vidgrids.com : Online Video Search & Discovery Engine :

Drprasad1 Videos

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/

How Post Facelift Swelling Can Make Lines Look Temporarily Deeper, & When to Add Volume
How Post Facelift Swelling Can Make Lines Look Temporarily Deeper, & When to Add Volume

A 54-year-old woman looks younger than her age. She had facelift, necklift and fat grafting. However, after the procedure, her nasolabial and marionette lines became deeper. She wants to know how to improve her appearance.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, explains that face lifting surgery is to reposition sagging skin, improve jowls, and soften marionette lines and the nasolabial folds. If a patient looks at their pre-operative photos and compare it with their results, there may be some improvement. They must also recognize that at a two-month point, there will be some degree of swelling that may be present. With any surgical procedure, swelling can be a factor of how these areas look for up to six months to a year.

Nasolabial folds and marionette lines may look prominent because of the depth relative to the adjacent height. Dr. Prasad wrote a book a few years ago called “The Fine Art of Looking Younger” and explained the two elements of facial aging: sagging where there is loosening of skin and support tissue, which is addressed with your facelift procedure; and volume loss where bone, muscle, fat, skin and soft tissue resorbs. He has always observed in women that the lower third of the face has a significant amount of volume loss which results in loss of lip definition, vertical lines, nasolabial lines, and mesolabial or marionette lines become deeper. There is indentation of the mandibular notch which makes the jowls looks more prominent.

The lady can have a strategy with her doctor to address volume loss, but she should wait until swelling has resolved before doing volume correction. In Dr. Prasad practice, he lets his patients understand volume loss after a facelift by having them hold the mirror and he lifts the face. Then, he points out to the patient that the mesolabial folds are improved but there is still some depth. He evaluates because when the whole architecture of the face is changed, the perception of the face also changes. Dr. Prasad thinks that there will be options that will help this woman look even younger than her age as she already expressed. She should talk to her doctor and express her concerns and she’ll find solutions that will be satisfactory for her.

For more information about facelifts, please go to our website:

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

To learn more about fillers for volume loss, please go to our website:

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

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

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

Why Swelling after Eye Bag Surgery Can Temporarily Affect Appearance, & Treating Adjacent Hollowness
Why Swelling after Eye Bag Surgery Can Temporarily Affect Appearance, & Treating Adjacent Hollowness

A man had blepharoplasty two days ago. He is worried that the surgeon may have removed too much fat which caused his lower eyelid to sag. He wants to know if he has how hollow eyes or if it just swelling.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, performs a lot of upper eyelid blepharoplasty. He also does a lot of facial cosmetic surgery such as facelifts and he always looks at the eye in the context of the whole face. When someone comes in into his office with bags under the eyes, he sees that the bags under the eyes are the most prominent and dominant feature on their face, but he also discusses with them how it relates to other areas of the face. This means he considers how the whole face looks like when the eye bags are reduced.

In Dr. Prasad’s practice, he first explains that if patients have bags under their eyes, there is often adjacent volumetric loss in the eyelid cheek area and the sub malar area. He shows the volume loss in different views of the face so that patients can see how the bags are prominent relative to the eyelid adjacent to it. It’s ironic that when they have puffy bags under the eyes, they have too much fat in one place, and not enough fat in another place. In terms of hollowing and fillers, this depends on what the patient’s desired outcome and what they want look like long term.

Dr. Prasad says that this man's doctor is correct in saying that swelling has a tremendous impact in the overall appearance of the eyes, especially in the first month after eyelid surgery. Although Dr. Prasad’s practice is proud of how they do lower eyelid surgery and how they are able to get people back to work within a week, he always explains that swelling after surgery can last anywhere from 6 months to a year, which has to do with a process called wound remodeling. It’s a normal part of wound healing which means there are restorations of blood supply, muscle tone and other factors that contribute to the eyelid healing properly. He follows his patients at 1 week, 3 months, 6 months and until a year. His doors are always open to address any issues and concerns.

Hopefully this man will restore faith in his doctor and recall what his pre-surgical consultations were and what were explained. Dr. Prasad thinks he should discuss what his options are, but also allow some time to let the swelling resolve before he draws any conclusions. One cannot make any real judgments when there’s tissue swelling as it’s hard to predict. For Dr. Prasad, the pre-operative evaluation and what the patient look like beforehand and being aware of that helps patients understand what the change is after their surgery.

To learn more about the causes of temporary swelling after eye bag surgery and how they can be corrected, please visit our website:

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

To learn more about injectible fillers for hollow under eyes, please visit:

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

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

Puffy Eye Bags are Mostly Caused by Genetics and Can Appear While Still Young with No Health Issues
Puffy Eye Bags are Mostly Caused by Genetics and Can Appear While Still Young with No Health Issues

A 33-year-old man has under eye bags that make him look tired. Creams and other things didn’t work for him. He wants to know the best way to get rid of the bags.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, says that eye bags are one of the most common procedures he performs in his practice. Eye bags are the result of prolapsed orbital fat - the fat that is normally around the eyes pushes forward and creates a bulge. Very often people think they're due to lack of sleep, allergies or sinuses. Although those factors can make the bags appear worse, genetics play a role in early onset of eye bags especially in the teen years. MRI studies have shown that fat not only pushes forward, but the fat has expanded or increased in volume. Prolapsed fat has nothing to do with body fat - Dr. Prasad has observed marathon runners or people who are extremely fit with very low percentage of body fat who have these bags under their eyes.

The standard approach for bags under the eyes is via an external approach called a transcutaneous blepharoplasty or an internal approach called a transconjunctival blepharoplasty. For young patients like this man, Dr. Prasad tries to avoid external incisions by doing the transconjunctival approach. This is a more advanced approach because it is working close to the eyeball itself. A big advantage of this approach is that it preserves the structure of the under eye muscles that are responsible for eye shape. In addition, this approach leaves no external scars. Unfortunately, a lot of people have external approach eyelid surgery and their eye support structure becomes compromised. They end up with their eyelid pulled down called lower eyelid retraction, their lower eyelid everted out, or the combination of both called ectropion. The lower eyelid is a deceptively complex structure. It requires the balance of different factors like the lateral canthal tendon which supports the lower eyelid by connecting it to the bone, as well as the orbicularis oculi muscle that acts like a hammock. Dr. Prasad does a combination of resection, sculpting and repositioning which is customized to the individual patient.

If there are issues related to the skin quality, Dr. Prasad would also employ a method of regeneration or improvement of skin quality using called platelet-rich plasma. Platelet-rich plasma is derived from the patient’s blood and it takes advantage of the growth factors and cells necessary for healing called platelets. It stimulates collagen and blood supply which results in improvement of skin quality. In certain candidates, he also employs some type of thermal-based treatment using either fraction CO2 laser or a radio frequency device to stimulate skin tightening.

Dr. Prasad suggests that this man meet with qualified experienced cosmetic surgeons, particularly those with extensive experience with lower eyelid surgery. Like many areas of cosmetic surgery, this specialization or experience makes a very big difference on the outcomes that people have. He should get a sense of the aesthetic style and what surgeons are suggesting. Once the bags are reduced and addressed, it really brightens the whole facial expression.

To learn more about eye bag removal surgery without an external incision (transconjunctival blepharoplasty), please visit our website:

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

Creating a Parallel Eyelid Crease is Best Done with the Non-Incisional Suture Method
Creating a Parallel Eyelid Crease is Best Done with the Non-Incisional Suture Method

A 19-year-old Asian lady has naturally tapered double eyelids. She wants to know how to make her eyelids look parallel. She also wants to if an incisional or non-incisional technique can help achieve her desired look, which she demonstrates using eyelid tape.

In Dr. Amiya Prasad’s practice, he makes patients wear tape on their eyelids so that he can figure out where to place the non-incisional fixation sutures. The tape pushes up the crease and creates a point where the optimal placement of sutures can be used to mimic the effect of the tape. There’s a difference between tape and surgery - the tape only gives an outside physical pressure on the skin and the stiffness forces the eyelid skin to fold. On the other hand, in a non-incisional surgery, little openings are made in the skin and a suture is placed through the skin to engage the levator muscle. This creates an adhesion or connection between the skin and the levator muscle. Although this lady has a natural fold, it would have to be pushed up 1-2 millimeters to create a pleating effect.

Without a physical exam, Dr. Prasad can’t tell the relative skin thickness, quality and how much the skin is likely to cooperate from a surgeon’s perspective. A surgeon can do a lot of things with tape but if the skin is stiff, it’s not going to hold. Initially, it may look good but it may become undone to the point where it may regress back. That’s a risk that is part of this type of procedure.

Dr. Prasad would not recommend an incisional procedure for this lady because usually he reserves that for people who have either a single fold or need a small amount of skin removed. He also recommends that if there is a lot of fat that’s pushing down and that the non-incisional technique simply won’t work. The surgeon would have to make a skin excision in order to have access to the levator muscle. In a situation like this lady where she already has a fold, chances are there is enough space to create some internal fixation suture to create the same effect of the tape.

Dr. Prasad suggests that she meet with some cosmetic surgeons and get a physical examination. Based on the physical examination, she’ll get a certain sense of the predictability of the approach of the surgery. Most likely she would be a candidate for the non-incisional approach to have the parallel crease that she desires.

