must conduct a proper examination of the anatomic relationship of the patient’s eyes, in order to place the eyelids in the proper position and improve their appearance. In the meantime, maintaining proper eye lubrication is essential if there is lower eyelid retraction. Since a part of the eye that is normally covered is suddenly exposed, infection may occur.

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

Which Doctor is Best for Eyelid Surgery?
Which Doctor is Best for Eyelid Surgery?

The best way to determine the best doctor for your case is to do research and learn about the doctor’s training and area of expertise. Proper eyelid surgery is far more complex than that which general surgeons claim to perform. In addition to the proper training background, it is also essential to pick a surgeon with significant years of experience, as this speaks volumes about the mastery a surgeon has over procedures. As a cosmetic oculofacial plastic surgeon with over 20 years of experience, Dr. Amiya Prasad makes it his priority to inform patients about the specifics of eyelid surgery so they can make informed decisions.

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

For more information on upper eyelid ptosis, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/eyelid-ptosis-surgery/

What are the Potential Eyelid Surgery Complications?
What are the Potential Eyelid Surgery Complications?

Eyelid surgery is one of the most popular types of cosmetic surgeries today, and unfortunately, a large percentage of procedures performed end with undesirable results. Many of these bad surgical jobs often result in complications such as (1) drooping of the upper eyelid, (2) skin shortage that leads to the inability of the eye to close properly, (3) lower eyelid rounding or scleral show, (4) lower eyelid retraction, and (5) ectropion, wherein the inside of the lower eyelid is exposed.

In order to avoid complications such as these, it is of vital importance to seek out a surgeon who specialized in this type of surgery. There are too many general plastic surgeons nowadays that sell themselves using the term “board-certified” in order to convince prospective patients to choose their practice, when in fact, eye surgery requires a deeper level of specialization. Other complications can also be avoided if your surgeon spends a significant amount of time learning about your medical history and the specifics of the results you want. It also helps when the surgeon plans the procedure in such a way that will cause minimal trauma to the eye area of the patient.

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

How Do I Prepare Before Eyelid Surgery?
How Do I Prepare Before Eyelid Surgery?

When preparing for eyelid surgery, there are two things that patients must completely divulge to their surgeon: (1) the patient’s overall health (including any existing conditions, illnesses, prescribed medication or supplements) and (2) if they have any existing eye conditions such as dry eyes or blepharitis. Since eyelid surgery can have a significant influence on the overall health of the eyes, it is important to address conditions such as dry eyes in order to prevent any other complications. Remember, the more specific you are about your medical history, the more your surgeon will be able to perform a successful surgery that addresses your concerns and improve your eyes.


For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on upper eyelid ptosis, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/eyelid-ptosis-surgery/

Are the Results of Eyelid Surgery Permanent?
Are the Results of Eyelid Surgery Permanent?

The results of eyelid surgery can last for up to 5-10 years, depending on the age of the patient at the time of the procedure, the patient’s general health, and the condition of one’s skin. It is important, however, for every patient to understand the way the face natural ages over the years and how this affects the appearance of the eyes in order to foster realistic expectations.

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

Do I Have Eyelid Ptosis, Extra Skin, or Both?
Do I Have Eyelid Ptosis, Extra Skin, or Both?

Ptosis is a condition wherein the eyelid margin is lower than normal, resulting in sleepy or droopy-looking eyelids. This is caused by the stretching or thinning of the levator muscle, which is responsible for keep the eyelid open. This can also be caused by dermatochalasis, which refers to the excess skin over the eyelids which can make one’s eyes look “hooded” and heavy. Ptosis surgery can help correct the levator muscle and can be done alongside an upper eyelid blepharoplasty.

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on upper eyelid ptosis, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/eyelid-ptosis-surgery/

How is Transconjunctival Blepharoplasty Different from Other Types of Lower Eyelid Surgery?
How is Transconjunctival Blepharoplasty Different from Other Types of Lower Eyelid Surgery?

Transconjunctival blepharoplasty addresses the problem of puffy, tired-looking eyes without making any external incisions. Dr. Amiya Prasad favors this approach as it avoids disrupting the delicate muscles and ligaments that are necessary for lower eyelid support and function. In Dr. Prasad’s practice, transconjunctival blepharoplasty may be performed on people of all ages and is usually combined with fractional CO2 laser and platelet rich-plasma treatment to improve dark circles and fine lines.

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

How are Eyelid Surgery Scars Minimized?
How are Eyelid Surgery Scars Minimized?

Minimizing post-operative scarring requires precise planning, a minimally traumatic surgical approach and high quality post-operative care. When approaching blepharoplasty, Dr. Amiya Prasad prefers to avoid making any external incisions and therefore favors the transconjunctival approach. When addressing excess skin on the upper eyelid, an artistic eye is required. The incisions on the upper eyelid need to be placed in such a way that even when the eyes are closed, they should be barely visible. When it comes to speeding up the patient’s recovery rate, Dr. Prasad chooses an optimal suturing technique and makes use of platelet-rich plasma, an advanced wound healing serum. The combination of these, in addition to proper home aftercare, helps patients recover faster with less scarring.

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

What are the Risks of Eyelid Surgery?
What are the Risks of Eyelid Surgery?

Like other types of surgery, eyelid surgery poses the risk of bleeding and infection. However, unlike other types of surgery, eyelid surgery directly impacts the function and health of the eyes. This means that a poorly executed surgical job could lead to even more complications than there were to begin with.

Such complications may include: drooping of the upper eyelids after surgery, skin shortage which prevents proper eyelid closure, undesirable scarring, lower eyelid retraction, as well as ectropion. Unfortunately undesirable results can also be associated with eye problems including dry eyes and corneal ulceration.

Before undergoing eyelid surgery, it is essential to have a properly detailed medical and physical examination of the eyes in order to reduce the risk of undesirable results and further complications. This should include a proper diagnosis of any existing conditions such as ptosis or lacrimal gland prolapse.

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

For more information on upper eyelid ptosis, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/eyelid-ptosis-surgery/

How are Upper and Lower Eyelid Surgery Performed?
How are Upper and Lower Eyelid Surgery Performed?

Blepharoplasty is performed under local anesthesia, local anesthesia with intravenous sedation, or general anesthesia. In his practice, Dr. Amiya Prasad prefers to use intravenous sedation with LITE™ IV sedation, to allow patients to experience a faster recovery period.

Upper eyelid blepharoplasty addresses the eyelid crease and any excess skin on the eyelids. If needed, additional fat and soft tissue can be sculpted into the area to improve its appearance. Lower eyelid blepharoplasty addresses saggy, puffy and tired-looking skin under the eyes. This procedure can be executed in two different ways: (1) from the outside (transcutaneous approach) and (2) from the inside (transconjunctival approach).

When considering which type of procedure to undergo, make sure you choose a surgeon with a significant amount of knowledge and experience, as well as advanced eyelid surgery techniques, as lower eyelid surgery can negatively impact the appearance of the lower eyelid if not done properly.

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

For more information on LITE™ Anesthesia, go to:

http://prasadcosmeticsurgery.com/dr-prasad/lite-anesthesia-for-cosmetic-surgery/

Why do My Eyes Look So Tired? Should I See an Eye Surgeon or a Plastic Surgeon?
Why do My Eyes Look So Tired? Should I See an Eye Surgeon or a Plastic Surgeon?

Tired eyes are usually a result of hooded and/or sagging upper eyelids and puffy under eye bags. As a practicing Cosmetic Oculofacial Plastic Surgeon with over 20 years of experience, Dr. Amiya Prasad has performed revision eyelid surgery to correct bad surgery jobs done by other surgeons, restoring not only the appearance of the eyes but their health as well.

Dr. Prasad stresses the importance of understanding that surgery of the eyes has a significant effect on the function and health of eyes, and it is essential that those considering the procedure seek out a qualified surgeon to do the job. While terms like “Board Certified Plastic Surgeon” do seem impressive, it is not indicative of any specialized training or expertise in the sensitive and delicate eye and eyelid areas. Proper research on the part of the patient is necessary. Dr. Prasad recommends a surgeon with expertise in eye surgery, artistic ability, and extensive experience.

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

Can Puffy Eye Bags be Removed without Surgery?
Can Puffy Eye Bags be Removed without Surgery?

Eye bags are caused when orbital fat—the fat that occupies the space around the eye—becomes displaced and sags, making the eyes look puffy and tired. Though many cosmetic eye creams and non-surgical skin heating devices claim that they can remedy eye bags, some type of surgical procedure is still needed to completely fix them. In Dr. Amiya Prasad’s practice, when lower eyelid blepharoplasty is performed, special focus is paid to making sure the patient recovers well and heals fast.

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

For more information on transconjunctival blepharoplasty, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/transconjunctival-blepharoplasty/

What is the Best Treatment for Tear Troughs?
What is the Best Treatment for Tear Troughs?

The tear trough—located near the inner corners of the eyes—requires detailed assessment as this area is affected by many factors, such as skin thickness, skin color, bone structure, and the presence or absence of fat pockets. In the event that there are no prominent fat pockets present, a combination of volume correction and skin quality improvement will be administered. In this case, Dr. Amiya Prasad prefers using dermal fillers such as Restylane, and platelet-rich plasma (PRP) which is derived from the patient’s own blood. Platelet-rich plasma uses the concentrated growth factors found in the blood which can improve skin quality by increasing blood supply, generating new collagen, and increase healing and skin thickness in the applied area.