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

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

Why Temporary Swelling after Double Eyelid Surgery Occurs & How Long Post Surgery Swelling Can Last
Why Temporary Swelling after Double Eyelid Surgery Occurs & How Long Post Surgery Swelling Can Last

A man had Asian eyelid surgery 3 weeks ago and noticed one of his eyes has a different shape. He wants to know what could cause this.

Dr. Amiya Prasad, an oculofacial plastic surgeon, observed from his photos that there is swelling and it has a tremendous impact on the appearance of the eyelid crease. This is probably a result of Asian eyelid surgery where it requires a connection between the skin and the levator muscle. The levator muscle is the muscle that lifts the eyelid. This procedure creates a very tight compartment where fluid has a tendency to linger. This applies to both the incisional and non-incisional techniques of Asian eyelid surgery.

Although there are examples of people who look good in a week or a month, eyelid swelling can last up to a year although it rarely lasts that long. Typically, enough swelling has resolved by 3-6 months and a patient can have a good sense of their final appearance. In Dr. Prasad’s practice, he follows his patients very closely: he sees them at 1 week, then 3-4 weeks later, then monitors them again at 3 and 6 months. He has observed that some people can have swelling that lingers, with factors such as allergies and sinus problems having an impact.

Dr. Prasad is certain that this man's doctor has discussed this with her prior to surgery. This is part of the standard discussion about eyelid surgery, whether it’s an Asian eyelid surgery or a non-Asian eyelid procedure. He must simply wait for swelling to resolve. Surgeons cannot operate on something that’s swollen unless there’s a very strong indication and usually wait until they can manipulate the tissue when necessary. In Dr. Prasad’s practice, he let his patients open and close their eyes even when he is doing Asian eyelid surgery just to confirm that the crease looks like the way the patient wants it to.

Dr. Prasad explains that communicating with the doctor is critically important. No one knows the patient’s anatomy or what was experienced during the surgery better than the surgeon. He thinks that waiting it out would probably work out in the patient’s favor.

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

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

Why Lower Eyelid Surgery Should Include Anatomical Support to Prevent Complications
Why Lower Eyelid Surgery Should Include Anatomical Support to Prevent Complications

A 46-year-old woman is concerned about her lower eyelid. She wants to know if she will benefit from a blepharoplasty procedure.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon explains that lower eyelid blepharoplasty addresses puffiness, eyelid position and excess skin. If someone has puffiness under their eyes like this woman, then addressing the lower eyelid area with a blepharoplasty makes sense.

At 46-years-old, this woman probably noticed that there’s been some volume loss under her eyes. In Dr. Prasad’s practice, most of his patients are confused between a filler versus surgical procedures to address this area. A few years ago, he wrote a book “The Fine Art of Looking Younger” where he explained the issues of facial aging. Facial aging has two essential principles: first is volume loss where there is loss of bone, muscle and fat; second is laxity. For example, the lower eyelid tendon becomes looser and the obicularis muscle gets a little more lax. Overall, there’s a support issue that may be part of the whole lower eyelid rejuvenation process.

When Dr. Prasad does an evaluation for lower eyelid blepharoplasty, he looks at the tone of the lower eyelid. He does a snap test by pulling the eyelid down and sees how well it comes back up. In addition, he thinks it is important to address the fat pockets as well as lifting or tightening the lateral canthal tendon. Looking from different perspectives, he also assesses if there’s a relative prominence of the eye to deal with any type of support structure in the lower eyelid.

Dr. Prasad also wrote an article many years ago called, “Ethnic Considerations in Eyelid Surgery” to cater patients who were not Caucasians and were embracing and exploring cosmetic surgery procedures. Unfortunately, traditional cosmetic procedures like an external incision lower eyelid blepharoplasty where the lower eyelid is opened up and fat and skin removed was problematic for patients of African origin as it resulted in the eyelid being pulled down. Someone with dark skin color has to be mindful of the techniques applied to lower eyelid blepharoplasty. At the same time, addressing the volume loss can be the second part of the equation. By adding volume in the cheek area through augmentation with fillers, cheek implants or through face lifting, it can have a tremendous impact in the context of how the eyes look.

The last part of this equation is skin quality. People often mistake lower eyelid surgery as a way to reduce wrinkles and dark circles.To address the skin quality issue in Dr. Prasad’s practice, he routinely uses platelet-rich plasma for lower eyelid rejuvenation. He draws the patient’s own blood, spins it and concentrates the platelets and growth factors which are the necessary for healing. He places it under the skin of the eyelids and see a qualitative improvement in the skin which including wrinkles and skin color. This gives an overall healthier glow to the skin.

Dr. Prasad thinks she should meet with experienced cosmetic surgeons who have a lot of experience with different skin types. Once she finds someone that resonates with her, she can move on with the procedures.

To learn more about eye bag removal surgery without an external incision (transconjunctival blepharoplasty), please visit our website:

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

To learn more about fillers for volume loss, please go to our website:

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

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

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

Why Ptosis Correction Can't be Done with Regular Cosmetic Eyelid Surgery
Why Ptosis Correction Can't be Done with Regular Cosmetic Eyelid Surgery

A 50-year-old woman was born with a double eyelid. However, her eyelid has drooped. She also has some hollowness at her eye socket. She wants to know how to address both of her problems.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon can tell from here photos that she has ptosis. Eyelid ptosis means that the muscle that is responsible for lifting the eyelid has thinned, stretched, and the eyelid level and height droops down. As people get older and as long as there is no neurological basis for the ptosis, it is likely a condition called levator aponeurosis ptosis, levator muscle attenuation or involutional ptosis.

Dr. Prasad explains that if a traditional cosmetic surgery is done first like blepharoplasty to enhance the appearance of the eyes, if the ptosis is not addressed, then there may be no significant improvement. If ptosis is not addressed first, the eyelids will still be low and she will still look tired after surgery. He suggests doing the ptosis procedure first before she addresses the relative hollowness of her upper eyelids.

In Dr. Prasad’s practice, he does ptosis surgery in his Joint Commission certified operating facilities. He does the surgery with the patient under local anesthesia with LITE™ sedation. This is a relatively complex procedure because it involves a muscle that’s very sensitive. During the procedure, he lets the patient open and close their eyes while they are lying down, then have them sit up. Through this, he is able to adjust the height, shape and contour to get the right symmetry. The patient doesn’t feel any pain and is perfectly fine and comfortable. He finds that more than 95% of his ptosis patients get really nice results. However, there are also some people who still need to come back for some type of revision because the eyelid is too high or too low.

Dr. Prasad says that hollowing is very common. Asians can have very full eyelids when they are young, but aging can make big changes in the shape of the eyelid and can cause hollowing. It is comparable to volume loss in the breast when the upper pole of the breast diminishes - similar things happen in the upper eyelid.

Dr. Prasad’s advice is to not be too aggressive when restoring volume in the upper eyelids. This also applies to Caucasians or people who used to have full upper eyelids. As they get older, they have extra skin and they try use fillers or a fat transfer. They can end up with bagginess and excess volume that doesn’t look good. In Dr. Prasad’s practice, he has been very successful in using a hyaluronic acid filler to restore some volume conservatively in the sub brow space to restore a nice natural appearance that they’re satisfied with. It’s not the same as what they had when they were younger, but it looks more like them. In other patients, he actually uses fat transfer, but he tells them that 30-70% of that fat can be absorbed, so they should be prepared for a second procedure.

Dr. Prasad explains that in a situation like this woman, she would probably address the ptosis first and allow everything to heal. Ptosis can have a dramatic impact on the physical appearance of the eyes and she can really look dramatically better, so the hollowing may not bother her so much after.

For more information about ptosis correction surgery, please visit our website:

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

Why Double Eyelid Surgery Swelling can Take Months to Resolve, & Patience before Any Revision
Why Double Eyelid Surgery Swelling can Take Months to Resolve, & Patience before Any Revision

A woman had eyelid surgery. However, her right eye is not folding. She wants to know the cause of this and would she need another operation to correct it.

Dr. Amiya Prasad, an oculofacial plastic surgeon, explains that when evaluating the stability of the eyelid crease, it is important to understand that there are many dynamics that contribute to the ultimate outcome of this type of surgery. When someone is in the 7-week point, there is still some degree of swelling that may not always be apparent. The process of fluid absorption related to surgery happens not only at the superficial level like in the eyelash, eyelid margin, or crease, but also in the deeper levels of the tissue underneath the skin. There is a lot of healing going on and the healing process has several stages. True healing goes on for months and can take up to a year to settle.

If her doctor feels that the eyelid is still swollen, then any further enhancement surgery is not likely beneficial. Dr. Prasad always explains to his patients that swelling changes the dynamics of the predictability of how the surgeon places the tissue when doing surgery. Unless there is a specific indication that requires earlier treatment, then it is usually best to allow swelling to resolve to a reasonable level to the point the surgeon feels comfortable about going in and doing something to revise the result. He has seen patients who came in for revision surgery who had several surgeries done in a very short time frame, with the doctor trying their best efforts to try to get the patient happy. Unfortunately, with every surgical trauma, there is the potential of scar tissue formation and other issues. More importantly, swelling is a moving target and therefore it changes the dynamic.