For more information on platelet-rich plasma (PRP), go to:

http://prasadcosmeticsurgery.com/injectables/platelet-rich-plasma/

For more information about hyaluronic acid fillers, go to:

http://prasadcosmeticsurgery.com/injectables/restylane-perlane/

and

http://prasadcosmeticsurgery.com/injectables/juvederm/

Can I Change my Eye Shape?
Can I Change my Eye Shape?

The shape of the eye is largely dependent on genetic factors that are specific to each individual. It is important to understand that these characteristics—the dimension, prominence, and shape and position of bones, tissues and ligaments of the eye—all vary for each person, and therefore, it is important to first discuss different procedures that can address the shape of the eyes in such a way that still looks natural to one’s face.

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on lower eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

How Much Swelling Occurs after Upper Eyelid Surgery?
How Much Swelling Occurs after Upper Eyelid Surgery?

Swelling after eyelid surgery are usually influenced by the following factors: (1) surgical technique, (2) method of anesthesia, (3) aftercare received immediately after completion of surgery, (4) at home aftercare, and (5) presence of other conditions such as sinus problems and allergies.

To help alleviate a significant amount of post-surgery swelling, Dr. Amiya Prasad developed LITE™—a light local intravenous sedation method that allows patients to recover from surgery and return to work much faster. This type of sedation is so effective that patients are even able to go home after surgery without the characteristic grogginess that accompanies other typical anesthesia methods.

For more information upper eyelid surgery, go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

For more information on LITE™ Anesthesia, go to:

http://prasadcosmeticsurgery.com/dr-prasad/lite-anesthesia-for-cosmetic-surgery/

Fox 5 News Features Hair Regeneration Non-Surgical Hair Transplant Alternative
Fox 5 News Features Hair Regeneration Non-Surgical Hair Transplant Alternative

Kerry Drew of Fox News shows us one treatment let's a person use their own blood to regrow thinned hair. The treatment has been successful for many patients as an alternative to a hair transplant as it stops further hair loss and thickens existing hair for a more natural looking hair density than a hair transplant.

Paul noticed that every time he looks at the mirror, and especially looking at old photos that his hair was thinning and receding. He felt self-conscious about a section of thinning hair on the back of his head. Looking at his family, there are some people who don't have any hair and realized it might happen to him slowly. Paul did some research and came across cosmetic surgeon Dr. Amiya Prasad who specializes in a procedure called Hair Regeneration.

Dr. Prasad says that he can't bring back hairs that are gone, but he can take hairs that are thinning and make them thicker. The treatment is unique: through the use of the patient's own blood and a material called extracellular matrix it generates growth and thickening of hair. Platelet-rich plasma is derived from the patient's own blood. He customizes the formulation and injects it into the scalp. And what seems to occur is a wound-healing mechanism that results in reversal of hair thinning.

To begin, Dr. Prasad examines Paul's head under a microscope, to figure out where the injections will go. Dr. Prasad chooses the area that will respond nicely to the treatment. Then Paul gets his blood drawn, and that same blood will be used for about 100 injections all over his scalp. Dr. Prasad said he has perfected this procedure over the past few years, and the results have been amazing.

Dr. Prasad says that if there is one solution for male pattern hair loss that's almost close to 100 percent in his clinical experience over the past few years.

The Hair Regeneration treatment can restore hair volume better than a hair transplant since it thickens native hair. Native hair is much more densely packed than transplanted hair. To achieve natural looking density through a hair transplant, several sessions are needed.

Hair Regeneration can stop further hair loss, which a hair transplant can not. Hair Regeneration works as a stem cell therapy by activating adult stem cells to create the cells and signals necessary for hair growth.

Hair Regeneration has worked as an effective hair transplant alternative for people with thinning hair, and also for people who already had a hair transplant and want to avoid second or more successive hair transplants.

The one-time treatment is not as effective for men and women with significant hair loss or those who are totally bald. As for Paul, he should start to see results in about a month. In a year, it will be even better. Paul says that Dr. Prasad was very thorough and clear and made him feel very optimistic about this. So he's looking forward to a few months from now.

For more information, visit our websites:

http://nyhairloss.com

http://prasadcosmeticsurgery.com/prasad-hair-restoration/

Hair Loss and Hair Thinning Treatment Can Restore Hair with More Density than a Hair Transplant
Hair Loss and Hair Thinning Treatment Can Restore Hair with More Density than a Hair Transplant

A 30-year-old male has high temporal peaks and has a receding hairline. He wants to know if he can be a candidate for a follicular unit extraction, and wants to avoid finasteride (Propecia™) because of possible long-term sexual side effects.

Dr. Amiya Prasad, a hair transplant specialist, explains that when considering hair transplant surgery, it is important that patients think about the progression of their hair loss. Presently, there is a big interest on follicular unit extractions (FUEs) which are a method of transplanting hair from the permanent zone. This area is located at the back of scalp and has hairs that never go away can be placed in areas that need hair. There is also another procedure commonly called the strip method, or follicular unit transplants (FUTs). However, both of these procedures have a big limitation and that is the donor area.

In Dr. Prasad’s practice, he usually counsels his patients that hair loss is ongoing. The donor area has a limited number of hairs. It is important to prevent the progression of hair loss and reverse the hair thinning to achieve a certain level of stability and predictability. Dr. Prasad has seen patients who had several transplants, but at a certain point their hairs thin out and they are left with only the transplants. They had a “pluggy look” or the look with isolated plugs of hair.

Dr. Prasad has developed a method of restoring thinning hair called Hair Regeneration. Hair Regeneration is a method of using platelet-rich plasma combined with a material called acellular matrix. It is customized and applied in a very specific dosing depending on factors such as age, gender and degree of hair loss. There is significant improvement in being able to halt the progression of thinning and reverse the thinning process to gain greater hair volume. In addition, it improves the healing of the donor area.

Hair Regeneration has made a tremendous impact on the choices that many people are making about if and when to do a transplant. In fact, it is not unusual now for people to come to Dr. Prasad who had a hair transplant recently to have the treatment in order to not only prevent the progression of hair thinning, but also to enhance the survivability and results of hair transplants. Dr. Prasad also had patients who wanted a second transplant, but found out through microscopic examination that they didn’t have hair loss their native hairs are thinning. As long as hair is present, the hairs that are thinning can potentially be thickened significantly. If hairs are thickened in a given area, the volume is greater compared to a hair transplant surgery because nature places hairs in dense clusters. No matter how technically skilled the surgeon and technicians are, they can never create the same level of density as nature does with one transplant. Hair Regeneration has become a good option for people who are considering a second transplant.

Dr. Prasad suggests that this man consider a stabilizing alternative such as Hair Regeneration. In Dr. Prasad’s practice, he explains that a given patient can have full results from anywhere from a year to 18 months. He follows his patients every 3 months after the injection. He documents with standardized controlled photography in specific positions and looks at the scalp and with a microscope to document the progression and improvement. Once a certain maximal reversal is reached where most of hairs are good quality thick hairs as opposed to miniaturizing or villous hairs, then he can make a decision. Depending on the level of hair loss, if he chooses to move on to have a transplant, he can be strategic in the placement of these limited hairs and place them more effectively to get a better cosmetic result. Hair transplant can be delayed if hair thinning is reversed. Some of Dr. Prasad’s patients even feel that they don’t need a hair transplant after they have Hair Regeneration because they are comfortable with their look.

For more information about hair loss, please visit our website: http://nyhairloss.com/

To see more Hair Regeneration results, please visit:
http://nyhairloss.com/hair-regeneration-acell-extracellularmatrix-prp-by-dr-amiya-prasad/

Why Hairline LoweringTransplant is Not Advised at 20, & Stopping Further Hair Loss Non-Surgically
Why Hairline LoweringTransplant is Not Advised at 20, & Stopping Further Hair Loss Non-Surgically

A gentleman just turned 20 years old and is bothered by his receding hairline. He wants to know if hairline lowering surgery is suitable for his age.

Dr. Amiya Prasad, a hair transplant specialist, explains that hairline lowering surgery is probably not appropriate for this gentleman. When someone has a hairline that’s thinning and receding, they have a moving target and they fall in a category of a more aggressive early onset of male pattern hair loss. The guiding principle of male pattern hair loss called the Rule of Decades states that when someone is in their 20s, 20% of their contemporaries have hair loss. Unfortunately, that means 80% of their contemporaries have lots of hair. As they hit their 40s or 50s, it becomes closer to 50%. The age of onset and rate of progression is critically important when making a decision about a surgical treatment for hair loss.

For years, it has always been discouraged for men in their early 20s to have hair transplants, and one of the reasons is that there was a mismatch between the amount of hair someone can transplant and the desired result. When someone is in their 20s, they want a lot of volume, but if they’ve lost a lot of hair, the limited donor area prevents them from getting that volume that all their contemporaries have. In contrast, older men are satisfied with a definition of a hairline and coverage of the mid-scalp area.