If there are multiple folds and if the crease is not well delineated, it’s usually something that is amenable to a procedure such as a non-incisional fixation. Little openings are made and a connection between the eyelid and the levator muscle is created. A principle of most eyelid crease surgeries is to create a connection between the skin and levator muscle. If there is fat in the way of the space, then the fat is reduced or shifted out of the way in order to create the connection. However, when the sutures are removed, there is a possibility that the skin can detach a little so it does not create the crisp, nice-looking fold.

Dr. Prasad suggests not losing hope and continuing communicating with her doctor. In Dr. Prasad’s practice, he sees his patients at 1, 3 and 6 months and beyond and the doors are always open if they have questions or concerns at any time. Once she has this continuous dialogue and if her doctor takes photos and documents the progress, it might be easier for her to see where things are going. Surgical healing can take up to a year and swelling can be a factor.

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

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

Why Age Doesn't Always Determine if Someone is a Candidate for a Facelift Procedure
Why Age Doesn't Always Determine if Someone is a Candidate for a Facelift Procedure

A 55-year-old woman wants to know if she is too young for a facelift.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, explains that most people think a full facelift is a procedure that starts from the top of the head all the way to the bottom of the neck. They think that it includes a brow, eyelid, cheeks, the jawline and the neck. However, the reality is that a facelift and a neck lift are two separate procedures. A facelift lifts the cheek, improves the jawline and part of the neck while a neck lift is a more extensive procedure involving the lower part of the neck. In a facelift, the surgeon is addressing sagging cheek skin, jowls, loss of definition of the jawline and the loose skin under the chin.

In Dr. Prasad’s practice, he has operated on patients who were as young as 37 and as old as 87-years-old. After looking at this woman’s photo, Dr. Prasad thinks that she not a candidate for a facelift. 55 years old is not too young for a facelift, but at her age she still doesn't need one. Age is not always the best indicator if someone is a candidate for a facelift. Chances are she would not have much movement after the skin is pulled upwards. A person can do a simple test called the mirror lift by lifting the side of the face and see if the jawline has improved. If there isn’t that much movement, then there really isn’t much a surgeon can do.

In addition, Dr. Prasad explains that different ethnicities and skin types age differently. Very light-skinned Caucasian patients with blue eyes like patients of Irish descent have skin that tends to be thinner and tends to sag when they are younger. Darker skin types like that of African descent have very thick skin, with volume and tone. Procedures such as face lifting surgery may be done later in their 60s or beyond. With ethnicity, there is a lot of blending so it’s hard to decide when to have a facelift. Age is not necessarily the strongest indicator, but instead an individual's face should be evaluated at a given stage.

Dr. Prasad thinks she should move forward with meeting with doctors and articulating what it is that is bothering her about her face. Dr. Prasad thinks that with the single photo that she submitted, there is no evidence of a jawline that needs better definition or excess neck skin.

For more information about facelifts, please go to our website:

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

Why Fat Grafting Under Eyes is Not Advised, and Alternatives for Volume Enhancement
Why Fat Grafting Under Eyes is Not Advised, and Alternatives for Volume Enhancement

A 37-year-old Caucasian woman wants to know the pros and cons between fat grafting and blepharoplasty.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, observed that this woman has relatively prominent eyes, puffiness, and hollowness below the eyes. The key to the best plan is identifying what affects her appearance the most. He says it is always tempting to have multiple procedures at one time, but he strongly believes in minimal trauma and getting the goals clearly defined. Different doctors will have different perceptions about a patient’s case. He had a number of patients who had procedures done by another doctor, but were disappointed with their result because their expectations were not met.

Dr. Prasad says that fat grafts placed in the lower eyelid area is unpredictable. Although theoretically or technically it makes sense to try to restore fat in the lower eyelid area, little bumps and irregularities are common in fat grafting. About 30-70% of grafted fat can be absorbed by the body. In addition, the lower eyelid skin is so thin that it easily shows all irregularities. He has had patients from all over the world with fat grafts who wanted him to remove the lumps. He had to get to the grafts through different planes of the eyelid in order to reduce the irregularities, which often results in potential destabilization of the eyelid structure that requires more than one surgery. Fat grafts placed in the cheek area, nasolabial folds and in other areas except the lower eyelid is acceptable as those areas have thicker skin so will not show irregularities.

If the face is relatively hollow like this woman’s, Dr. Prasad suggests a facelift, volume augmentation in the cheek area or placement of submalar or cheek implants. There are many options to explore when dealing with the lower eyelid puffiness. A limited blepharoplasty such as a transconjunctival blepharoplasty with some reduction of that fat may be helpful for her.

Dr. Prasad says that if she is going to choose fat grafting, she should have it done in the lower face rather than the lower eyelid. There are also alternatives to fat grafting on the face such as the placement of submalar implants to add volume in this area. She should think about her priorities, find a doctor that she resonates with and take smaller steps. She should also be more conservative in the beginning before moves forward with a more extensive procedure.

To learn more about fillers for volume loss, please go to our website:

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

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

Non-Surgical Face Treatments in the Mid 30s are Likely a Better Option than Facelift Surgery
Non-Surgical Face Treatments in the Mid 30s are Likely a Better Option than Facelift Surgery

A 36-year-old woman is athletic and has a healthy lifestyle, but is unhappy with her facial appearance. She wants to know if she needs a facelift.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, says that the youngest patient he ever performed a facelift on was 37-year-old woman who had genetic laxity of her facial features. However, the majority of his patients for face lifting are women in their mid-40s and older, so he is hesitant to recommend a facelift for this woman.

The genetic factors that causes facial aging involves two things: volumetric loss of bone, muscle, and fat; the other is skin laxity. To assess this, a person can do a "mirror lift" by looking in the mirror and gently pulling up their face. If there is significant improvement, then they would probably need a facelift. However, there are some patients who put excess tension and pull tightly. This is not advisable because the skin still needs to move.

For younger patients like this woman, Dr. Prasad thinks that volume correction using a filler like Restylane or even a thicker filler that goes under the skin like Radiesse is a better option to add facial volume without surgery. Lifestyle associated factors such as smoking cessation, increased sleep and a healthy lifestyle can affect facial appearance. If their skin is too lax, there wouldn’t be much benefit from a filler and a limited facelift may be appropriate.

The best way to decide whether or not a facelift is right for someone is to meet with qualified, experienced cosmetic surgeons. There are many different surgeons who do facelifts and looking at a wide variety gives a sense of what her options are. Dr. Prasad’s approach to face lifting surgery is to do the surgery under local anesthesia with LITE™ IV sedation. Face lifting is an art that is also about communication between the doctor and the patient about the desired outcome. She’ll hopefully find a doctor with whom she resonates who will help guide her if she should have a face lift, or can buy some time with injectables.

Dr. Prasad would advise avoiding thermal devices that tighten skin. These thermal devices are marketed very aggressively and create the perception of being highly effective. For at least 10 to 15 years of different types of thermal devices, he has never seen one that does anything close to what a face lift does. Thermal devices create the illusion of benefit because of swelling. His observation is that aggressive thermal devices that heat up the skin very rapidly at very high temperatures are actually making skin lose collagen and fat. Losing the thin layer of fat just below the dermis accelerates the aging process.

In Dr. Prasad’s practice, he is doing a lot of regenerative medicine particularly the use of platelet-rich plasma. With 20 years of experience and taking care of patients, his opinions are all based on his experience. He advises that she should learn more about her options.

To learn more about fillers for volume loss, please go to our website:

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

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

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

Causes of Droopy Lower Eyelids after Eye Bags Surgery, & Treating Hollows Under Eyes
Causes of Droopy Lower Eyelids after Eye Bags Surgery, & Treating Hollows Under Eyes

A woman had eye bag surgery three years ago. Unfortunately, her lower eyelid has descended and her under eye area is hollow. She wants to know how to correct this area.

Dr. Amiya Prasad explains that lower eyelid surgery addresses fat pockets or herniated fat. However, when those fat pockets are addressed, often surgeons overlook the adjacent area of the eyelid called the eyelid-cheek junction or not pay attention to the cheek area or the submalar area. As a cosmetic oculofacial cosmetic surgeon, Dr. Prasad performs eyelid and facelift surgery as well as cheek implants so he really looks at the eyes from the perspective of the whole face. During lower eyelid surgery, he explains to his patients that there is often concurrent volumetric loss in the eyelid-cheek area and the cheek area.

A few years ago, Dr. Prasad wrote a book called “The Fine Art of Looking Younger” where he explained the basic philosophy about genetic and age-related changes where there is often descent or laxity. In this woman’s case, the position of her lower eyelid relative to her iris or pupil is slightly lower. The factors that are required for stability of the lower eyelid position needs to be addressed. This includes the lateral canthal tendon that attaches the outer corner of the eye to the bone, and the orbicularis oculi muscle which supports the lower eyelid. Depending on the type of surgery she had, whether or not she had skin removal or if it was done from the inside, there may be some loss of support in the middle part of the inside of the eyelid called the middle lamella. When the lower eyelid sags in the middle, it may be an indication of that laxity of the support structures under the eyelid.

Dr. Prasad says it is important to do a physical exam to really understand what the patient’s eyelid tone is. He does a snap test where he pulls the eyelid down and lets it snap up to see what the eyelid tone is. Laxity may be part of the situation with her lower eyelid. If she had skin removal, there may be some degree of a skin shortage.