In this country, there are two medications used in treatment of hair loss: one is finasteride, and the other minoxidil. Finasteride is an oral medication that’s used to inhibit an enzyme called 5-alpha reductase which interrupts the conversion of testosterone to dihydrotestosterone or DHT. There are specific hairs that are sensitive to DHT. Many younger men who take finasteride who have aggressive hair loss may not respond to finasteride when compared to a male who is in their 30s or 40s. Unfortunately, there are concerns of the long term sexual side effects of finasteride. In Dr. Prasad’s practice, any man who comes in their 20s and 30s usually doesn’t want to take finasteride at all. There are men in their 50s and 60s who’ve been taking finasteride since the 90s and they’re fine.

Dr. Prasad’s practice has developed a method called Hair Regeneration to treat people with actively thinning hair. Combining platelet-rich plasma with a material called extracellular matrix, he has successfully been able to develop a formulation and a method of delivery that helps male and female pattern hair loss. Most patients are able to stop thinning and thicken their hair. He has up to 5 years of data to support the longevity and it’s been successful for patients who come from all over the world. For this gentleman, it’s exactly what Dr. Prasad would recommend.

Many people still choose to have a hair transplant, depending on the degree of progression and how much hair can be restored. Dr. Prasad usually tells people to not do a transplant first. He suggests for them to do Hair Regeneration and allow the full 18 months to go by. At this point, he has made Hair Regeneration a real viable alternative to hair transplantation. It can also treat people who had hair transplant, and as an alternative to a second transplant. They come in and he looks at them with a microscope and sees that there are thinning hairs that he can salvage. He can thicken those hairs and so they avoid doing a transplant. Another group of patients are people who have had transplants and want to help and improve their transplant’s yield. They maximize the volume by reversing the existing thinning hair, healing the donor area and the growth of the transplanted hair. He always encourages people that once they start noticing thinning, the sooner they come in, the better it is because there is more hair to work with. He can’t save hairs that are lost, but can save hair that are so thin they appear to be lost, and thickens and saves them.

Dr. Prasad thinks that this gentleman needs something that would stabilize the hair thinning. After stabilization, having a rational plan for transplantation for definition is reasonable, but he should understand the limitations of the donor area. Although people go outside of the safe donor area, those hairs are likely to thin, which is a big problem with FUEs as they are taken in a much wider area in order to yield enough grafts for transplantation. This is what makes Hair Regeneration really significant because it helps people before undergoing transplantation, or in many cases avoid transplantation entirely.

To learn more about Hair Regeneration, please visit:

http://nyhairloss.com/hair-regeneration-acell-extracellularmatrix-prp-by-dr-amiya-prasad/

Why Hair Loss and Thinning Treatment is Advised Before a Hair Transplant in Your 20s
Why Hair Loss and Thinning Treatment is Advised Before a Hair Transplant in Your 20s

A 21-year old gentleman is suffering from hair loss and thinning for the past 2 years. He has started taking finasteride and minoxidil. Although these drugs have helped him a lot, he still wants to consider a transplant.

Dr. Amiya Prasad, a hair loss specialist, explains that the level of this man’s hair loss can be classified as a more aggressive type of hair loss. Male pattern hair loss in a man’s lifetime has a “Rule of Decades”: in their 20s, 80% of their contemporaries have lots of hair and 20% have hair loss; as they approach their 40s and 50s, it becomes 50%. If someone has been taking finasteride and minoxidil and it was effective, they created some degree of stabilization. However, finasteride and minoxidil may slow down hair thinning but it doesn’t necessarily stop it. In addition, the rate of progression is different based upon the age of onset of hair loss. Dr. Prasad suggests that before someone considers a transplant, they should do an evaluation first by looking at their scalp with standardized digital photography and microscopy to determine relative percentages of miniaturizing or thinning hair in the scalp.

The limitation in hair transplantation is the donor area. The donor area is the area in the back of the scalp that is permanently present regardless of the degree of hair loss. A personal concern Dr. Prasad has with the aggressiveness of follicular unit extractions is the nature of the surgery. So many grafts are being harvested outside the safe zone of the donor area. Unfortunately, one of the reasons why follicular unit extractions become unpopular has to do with the unfortunate scars that resulted from the strip method. Dr. Prasad thinks it wasn’t the method but the communication about what to expect after harvesting the strip that ultimately led to the undesirable result. In Dr. Prasad’s practice, he uses the strip method as well as the FUEs but he also has a very good explanation about what to anticipate after the surgery. He also uses cosmetic surgical techniques to do the closure and a wound healing material called Acellular matrix.

If a patient decides to do a transplant, they cannot undo the loss of the donor area. If their hair loss continues then unfortunately those transplants become more obvious. They are forced to do another hair transplant surgery. So before moving forward with a transplant, Dr. Prasad has an option called Hair Regeneration. Hair Regeneration is a method that he developed by combining platelet-rich plasma with Acellular matrix. Platelet-rich plasma is derived from the patient’s own blood and has the active growth factors and healing properties. It has been observed that thinning hair became thicker when the material was used to help heal the donor area of a hair transplant. Over the past several years, he customized this treatment by developing a method of delivery, formulation, dosing, and technique that is based on the age, degree of hair loss, the type of hair loss and also other factors. This treatment is a non-surgical option because it is an injection treatment. Through this treatment, he is able to stop the thinning and reverse existing thinning hairs to becoming thicker hairs. The benefits can be observed in a course of a year to 18 months and we follow our patients every 3 months to watch their progress.

Dr. Prasad thinks it is important that he undergo Hair Regeneration to be sure that if he is going to undergo a hair transplant surgery that the results would be stable. He also has to think about what he would look like years from now. In addition, there are concerns about the sexual side effects of finasteride so he also has to think about the case scenario if he stops taking finasteride. It’s very important that he make these decisions with the full understanding of all of his options.

Hair Regeneration has been an incredible transformational process for many people. Dr. Prasad has patients who: have onset of thinning hair; patients who had transplant done elsewhere who are coming in to improve the results of their transplants, both in the growth of the transplants and improving the healing of the donor area, and to stop the progression of thinning hairs; and patients who had a transplant who are considering a second one, but then learn that there’s a lot of thinning hairs mixed in with the transplanted hairs. Dr. Prasad can thicken those hairs and can dramatically improve the coverage of the scalp than a hair transplant would. For a younger man with a questionable predictability of the hair loss or thinning pattern, a surgical transplant option has to be really considered very carefully before moving forward.

For more information about hair loss, please visit our website:

http://nyhairloss.com/

To learn more about Hair Regeneration, please visit:

http://nyhairloss.com/hair-regeneration-acell-extracellularmatrix-prp-by-dr-amiya-prasad/

The Physical Effects of a Hair Transplant for Hairline Lowering that Need Careful Consideration
The Physical Effects of a Hair Transplant for Hairline Lowering that Need Careful Consideration

A gentleman who is almost 30-years-old explains that his hairline looks bizarre. He is wondering about getting a hair transplant and wants to know if it is appropriate for him.

Dr. Amiya Prasad, a hair transplant specialist, explains that when someone has their hair wet, a lot more scalp that can be seen. However in this gentleman’s pictures of his hair wet, he looks to have a great amount of volume. Dr. Prasad says that he has to ask himself how motivated he is to have this frontal hairline transplant. In a hair transplant, a patient has to think about the area that needs the transplant and the amount of hair available to transplant. In Dr. Prasad’s practice he would evaluate the donor area, determine the density of hair, and how much hair would be available to transplant.

There are two types of transplant: follicular unit extraction (FUE), and follicular unit transplant (FUT)also known as the strip method. It’s very important to understand that there’s no such thing as a scar-less hair transplant. A lot of people are making claims using FUEs where they’re making little punches to remove individual hair clusters and then stating that there are no scars, which is not true. There are actually more scars with FUEs than in a strip method. If someone is to go and get a second FUE, they’ll definitely have a lot more scars. So whether they are using a robot, or a new device, or just doing it manually, hair transplant means scars in the back of the head. When Dr. Prasad does an examination, he looks for places where the scars would be obvious and could draw attention and can be a source of potential embarrassment such as when the hair is wet. He also has to think about how many transplant sessions they need to achieve their goal.

One of the biggest challenges of transplant surgery is achieving density. The level of density this gentleman has is very difficult to achieve with a single transplant surgery. Lots of doctors make all kinds of claims about the number of grafts per square centimeter. Although a skilled surgeon or technician can place these hairs very close together, every hair needs a circle of skin or tissue. Depending on the transplant factors in terms of the method, the survivability of the grafts and things a surgeon can and cannot control, the yield of the transplant is not the same with the number of grafts placed. Dr. Prasad had patients who have lost over 90% of grafts when their transplant was done elsewhere. One patient of his had a blood pressure that was not well controlled and his transplant facility did the transplant in spite of the blood pressure. It led to more bleeding which led to grafts not taking.

In Dr. Prasad’s practice, when he does a hair line lowering procedure, he tries to be conservative and try to feather the transplant. It starts in the edge of the existing hair and goes downward as opposed to drawing a line down and fill that space with grafts. For him, that’s not the way he likes to work. He thinks that most people would disagree that this gentleman’s hairline looks bizarre. He suspects that this is most likely a familial trait. A lot of people would actually envy the amount of hair that this gentleman has.

Dr. Prasad suggests that he meet with experienced hair transplant surgeons and get some opinions. He should get some understanding of the realistic expectations and think of what he is willing to put up with. In Dr. Prasad’s practice, he tries to maximize graft survival using a material called extracellular matrix that helps with the wound healing in the donor area. It also helps with the survivability and healing process of the grafts. It even reverses the thinning process of people who have thinning hair and makes those hairs thicker. He calls that Hair Regeneration. In this gentleman’s situation, if he were to do a microscopic evaluation, there’s a good chance that he won’t find miniaturization so what he is looking for is a specific type of result which is fine as long as he understands the process and the steps involved.