In terms of problems like hollowing, there is often an involution or a loss of volume in between the rim of the eyelid and the cheek. In Dr. Prasad’s practice, he discusses options for enhancing that area of the rim using a hyaluronic acid filler like Restylane and combining that with platelet-rich plasma (PRP). Platelet-rich plasma is derived from the patient’s own blood and it is used to stimulate blood supply, collagen and even increase fat volume in the layers of the skin. From Dr. Prasad’s perspective, regenerative medicine is an important part of his surgical procedures, and is also independent of surgical procedures such as in hair loss treatment. He really appreciates the importance of the healthy fat layer under the skin and people lose that as they get older, and because of genetics.

In addition, Dr. Prasad advises patients to also address volume in the submalar or cheek area so that there’s continuity and a contour that is very smooth. He has seen patients who have had filler done along the rim or in the tear trough and it looks like their eyes are puffy and he ends up dissolving it or adding volume to create continuity. He always thinks of the eyelid and cheek as one unit and looks at it from different angles.

In the absence of a physical exam, Dr. Prasad thinks it’s best for her to move forward with meeting with either her original surgeon or other doctors who specialize in treating volume. At the same time, she should consider options related to the lower eyelid. The lower eyelid is deceptively complex and support structures have to be in perfect balance to get a really nice almond shape.

To learn more about the causes of lower eyelids drooping after eye bag surgery and how they can be corrected, please visit our website:

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

How to Treat Under Eye Indentations & Dark Circles with Fillers and Platelet-Rich Plasma
How to Treat Under Eye Indentations & Dark Circles with Fillers and Platelet-Rich Plasma

A woman has hereditary dark circles she can live with, but she is more concerned with the indentations around her eyes.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, can tell that this woman is concerned about the area called the tear trough. He thinks she is good candidate for a filler like a hyaluronic acid filler combined with platelet-rich plasma. This was a serendipitous discovery a few years ago when he used this on patients who had an aged appearance to the skin and dark circles. They had improvement in the skin quality and dark circles even if they were genetic. Eyelid skin is affected by aging and environmental changes. It is also affected when someone wears make up and then aggressively takes it off. The chemicals used to wipe off the makeup can often dry out the skin and accelerate aging.

In Dr. Prasad’s practice, he has been doing a combination approach of hyaluronic acid filler such as Restylane. This provided volume to fill the tear trough area and the rim between the eyelid and the cheek called the eyelid-cheek junction. He combines that with platelet-rich plasma which helps skin quality. There have been studies where the combination of hyaluronic acid with platelet-rich plasma resulted in improvement in wound healing. He is very pleased with the qualitative improvement of the skin and the area.

During the procedure, Dr. Prasad spends a lot of time on every patient where he’ll put a little filler, mold it, and come back to the patient after a few minutes to see how it looks. Once it’s done and it looks good, it can make a real improvement on the patient’s appearance. It does require maintenance as there’s no permanent solution. There are some doctors who recommend fat transfer. Unfortunately, it’s been his experience that eyelid skin is very thin and does not do well with fat grafting as it often results in irregularities and bumps. He has had patients who come from all over the world for him to address fat that did not work out so well, and they even needed more extensive surgery to remove and reconstruct the tissue. Removing fat transfers often involves more than one surgery.

There is a safety mechanism associated with hyaluronic acid filler. An enzyme called hyaluronidase melts hyaluronic acid fillers if too much is applied. He uses this for some patients who had excess hyaluronic acid under their eyes applied by outside practices.

Dr. Prasad suggests that she meet with doctors who have a lot of experience with dealing with dark circles and hollowed areas using hyaluronic acid. There are some doctors who also use platelet-rich plasma for this area as well. She should learn more about these options and start meeting some doctors to find one that she is comfortable with.

For more information about platelet-rich plasma (PRP) treatments for dark under eye circles, please go to our website:

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

To learn more about injectible fillers for volume loss, please visit:

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

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

Best Solution for a Receding Hairline in Your 20s - Non-Surgical Treatment
Best Solution for a Receding Hairline in Your 20s - Non-Surgical Treatment

A 22-year-old has a receding hairline. He wants to know if he is a candidate for hairline lowering surgery.

Dr. Amiya Prasad, a hair transplantation specialist, explains that one of the most common questions raised about hair transplantation is the number of grafts a surgeon can transplant. Technically, he says it is not difficult to address a small amount of hairline recession in a person who is young. Hair transplant is the selective use of genetically resistant hairs from the donor area or the area where the grafts are harvested. These hairs will always be there and are not affected by hormones. However, the donor area has a limited amount of hairs.

Dr. Prasad says it is important that he look at his family history such as the other male members in his family and see their hair loss patterns. Within a family, hair loss is not determined by any specific dominant or recessive pattern. Even within siblings, it can be variable: one brother can have a lot of hair, and another brother can have thinning hair or hair loss at a relatively young age.

In the United States, there are two drugs that are approved for hair loss: minoxidil which is a topical solution or foam, and finasteride which is an oral medication that blocks an enzyme called 5-alpha reductase. 5-alpha reductase blocks the conversion of testosterone to dihydrotestosterone (DHT). A specific subgroup of men with male pattern hair loss have androgen-sensitive hair follicles. Those androgen sensitive hair follicles will thin in response to circulating DHT. By taking finasteride DHT is reduced, thereby restoring the functionality of the hair follicle. However, a significant number of men do not respond to finasteride. In addition, there are long-term sexual side effects of men taking finasteride.

In Dr. Prasad’s practice, he developed an alternative called Hair Regeneration. This is the application of a material called extracellular matrix combined in a specific way with platelet-rich plasma. Over the past several years, he developed his own method of formulation and customization based on a large clinical pool of data. He does a onetime injection that appears to last up to five years. It has been a remarkable benefit for men who don’t want to take Propecia or finasteride, or men who are taking them and are still losing hair. It also has proven to be beneficial for female pattern hair loss.

When considering a solution for a receding hairline, one should think about the future and what could happen if they are 25 or 30-years-old. They should also think about medical options as opposed to surgery and then consider some of these newer treatments like called Hair Regeneration that uses extracellular matrix to help restore the functionality of the hair follicle. Dr. Prasad has been very fortunate that a material that was originally approved for wound healing has been able to help a lot of patients who have male and female pattern hair loss.

To learn more about the Hair Regeneration non-surgical hair thinning treatment, please go to our website:

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

The Challenges of Reversing Almond Shaped Eye Surgery Performed at a Very Young Age
The Challenges of Reversing Almond Shaped Eye Surgery Performed at a Very Young Age

A 20-year-old man had almond shaped eyes. However, he had multiple surgeries to change his eye shape at age 11. He wants to know if his eyes can go back to their original shape.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, observed from his photo that the outer corner of the eyes appear to have been pulled outward. It’s possible that as the bones grow, the corners which were fixated have shifted outward. He also noticed that the lower eyelids appear to be rounded or over-rounded for his facial features and structure, called relative lower eyelid retraction. A strategy is the correction of the outer corner as well as vertical correction of the lower eyelid.

In order to be able to do a repair or reconstruction of the eyelid structure, Dr. Prasad has to determine the anatomic elements of the eyelids that need additional tissue. The lower eyelid position is dependent on the lateral canthal tendon which is responsible for stabilizing the lower eyelid. It is attached to the bone, the lower eyelid retractors, orbicularis oculi muscle and the skin. All of these factors determine the eyelid position.

If there’s a shortage of support that causes eyelid retraction, Dr. Prasad does grafting using a material like Enduragen or human acellular dermis. These structural benefits or grafts need to be placed on the inside to give the eyelids vertical support. Unfortunately, a lot of plastic surgeons try to pull the lower eyelid up without any vertical support and end up creating a bold look that doesn’t really work out. In addition, patients may also benefit from waiting and seeing how their face matures over time which may be the most practical decision.

The upper eyelids are also dependent on how much available skin there is. If there’s a skin shortage, then patients may require skin grafting. Skin grafts are beneficial to younger patients because they have good healing. When Dr. Prasad does skin grafts, he maximizes the aesthetic result by the use of platelet-rich plasma to improve the healing. He also uses extracellular matrix. Good surgical technique is also important to get optimal and natural results.

Dr. Prasad does a fair amount of Asian eyelid surgery and has had patients who come for revision surgery. One of the most common reasons for their revision surgery is that as they got older, their upper eyelids got more hollow. The solution for hollowness in the upper eyelid is fat grafting. He takes fat from one part of the body and places it into the space just below the brow and the orbital space to to restore some volume.

In the absence of a physical exam, Dr. Prasad can’t tell the elasticity of the skin and how much skin is available. He concludes that as a young person, he doesn’t have a lot of skin laxity thatlimits the amount of stretch that any type of surgery would be able to use in order to move tissue from one point to another.

Dr. Prasad suggests that he meet with qualified experienced cosmetic surgeons. He should get some opinions and understand the strategy is and what he’s willing to accept. With the help of experienced surgeons, he’ll come up with a game plan that he can live with.

To learn more about almond eye surgery, please go to our website:

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

How to Address Both Sunken Under Eyes and Puffy Eye Bags with Separate Treatments
How to Address Both Sunken Under Eyes and Puffy Eye Bags with Separate Treatments

A 35-year-old woman has noticed that her eyes have sunk in more and she has under eye bags. She wants to know the cause of this.