For more information about hair transplantation, please visit our website: http://nyhairloss.com/hair-restoration-by-dr-amiya-prasad/hair-transplantation/

The Causes and Treatments for Bags and Fine Lines Under the Eyes
The Causes and Treatments for Bags and Fine Lines Under the Eyes

A woman has lines and bags under her eyes and she’s not sure how to handle them. She wants recommendations on how to address her problem.

Dr. Amiya Prasad, a cosmetic oculofacial cosmetic surgeon, does a lot of eyelid procedures. He says that for lower eyelid rejuvenation, there are some key elements that should be addressed to maximize the results. He first assesses for lower eyelid fat prolapse where the eyes are puffy all the time regardless of adequate sleep or management of allergies or sinuses. It is caused by herniated fat that has pushed forward. In order to address it he does a lower eyelid blepharoplasty.

Depending on the presence of redundant skin or laxity of the lateral canthal tendon which supports the lower eyelid, Dr. Prasad makes decisions on whether to do an external approach called a transcutaneous blepharoplasty or an internal approach called a transconjunctival blepharoplasty. Most of his patients who come for eyelid surgery typically don’t have excess skin so he generally does a transconjunctival blepharoplasty. If they do have some extra skin, he does a transconjunctival blepharoplasty with a skin pinch excision. In his practice, he does all these procedures under local anesthesia with LITE™ IV sedation.

Years ago, when Dr. Prasad would do an isolated blepharoplasty, he was always challenged with the issue on how to manage the skin. In addition to the puffiness of the eyes which is a big negative, there might be the presence of fine lines and wrinkles that make the eyes look aged in appearance. It is important to distinguish skin quantity from skin quality. People who have wrinkles under the eyes will undergo procedures to remove what they believe is excess skin. Unfortunately, a lot of those people will have a shortage of skin after the surgery that leads to a rounded lower eyelid, or eyelids getting pulled down called lower eyelid retraction.

Dr. Prasad suggests that she should be cautious and understand that a distinction between skin quality versus skin quantity has to be made. When someone has fine lines under the eyes then skin quality is the dominant issue. In skin quality, there might be loss of collagen, blood supply and the thickness of the skin. Dr. Prasad’s current approach to addressing skin quality is usually an application under the skin of platelet-rich plasma (PRP). Platelet-rich plasma is derived from the patient’s own blood where growth factors necessary to for healing are concentrated to stimulate collagen, blood supply and improve skin quality. In addition, he’ll use fractional CO2 laser which addresses the superficial lines and improves the skin quality through collagen stimulation.

Dr. Prasad suggests that she meet with qualified experienced cosmetic surgeons particularly those who have a lot of experience with eyelid surgery and understands that there are some potential pit falls. She should also consider the integrity of the support structures of the lower eyelid which need to be addressed, but are often overlooked by a lot of general plastic surgeons.

To learn more about lower eyelid surgery to remove eye bags, please go to:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/lower-eyelift/

To learn more about platelet-rich plasma (PRP) for under eye wrinkles, please go to:

http://prasadcosmeticsurgery.com/injectables/platelet-rich-plasma/

To learn more about fractional CO2 laser for wrinkle treatment, please go to:

http://prasadcosmeticsurgery.com/prasad-medi-spa/laser-light-treatments/microfractional-co2/

How to Maximize Graft Survival in a Hair Transplant Procedure, and Stop Further Loss
How to Maximize Graft Survival in a Hair Transplant Procedure, and Stop Further Loss

A gentleman has thinning hair and a progressively higher hairline which may be have been caused by telogen effluvium from irritable bowel syndrome. He wants to have a natural look after a hair transplant how many grafts he would need to achieve it.

When a patient comes to Dr. Amiya Prasad’s practice, he first measures the desired area to be filled in square centimeters. After, he looks at the limitations of the area where the hair will come from called the donor area. The donor area is the band of hair at the back of the scalp which are genetically resistant to hair loss and do not go away. They serve as the bank where the hairs are harvested to fill the bald areas of the scalp. To achieve the right amount of density, Dr. Prasad estimates the amount of hairs to be grafted based on the measurement of the length and width of the bald areas. He takes the hairs by doing either a traditional strip method of follicular unit transplant (FUT), whereby other practices do a follicular unit extraction (FUE).