A few years ago, Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, wrote a book called “The Fine Art of Looking Younger” and pointed out some key elements of the important things when a patient considers cosmetic procedures. His practice has a strong focus on facial aging. In facial aging, there are two things that happen: volume loss and descent or sagging. Volume loss can cause hollowing. In terms of thyroid hormone levels, the patient can speak to their medical doctor or internist to check hormone levels. Thyroid hormones are standard testing for any general medical workup.

Most patients who come to Dr. Prasad’s practice have volume loss in the eyelid-to-cheek area or the submalar area. They also have a bit of fat prolapse where there’s a bag pushing forward. When a person has a bag pushing forward, they think that their face being hollowed because the valley next to the eye bag is deep. They don’t see how the hollowing relates to the puffiness.

Lower eyelid puffiness that is constant is called lower eyelid fat prolapse. Paradoxically, the patient will have volume loss in other areas. They will also lose bone, muscle, fat and soft tissue around the eyes. Genetically, they could have a forward movement of fat that is normally around the orbital space and creates a hernia. Dr. Prasad would address this with the most common procedure which he does in his practice called transconjunctival lower eyelid blepharoplasty. In this procedure, he goes from the inside of the eyelid and sculpts the eyelid fat so that the patient doesn’t have the bulge under the eye.

Dr. Prasad also informs his patients to be mindful of the relative volume loss in the eyelid-to-cheek junction. He can strategize volume correction as appropriate based on the patient’s own aesthetic. If they feel that there’s still some volume loss even if they improved the bagginess under the eyes, then he’ll address that with Restylane or another hyaluronic acid filler. He’ll also use platelet-rich plasma (PRP) which is a product derived from the patient’s own blood. This has healing and growth factors from the cells called platelets and the plasma that are separated from the red blood cells. PRP stimulates collagen formation and blood supply that are part of the youthful appearance of vibrant skin with substance to it.

Besides seeing her medical doctor, Dr. Prasad suggests that she has to rule out any other metabolic issues. She should meet with qualified and experienced cosmetic surgeons because surgeons can do both non-surgical and surgical procedures. Also, she must learn about her options for rejuvenation in the eye area and get a sense of what she is comfortable with and which doctor she feels would address the issue that’s the highest priority in her mind.

To learn more about eye bag removal surgery without an external incision (transconjunctival blepharoplasty), please visit our website:

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

To learn more about injectible fillers for hollow under eyes, please visit:

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

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

What Causes Tired Eyes in Young People, and Eye Puffiness Treatment Options
What Causes Tired Eyes in Young People, and Eye Puffiness Treatment Options

A 20-year-old gentleman has prominent and tired-looking eyes. He wants to know the ways to fix them.

Dr. Amiya Prasad, a specialist in facial aging and a cosmetic oculofacial plastic surgeon, asks his patients about genetic factors - if their appearance runs in the family. He also asks them about lifestyle issues that could affect the eyes like: lack of sleep, smoking, environment factors such as sun exposure or a toxic environment, and about stress which also affects appearance. One of the most common reasons people come to him is when their friends and coworkers comment about their eye bags.

One thing that Dr. Prasad noticed from this gentleman’s photo is that there is a bit of a puffy area in the inner aspect of the lower eyelids. This is called lower eyelid fat prolapse. Lower eyelid fat prolapse means that the fat that is normally around your eyes slightly pushes forward and creates a bulge. Dr. Prasad has operated on a patient as young as 14 who had significant bags under their eyes. He became withdrawn from school because everybody thought he was on drugs, so his parents brought him in and Dr. Prasad took care of the bags under the eyes.

During consultation, one of the questions Dr. Prasad would ask is if the eyes are puffy all the time or do they have good and bad days. If there is variability on how puffy they look and the eyes are very puffy most of the time, then that’s a good time to consider a procedure such as a lower eyelid blepharoplasty. They can also consider some conservative methods such as topical creams that are good moisturizers and things that are holistically good for them such as better diet, sleep and exercise.

If they feel there are aspects that they just can’t deal with, then consulting with qualified and experienced cosmetic surgeons will be a benefit. When they are getting opinions, they should remember that surgeries can’t easily be undone or reversed, which is a decision they have to live with. Often Dr. Prasad tries conservative measures first such as topical creams or even injections like platelet-rich plasma and Restylane to help improve the appearance. The nice thing about these modalities is that they are not permanent. If the patient doesn’t like them, they just disappear. If he really wants to do something that’s more definitive beyond lifestyle changes then he can explore these options.

To learn more about eye bag removal surgery without an external incision (transconjunctival blepharoplasty), please visit our website:

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

The Limitations of Hair Transplant Surgery in the Early 20s, and How to Stop Hair Loss
The Limitations of Hair Transplant Surgery in the Early 20s, and How to Stop Hair Loss

A 24-year-old gentleman has been losing hair for the past 5 years. He has been taking medications such as minoxidil but didn’t see any considerable change. He wants to know if he is eligible for hair transplantation.

Dr. Amiya Prasad, a hair transplant specialist, explains that male pattern hair loss is genetic and it runs in families. In the United States, there are two FDA approved drugs for hair loss: one is minoxidil which is a topical agent that prolongs the growth cycle of thinning hair making it last longer on the scalp; the other is finasteride which is known as a blocker of an enzyme called 5-alpha reductase with converts testosterone to dihydrotestosterone (DHT). Dihydrotestosterone is the causative agent for hair loss but a lot of younger people continue to have thinning hair despite taking it.

When a patient is in their late 20s, the expectation of hair transplantation is very different compared to people in their 40s and 50s. From Dr. Prasad’s 20 years of practice, the Rule of Decades says that in men in their 20s, only 20% have significant hair loss while 80% have a lot of hair. When they have a transplant, they need to cover a very large area. However, the donor area or the area where the hairs are grafted has a limited number of hairs.

Presently, a lot of people are doing follicular unit extractions or FUEs and making openings far above and below the donor area. Unfortunately, these FUEs that are transplanted are not going to stay because it’s genetically programmed to thin out and disappear. Hairs should be strategically placed in order to maximize the amount of hair in the donor area. Sometimes they are placed in the frontal hairline to define the face. In order to get a really good result, patients usually need more than one session in order to get the density of a natural appearance.

Dr. Prasad’s has been performing a non-surgical procedure for hair loss called Hair Regeneration. He uses a material called extracellular matrix which was intended for wound healing. It was an accidental discovery that when used in the incision sites of a hair transplant, the hair around that area began to thicken. In his practice, extracellular matrix is combined with a blood product called platelet-rich plasma. This combination of a formulation and a delivery method reverses thinning hair. Instead of transplanting hair, it stops the progression of hair loss and thickens remaining hair. With 5 years of data, 99% of patients do not need re-injection.

Dr. Prasad advises that he should learn more about Hair Regeneration. He must also consider the medical options such as finasteride and minoxidil and learn more about these options before he makes a decision to pursue a hair transplant. Dr. Prasad would do Hair Regeneration first to thicken hair. Somewhere around 18 months, he might consider a secondary injection.

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/

Under Eye Dark Circle Treatment Using Platelet-Rich Plasma and Hyaluronic Acid Fillers
Under Eye Dark Circle Treatment Using Platelet-Rich Plasma and Hyaluronic Acid Fillers

A 26-year-old woman has dark under eye circles. She wants to know a permanent solution to get rid of them.

Dr. Amiya Prasad, an oculofacial plastic surgeon, explains that dark under eye circles are mainly caused by genetics. 20 years ago, he didn’t really have that many options to offer his patients who had dark under eye circles. He would do things like glycolic acids and retinoids to improve the skin quality but they were limited. With the introduction of hyaluronic acid fillers around 2005, he started to see some possible options even though they weren’t initially used for dark circles under the eyes.

Dr. Prasad first looks at the anatomy to determine if the cause is coming from relative hollowing. If that hollowing is genetic or volumetric loss from aging, it’s part of the decision-making plan. If there is volume loss, he uses a hyaluronic acid filler like Restylane to augment or to restore some volume under the skin at a level that’s closer to the bone called the tear trough. That has to be done very carefully and meticulously. Unfortunately, a lot of people don’t get the best results so they come to him to dissolve the hyaluronic acid filler with a material called hyaluronidase.

The second option is using platelet-rich plasma. This material is also used in orthopedic and oral surgery. It is derived from the patient’s own blood. He spins the blood to concentrate the growth factors and platelets which are the critical cells for healing. When platelet-rich plasma is injected under the skin in the appropriate candidate, it improves skin quality, blood supply and collagen. He follows his patients every three to four months and then he re-evaluates. If the skin quality looks improved and the patient is satisfied, then he just basically waits and sees how long this particular treatment lasts for them. There are some patients who come in for PRP treatments or platelet-rich plasma treatments once a year, others come twice a year, and others come three to four times a year. It’s very individualized because there are factors such as age and environmental factors.

Both hyaluronic acid and platelet-rich plasma are not permanent solutions. In a way, that’s an advantage because unlike surgery, it’s something that someone doesn't have to live with forever. The patient can see how they respond to it and then decide if they want to integrate it in their lifestyle.

For people with lighter skin types, Dr. Prasad also has other options including lasers. For somebody with a darker skin type, lasers are usually not an option because there’s a risk of hyper or hypopigmentation. In addition, he wouldn’t completely discourage moisturizers as a solution to dark under eye circles because moisturizes do have a role. They don’t completely resolve the problem but they work in combination with other solutions. For example, he has patients who benefit from hyaluronic acid injection, platelet-rich plasma and a good topical cream.