Dr. Prasad explains that hair transplant is very tricky and is intrinsically flawed in its ability to make someone happy long-term because it doesn't prevent hair from thinning. Some patients don’t take medical therapy like finasteride after hair transplants so their hairs continue to thin leaving them a “pluggy” appearance. There are also claims that a hundred hairs can be placed per square centimeter. However, hair grafts are based on the intrinsic anatomy of a particular person’s hair follicle. Patients with finer and thinner hairs won’t be able to cover an area compared to someone who has thicker, or wavier hair. In addition, each hair needs a surrounding amount of tissue that will allow for it to grow and survive.

In Dr. Prasad’s practice, he maximizes the survivability of the hair grafts. He manages blood pressure to prevent bleeding after surgery and he also provides IV intravenous sedation during sessions. He will also use a material called extracellular matrix to maximize the graft survivability. He has had patients who had mega sessions done elsewhere and they had 90% loss of grafts because their surgeons didn’t consider the survivability of the hairs. In addition, if he sees patients who have miniaturization of their hairs and they continue to thin, he offers them medical therapy such as finasteride and minoxidil. Unfortunately, a lot of people are hesitant to take finasteride because of the potential long-term sexual side effects.

A majority of patients who come to Dr. Prasad actually choose an option he developed called Hair Regeneration. Hair Regeneration is the use of extracellular matrix that was originally used for wound healing. He developed a formulation, a method of delivery and a technique to reverse the hair thinning process. Hair Regeneration is using the patient’s adult stem cells to repair the flawed mechanisms and the cells and signals needed for hair growth. Unfortunately, the questions of what causes hair loss have not been fully answered and the mechanism of hair growth still remains with missing pieces to the puzzle.

Dr. Prasad’s advice is that patients should know the density and the amount of hair that they would need. In his practice, he defers hair transplantation on someone who’s actively thinning. He treats them first with Hair Regeneration and sees how much density and volume they get back. He is confident that they won’t continue to thin for at least 5 years based on what he has experienced with Hair Regeneration which can deliver a realistic and natural-looking appearance. Unfortunately, a hair transplant is one of those areas where a person can look good for a while, but if their hair keeps thinning then they can look like they had plugs or they end up being committed and forced to do more transplantation.

Dr. Prasad hopes that patients have full understanding of what to expect from a transplant before they make decisions. They should keep in mind that the donor area has limited amount of hairs and eventually, it will tap out, so they should be extra careful about how they strategize their hair loss treatment plan.

For more information about hair transplants with Hair Regeneration, please go to our website:

http://nyhairloss.com/hair-restoration-by-dr-amiya-prasad/hair-transplantation/

http://nyhairloss.com/hair-regeneration-acell-extracellularmatrix-prp-by-dr-amiya-prasad/

The Importance of Communicating Desired Results Prior to Upper Eyelid Surgery
The Importance of Communicating Desired Results Prior to Upper Eyelid Surgery

A 26-year-old female has heavy upper eyelids. She wants to know the best option for her but she is worried about ending up with hollowness above her eyes.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, explains that when someone is considering doing something about their upper eyelids, it is very important to clearly communicate with their surgeon their desired results. An upper eyelid blepharoplasty is the procedure she is seeking, but she needs to communicate if she wants it conservatively or aggressively done. This procedure will create the platform where patients apply eye shadow.

When Dr. Prasad does an evaluation for upper eyelid blepharoplasty, he lets his patient hold up a mirror, and uses a Q-tip to roll the skin over the eyes to show how much eyelid they will be able to see. A less aggressive would be the removal of skin and maybe a little of the orbicularis muscle. A more aggressive procedure would mean to go in the orbital fat compartment called the orbital septum and reduce fat in order for the eyelid to fold in. Sometimes, surgeons still need to do that in less aggressive procedures in order for the eyelid to fold in because of the presence of fat pushing forward. When he does this type of procedure, he sees what the anatomy is. Essentially, what this woman is asking for is a very conservative upper eyelid blepharoplasty. However, she should be sure that having something conservative is satisfactory for her.

As a surgeon, when a younger person comes to Dr. Prasad, he thinks that they are already starting at really good place and that they already look really good. It is his job is to take someone who already looks good and make them look a little better. The precision or the procedure is critical: making sure that the lines are in the right place, how much skin is removed, how it is sculpted and getting that symmetry is really about artistry and technical expertise.

Dr. Prasad suggests that she spend time with her doctor. A procedure is really more of the doctor’s style and really focusing on what her desired look is. Patients should discuss with their doctor how the procedure will be done and whether or not it’s attainable for what they want. If she has a procedure and she goes through the time and expense but it’s a little subtle for her taste, then she’s not going to be happy. The bottom line is that she should have clear communication with her doctor. She should meet with doctors who are extensively experienced with cosmetic upper eyelid surgery.

For more information about upper eyelid surgery (upper blepharoplasty), please visit our website:

http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/upper-eyelift-surgery/

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