Dr. Prasad thinks it’s probably a good idea for this woman to meet with some doctors now that she has learned more about these options. She can actually ask more specific questions, look for examples of before and after pictures and see if it’s an option for her to try.

For more information about platelet-rich plasma (PRP) treatments for dark under eye circles, please go to our website:

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

To learn more about injectible fillers for volume loss, please visit:

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

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

How Swelling after Ptosis Surgery Can Raise the Eyelid, and the Right Time for Enhancement
How Swelling after Ptosis Surgery Can Raise the Eyelid, and the Right Time for Enhancement

A woman had upper eyelid ptosis surgery. However, swelling changed the shape of her eyes. She wants to know if this is temporary or if she needs an enhancement.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, explains that ptosis surgery is one of those types of surgery where predictability is sometimes tricky. When doing this surgery, he wants to achieve the appropriate height, contour, symmetry and the aesthetics of the eyelid. When he performs ptosis surgery, he allows the patient to be awake during the procedure. The patient won’t feel anything because the area is numb, but he’ll have them open and close their eyes and even sit them up during the surgery. This is the best way to predict the outcome because the muscle is very sensitive and the eyelid backbone and tissue are delicate and can easily be affected by a variety of factors.

In every ptosis operation, there is a possibility of under-correction where the eyelid is too low or overcorrection where the eyelid is too high. However, only the patient’s doctor knows what happened during the surgery. Sometimes, the surgeon would overcorrect because they anticipate that the eyelid will come down after some time.

When Dr. Prasad does a ptosis evaluation, he measures the function of the muscle that lifts the eyelid called the levator muscle to see how strong it is. When the muscle is weaker, he sometimes over-corrects because the muscle is weak and there’s a tendency for the eyelid to drop down a bit. When a person has a normal levator function, he usually tries to make the eyes relatively symmetric during the surgery because he expects that after the healing, there’ll be some stabilization.

In the normal human population, there is always about a 1-2mm difference between the height of the two eyelids. As long as the patient is within that range, it’s acceptable. In this woman’s case, her doctor will be able to guide her as to why she looks this way, and whether or not this is a case of someone who is over-corrected. If that’s the case, the timing as to when to make an enhancement is also something that her doctor will help her decide. In Dr. Prasad’s practice, he usually waits for swelling to resolve to a reasonable level so that he can work on tissue that isn’t swollen but he does his enhancements on a case-by-case basis. Clearly with this photo, there is a difference between the two eyes. The right eye definitely does look more open and round but in the absence of other information, it is difficult to make a prediction.

Sometime after ptosis surgery, a bit of massage will help stretch the tissue out and allow for a little of descent. Dr. Prasad had patients who initially looked overcorrected, but with a little time it came down to a point where it looked appropriate. Dr. Prasad thinks that she should keep the faith and maintain communication with her doctor. She should work with the doctor about moving forward with any other adjustments that may be required later on.

For more information about ptosis correction surgery, please visit our website:

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

Possible Causes of Descent After Lower Face & Neck Lift, and Platelet-Rich Plasma for Skin Treatment
Possible Causes of Descent After Lower Face & Neck Lift, and Platelet-Rich Plasma for Skin Treatment

A woman had lower facelift but now her skin is loosening around her neck. She wants to know the procedures to remedy it.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, explains that during face and neck lifting, there is a balance as to how much sagging skin and muscle could be tightened that doesn’t create excess tension. He explains that facelift scars are caused by stretching and by procedures such as mini-lifts where too much skin was removed. These types of procedures do not involve the deeper structures so surgeons try to pull the skin as tight as they can until the skin widens and stretches. Skin is elastic and stretchable only to a certain extent. When a patient has this procedure done, there’s always a little bit of swelling afterwards. As people get older, the skin gets thinner so interestingly, a lot of people look a little bit better when there’s a little swelling.

Dr. Prasad always explains to his patients that when he does surgery, he tightens, resects or trims and does everything to make things look really good. A certain percentage of patients will have significant regression where the skin will stretch. Every time a person turns their head and brings their chin up they are stretching the skin. He will do enhancements to try to maximize the improvement of the neck and jawline. Sometimes, the face descends a bit and the skin collects under the chin so more aggressive lifting is necessary. He always makes sure to differentiate skin quantity versus skin quality.

In Dr. Prasad’s practice, he enhances skin quality with procedures like the injection of platelet-rich plasma (PRP). Platelet-rich plasma is derived from the patient’s own blood. It is a concentration of the healing factors that stimulate healing. With this method, he actually improves skin quality that includes the backbone of the skin, the dermis with collagen, and blood supply to the skin so the skin looks healthier. Even the fatty layer of the skin will improve which is shown in studies with biopsies.

Dr. Prasad suggests that she look at her before pictures, have a sense of what is realistic and then make a determination. If the surgeon feels that they can really get something done, then she might be a candidate.

For more information about facelifts, please go to our website:

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

For more information about how platelet-rich plasma (PRP) treatment can improve skin quality, please go to our website:

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

The Advantages of a Hair Transplant for Hairline Lowering with Hair Thickening Treatment
The Advantages of a Hair Transplant for Hairline Lowering with Hair Thickening Treatment

A gentleman had a high forehead since birth. He wants to know the benefits of a hair transplant and forehead reduction surgery.

Dr. Amiya Prasad, a hair restoration specialist explains that a “pluggy” appearance after a hair transplant is a result of loss of native hairs around the transplanted hair leaving the individual grafts. It is not because the hair transplant was not done properly. In addition, the patient may not have taken medication such as finasteride to try to slow down the hair loss progression. They might have never responded to the drug or had a drug side effect causing the further loss of hair.

Forehead reduction requires an incision that can be camouflaged very effectively when there’s hair. If the hair were to recede, then the incision could be apparent. For younger patients, they have to think of the future and be prepared for the consequences of making a decision. If their family history has lots of thick hair and no one recedes, then the discussion about their options should be a balance of what would happen if for any reason they did have some recession. They have to make a choice between an incision scar or the presence of grafts.

In Dr. Prasad’s practice, he tends to lean towards doing grafts. He uses a method called Hair Regeneration which has a vaccination effect and prevents the progression of hair loss in the area where the grafts are placed. In addition, Hair Regeneration maximizes the benefits of the grafts. During a hair transplant, not all grafts will survive and that’s a limitation considering the donor area is very limited. When he does a transplant, he combines it with Hair Regeneration to preserve existing hair as well as to maximize the survivability of the hair grafts.

If someone wants to lower their hairline, they should be prepared for two surgical procedures in order to achieve the optimum density that will give them the results that they desire. Nature creates a type of density which is fantastic and beautiful. From a surgeon’s perspective, recreating that with one transplant is challenging and it has to be done in a way that is natural and dense. Dr. Prasad has found that it takes two procedures to do that. This gentleman’s next step is to meet and have consultations with doctors who perform both procedures and learn about his options. He should think about the future possibility of hair receding and how it may impact his appearance.

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 Extent of Different Facelift Procedures, and Revising for Better Neck Lift Results
The Extent of Different Facelift Procedures, and Revising for Better Neck Lift Results

A woman had a full facelift but was not happy with the results. She wants to know what type of facelift would be good for her after having a full facelift.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, explains that initially after a facelift, an improvement of the jawline and the cheek and the neck means that the patient had good results. The results she is currently having may be a result of regression or relaxation. No matter who does the facelift, how well it’s done or how technically proficient the doctor is, there is always a certain amount of relaxation and elasticity.

The challenge with face lifting surgery which Dr. Prasad wrote in his book “The Fine Art of Looking Younger” is the sagging of tissue. There are two critical elements which cause the face to sag: one is that the skin gets thinner and stretches as we get older; and the is second, a deeper layer of muscle that is referred to the platysma or superficial musculo aponeurotic system (SMAS) is affected.

A facelift can mean anything from a short scar limited facelift to a facelift incision which goes from the temple to behind the ear. When Dr. Prasad does a face and neck lift, he extends the incision to behind the ear and into the hair so that he can address the band under the neck as well as the sagging skin. He also typically makes a small opening under the chin in order to do something called platysmaplasty. When Dr. Prasad looked at this woman’s photos, he noticed the two platysmal bands so something can be done to enhance the neck definition.

The definition of a facelift is often misinterpreted. Many think a facelift includes the brows where the incision is made on top of the head, but that is a brow lift. A facelift incision is at the temple to lift the cheek and the jawline. In contrast, a neck lift is more for sagging skin. Sometimes, a facelift will address a significant part of the neck depending on how old a person is. In a younger patient in their 40s or 50s, sometimes tightening the SMAS with limited platsymaplasty or release can give them really nice neck definition without making that incision in the back.

As far as the original procedure is concerned, they may want to discuss this with the original surgeon and ask what can be done in order to get the results that they desire. Often people want a conservative procedure where they have a 60-70% improvement in the jawline which in consultation they were willing to accept, but then they want more which is completely understandable. In Dr. Prasad’s consultations, he actually spends a lot of time discussing the details of what is involved to get optimal full correction.

Some patients end up with bad scars, pixie ears and a pulled down appearance when done by some of these people who do mini or shortcut procedures. Dr. Prasad ends up doing the full proper face and neck lift regardless of what their operative result state or the information they provide because it just doesn’t make much of difference when he is actually in surgery. The decisions are made in real-time during surgery with some projection and anticipation prior.

This woman is probably a candidate for either an enhancement from the prior procedure or a full face and neck lift based on the photos she submitted. The one thing that Dr. Prasad can’t do is a physical exam to feel how much tension there is and what the realistic expectations would be. Enough time has passed to allow for tissue swelling and other factors to be resolved. He recommends that she meet with her original surgeon and see if he can resolve this issue. If that’s not a viable choice for her, she can meet with additional doctors and consider the options of having a face and neck lift. She must avoid shortcut mini procedures as they tend not to work with this much platysmal banding and the amount of relative sagging that she demonstrated in her photos.

For more information about facelifts, please go to our website:

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

How to Reduce Dark Circles Under Eyes with PRP Treatment and Other Procedures
How to Reduce Dark Circles Under Eyes with PRP Treatment and Other Procedures

A woman has hereditary dark circles. She wants to know the best treatment to fix them.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, explains that there are creams of various kinds and a tremendous number of solutions for dark under eye circles. However, they are all basically moisturizers some with some tint. Dark circles are difficult to treat because they are caused by different factors including genetics which means pigmentation within the skin that runs in families. There is darkness from the pigmentation from melanin. Another factor that causes dark circles is the skin quality. A lot of people have very thin skin which gives a bluish appearance or a little bit dark because of the vessels. Sometimes the shape and the bones around the eye and also the way the skin drapes it accentuates various areas of hollowing. Lastly, aging and environment such as excess sun exposure or wind causes collagen to break down. The skin becomes crêpier and the skin quality diminishes.

In Dr. Prasad’s practice, he looks at his patients to know if they are dealing with any other issues that are also contributing to the overall appearance of the eyes such as puffy bags under the eyes, skin quality and the volume effect of the skin quality in that area. If there is loss of volume, there is an option to use a hyaluronic acid filler like Restylane along the tear trough area and the rim. This adds some thickness to the tissue underneath the skin and in the hollow areas to improve the dark circles. This requires proper patient selection as well as finesse in the technique. As a cosmetic oculofacial plastic surgeon specialist with 20 years of experience, he sees people who had this treatment done elsewhere and he needed to dissolve it because they got too much or it became irregular.

Another option that Dr. Prasad had a lot of success with even for hereditary dark circles is the use of platelet-rich plasma (PRP). Platelet-rich plasma is derived from the patient’s own blood. He does a blood draw like a lab test and spins it in centrifuge to get the growth factors and the platelets. This improves collagen, skin quality as well as blood supply that will actually help dark circles caused by genetics. However, if someone is too young, the skin quality is very fine so it won't make much of a difference even if he treats the patient.

Dark circles can also be a multi-factorial issue where it’s not only genetics but there are also some other lifestyle-related and environmental triggers. For example, there are patients who do a lot of water sports and they’re out in the sun. They’re young but they get a lot of ultraviolet light exposure which results in breakdown of collagen. The skin becomes very dry and very crêpey and so they do benefit from platelet-rich plasma.

Dr. Prasad explains that there is still a role for proper hydration of the skin. Eyelid skin is only half a millimeter in thickness and a lot of patients who have dark circles wear a lot of makeup and then use a plenty of makeup removal solution to remove it. They’re traumatizing and drying their skin. A lot of astringents have alcohol and they can be drying and irritating. Moisturizer does play an important role. People would also benefit with the use retinoids but Dr. Prasad does it very carefully because a lot of people can be sensitive to the retinoids. In his own practice, he actually has a particular moisturizer called Eye Rescue which is a combination of a moisturizer and some active ingredients that would be helpful. This definitely gave him a lot of good feedback from his patients.

He recommends that this woman meet with experienced cosmetic surgeons or aesthetic physicians to learn more about these treatments.

For more information about platelet-rich plasma (PRP) treatments for dark under eye circles, please go to our website:

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

Why Asian Double Eyelid Surgery Swelling Two Weeks After is Normal Part of Surgical Recovery
Why Asian Double Eyelid Surgery Swelling Two Weeks After is Normal Part of Surgical Recovery

A woman had double eyelid surgery 2 weeks ago. She wants to know why her eyes are still swollen after the surgery.

Dr. Amiya Prasad explains that swelling at this time is typical. He does a lot of Asian eyelid surgeries and he can certainly share over 20 years of doing this surgery that there is some degree of variability between patients regarding the amount of swelling they have. Asian eyelid surgery requires a particular type of method that involves the fixation of the eyelid crease to the muscle that lifts the eyelid called the levator muscle. In order to create that crease, there has to be a connection made between the skin and the levator muscle. This can be performed both with an incisional or a non-incisional procedure.

After surgery, there is crowding in the tight space. Fluid has the tendency to back up between the eyelid crease and the eyelid margin. That swelling can take time to resolve. Swelling is often the reason patients panic because they feel that the eyelid crease is too high. This type of swelling in two weeks is normal and that swelling can linger and be variable in the course of several months and can go on to as long as one year. True surgical healing can take up to a year to resolve.

Dr. Prasad explains that the swelling she is experiencing is likely normal and the only things that he suggests to his patients to help resolve swelling is to manage any allergies, particularly eye allergies. They should also manage any sinus issues, get adequate sleep and do things that are healthy.

Dr. Prasad recommends that she contact her doctor’s office and meet with her doctor. Judging by the photo she submitted, it doesn’t appear that there’s anything unusual about her situation. She must understand that the body takes it’s time to heal and swelling does eventually get better, but the time swelling lasts varies between individuals.

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

Why Some Hair Transplant Results Take Longer to Grow, and Stimulating Hair Growth After a Transplant
Why Some Hair Transplant Results Take Longer to Grow, and Stimulating Hair Growth After a Transplant

A gentleman had a hair transplant, but his hair growth is slow after normal shedding and wants to know the cause.

Hair restoration specialist Dr. Amiya Prasad explains that a hair transplant is the movement of genetically resistant hairs. These are hairs that are at the back of scalp in the limited space called the donor area. Little openings are made called stab incisions and grafts are placed individually where the scalp is losing hair. A graft is composed of skin, the hair, the root or the dermal papilla, and some of the tissue that surrounds it.

After a hair transplant is performed, a phenomenon called shock loss happens. This is when hair grafts and the existing hairs in the scalp temporarily shed. Although hair thinning can be to the point where there is barely any hair, using a microscope many miniaturized hairs are seen. Even the existing hairs can go into shock. A transition period for several months happens after hair transplant where there is no growth.

As a general rule of thumb, at one year most of grafts have grown in. However, from Dr. Prasad’s experience he has seen patients who have growth as late as 18 months. There are different factors that will affect the results in one year. One of those factors has to do with the rate of hair growth. In his practice, he does a procedure called Hair Regeneration that reverses thinning hair. When he does this treatment, he follows his patients every 3 months. Because of this, he is able to classify people as fast, medium and slow growers. People who have very advanced hair loss tend to be slow growers.

Dr. Prasad does a combination of Hair Regeneration treatment with extracellular matrix and platelet-rich plasma to maximize the survival and the yield of the hair transplant, and reverse the hair thinning concurrently. Patients who appear to have less hair or didn’t even have much growth at all at 12 months have robust growth of their thinning hair as well as their transplant at 18 months.

It is not unusual for people to come to Dr. Prasad who have had "mega sessions" where tremendous amounts of hair transplanted and not have any growth. Factors such as elevated blood pressure and manipulation of the grafts can make the patient lose up to 90% of the hair grafts. This is not a very encouraging thing to hear when someone has a limited donor space and amount of hairs. In this gentleman’s case scenario, he can just wait and see how he is doing for another 6 months or so, and then try to determine what the yield is.

The survival of grafts is critical for the success of a hair transplant. This means that although a surgeon may move 2000 or 2200 hairs, the yield may be 10%, 20%, 30% less than what the surgeon transplanted. In the popular method of FUE or follicular unit extraction, there is a very high rate called transection where the hair follicle gets cut and the important part of the hair doesn’t grow. Interestingly, some of those hairs will have enough stem cell activity present that they can grow. Unfortunately, a lot do not.

Dr. Prasad has been using Hair Regeneration as a way to help people who have had transplants done elsewhere. They come to him at 1 month after their transplant, and then have the Hair Regeneration treatment. As early as 6 to 7 months, they had robust growth of both their existing and their transplanted hair. Hair Regeneration has been of value to maximize the healing process and to accelerate the process where the hair grafts actually grow.

Dr. Prasad thinks that it is very important that he meet with his doctor, discuss the details of his surgery, have his doctor examine his scalp, and let him evaluate his situation with a microscope. Moving on, he is going to have limitations in his donor area his next hair transplant if he is going to consider it. This is why a lot of people who have had previous transplants continue to find Dr. Prasad. He does Hair Regeneration injection for them to thicken their thinning hair and for many people, they actually avoid a second transplant. That way, they can save the donor area and have that banked for later if they ever need it.

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/

What to Expect after Ptosis Surgery and Proper Revisions for Eyelids Still Drooping
What to Expect after Ptosis Surgery and Proper Revisions for Eyelids Still Drooping

A gentleman had conjunctival Muellerectomy performed by an oculoplastic surgeon exactly 2 months ago on his left eyelid. However, his eyelid still has ptosis after surgery. He wants to know if anything can be done to correct it.

Dr. Amiya Prasad is a practicing oculofacial plastic surgeon for 20 years and has done a lot of ptosis surgeries. He explains that there are challenges with ptosis surgery that makes it unique which is why most plastic surgeons do not ever do ptosis surgery. It involves a muscle in the eyelid called the levator muscle. Behind it is a muscle called Mueller’s muscle. Both muscles contribute to the lifting of the eyelid. The gentleman's doctor did a Mueller’s muscle shortening or resection which brings both tissues together.

In Dr. Prasad’s practice, he routinely lets the patient open and close their eyes during surgery both in a lying and seated position. They never feel any pain or discomfort and it gives him an opportunity to try to real-time adjust the height of the eyelid. These muscles are very sensitive and trying to get the ideal contour, height and symmetric result make it uniquely challenging. Dr. Prasad assumes that his doctor did something similar to that during his surgery and was satisfied with the result.

With the photo this gentleman submitted, Dr. Prasad assesses that the left eye looks like it is still drooping. Certain factors such as swelling can contribute to eyelid position. In the absence of a physical exam, there doesn’t appear to have significant swelling at this point. In Dr. Prasad’s practice, if someone didn’t have the optimal result whether the eyelid is too low or too high after the surgery, he’ll go back and make an enhancement or a different procedure. Dr. Prasad would probably do a levator muscle enhancement to get that eyelid contour and shape to be more symmetric with the other eye.

Dr. Prasad thinks that the left eye does deserve to be enhanced. There is probably a need for a different procedure performed in order to achieve that result. Sometimes after a procedure, the suture and the tissue separate and the eyelid droops again. This isn’t in any way a judgment to the skills of his doctor. If his doctor is an oculofacial plastic surgeon then he has a long history of doing this type of procedure and has appropriate training. Dr. Prasad thinks that he needs to meet with his doctor again. In 3-4 months, most of the significant swelling that would affect the surgery is typically resolved and he can probably safely have a revision procedure.

For more information about ptosis correction surgery, please visit our website:

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

Factors that Affect Asian Double Eyelid Surgery, and Revision Surgery Using the Suture Method
Factors that Affect Asian Double Eyelid Surgery, and Revision Surgery Using the Suture Method

A woman is having problems with allergies and swelling causing the crease in her left eye to disappear. She had incisional double eyelid surgery and wants to know if she needs a revision.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, explains that the challenge of Asian eyelid surgery has to do with several factors. He says that when doing this type of procedure, no two surgeons are exactly the same. The factors that affect the outcome are whether or not there’s excess skin, if the skin is thick or thin, and whether or not there’s fat present. There are also intra-operative issues such as the connection made between the skin and the levator muscle and how well that holds.

Dr. Prasad says that placing a piece of tape on the eyelid margin will actually force the eyelid to crease inward. However, he would suggest based on the absence of a physical exam and not being able to tell what her skin quality is or if her eyelid will cooperate, the non-incisional method or the suture technique that her surgeon suggested is possible to achieve this type of result. However, if she closes her eyes and the eyelid skin pushes away from the underlying muscle, then that crease is not likely to hold very well. If with the tape in place and her eye moves well and her surgeon really feels that this is possible, then it is probably worth pursuing. As long as there is no excess skin, then a non-incisional approach or suture method can create a necessary fixation for the eyelid skin to fold-in in a desirable height.

Dr. Prasad thinks that the best case scenario now is that she discuss with her surgeon. He says that this is generally a low risk procedure because no skin is being removed and the eyelid is not being opened up fully. It just involves several little entry points along where the desired crease is placed then the sutures are placed in those entry points to engage the levator muscle. He thinks that’s this is a decent option in terms of trying to achieve that eyelid fold. She should meet with her doctor to get a clear understanding of the process and the likelihood of her desired outcome.

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

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

What are the Possible  Complications of Blepharoplasty (Eyelid Surgery)?
What are the Possible Complications of Blepharoplasty (Eyelid Surgery)?

Eyelid surgery is one of the most precise and delicate types of cosmetic surgery. Eyelid skin is the thinnest skin in the body at less than half a millimeter in thickness. Dr. Amiya Prasad is leading Eyelid Surgery Specialist dedicated to helping his patients look better and maintain optimal eye health . Unfortunately many general plastic surgeons do not have extensive training and experience with eye anatomy and function which can lead to too much removal of eyelid skin creating an unnatural "surprised" look. Further, many people suffer from compromised eye health caused by the inability to close their eyes properly.

Lower eyelid surgery, frequently performed to remove puffy eye bags, is a common surgical procedure. Its popularity has unfortunately led to many patients having complications. Dr. Amiya Prasad, a leading eyelid specialist, performs lower eyelid surgery AKA lower blepharoplasty creating a natural-looking result that can leave virtually no trace of surgery. Many general plastic surgeons who perform the procedure have insufficient experience with eyelid support anatomy which results in eyelids being pulled down, skin exposure, eye overexposure, as well as excessive and visible scarring. Dr. Amiya Prasad performs complex reconstructive eyelid surgery for patients who come from all over the world who have complications.

Complications that may arise during or after a blepharoplasty procedure may include the following: (1) excessive bleeding, (2) infection, (3) undesirable scarring, (4) vision loss, or (5) double vision. These complications do not only affect your appearance, but can also affect the health of your eyes.

The term “complications”, however, must be clearly defined. For example, after having lower or upper eyelid surgery, your surgeon may need to address the issue of extra skin or more fat pockets. These are considered “enhancements” and not complications.

In Dr. Prasad’s practice, people often come to him for revision surgery in order to correct bad results from a previous surgery done by another surgeon. One of the most common reasons people seek out revision surgery is for lower eyelid retraction after lower eyelid surgery. This is a complication wherein the eyes become irritated from the exposure of areas on the eye that were previously protected with the normal position of the lower eyelid.

It is best to review these complications with your surgeon in order to determine how these complications are managed.

For more information, visit our website:

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

Or come to our clinic on the following address for a personal consultation today:

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

How Blepharoplasty is Performed by Oculoplastic Surgeon Dr. Amiya Prasad
How Blepharoplasty is Performed by Oculoplastic Surgeon Dr. Amiya Prasad

Eyelid surgery is one of the most precise and delicate types of cosmetic surgery. Eyelid skin is the thinnest skin in the body at less than half a millimeter in thickness. Dr. Amiya Prasad is leading Eyelid Surgery Specialist dedicated to helping his patients look better and maintain optimal eye health . Unfortunately many general plastic surgeons do not have extensive training and experience with eye anatomy and function which can lead to too much removal of eyelid skin creating an unnatural "surprised" look. Further, many people suffer from compromised eye health caused by the inability to close their eyes properly.

Lower eyelid surgery, frequently performed to remove puffy eye bags, is a common surgical procedure. Its popularity has unfortunately led to many patients having complications. Dr. Amiya Prasad, a leading eyelid specialist, performs lower eyelid surgery AKA lower blepharoplasty creating a natural-looking result that can leave virtually no trace of surgery. Many general plastic surgeons who perform the procedure have insufficient experience with eyelid support anatomy which results in eyelids being pulled down, skin exposure, eye overexposure, as well as excessive and visible scarring. Dr. Amiya Prasad performs complex reconstructive eyelid surgery for patients who come from all over the world who have complications.

Blepharoplasty is a general term for upper and lower eyelid surgery designed to improve the appearance and function of the eyes. This procedure is performed to address excess, saggy skin and bulging fat pockets around the eyes.

As an Oculofacial plastic surgeon, Dr. Prasad strongly believes in the utmost importance of performing blepharoplasty with a keen understanding of the health of the eyes, and in having the proper skills to accomplish the goals or the surgery.

A big part of Dr. Prasad’s practice involves performing advanced revision surgery on people who come from all over the world. Dr. Prasad performs all his surgeries in his Joint Commission-certified operating facilities. This type of procedure is normally done with local anesthesia with intravenous or IV sedation. Most of his patients are able to return to work in as little as one week and experience little to no discomfort.

For more information, visit our website:

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

Or come to our clinic on the following address for a personal consultation today:

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

What is Transconjunctival Blepharoplasty?
What is Transconjunctival Blepharoplasty?

Lower eyelid surgery, frequently performed to remove puffy eye bags, is a common surgical procedure. Its popularity has unfortunately led to many patients having complications. Dr. Amiya Prasad, a leading eyelid specialist, performs lower eyelid surgery AKA lower blepharoplasty creating a natural-looking result that can leave virtually no trace of surgery. Many general plastic surgeons who perform the procedure have insufficient experience with eyelid support anatomy which results in eyelids being pulled down, skin exposure, eye overexposure, as well as excessive and visible scarring. Dr. Amiya Prasad performs complex reconstructive eyelid surgery for patients who come from all over the world who have complications.

Transconjunctival blepharoplasty is a technique used to address puffy under eye bags from the inside of the eyelid.

One of the most important benefits of this technique is that there is no external incision visible, and therefore leaves no scarring or physical evidence that you’ve had a cosmetic procedure. Another important benefit of using this technique is that the natural shape of the eye is better preserved.

For more information, visit our website:

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

Or come to our clinic on the following address for a personal consultation today:

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

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

Ptosis, or drooping eyelid is caused by a defective or stretched muscle responsible for lifting the eyelid called the levator muscle. Ptosis surgery is not performed by most plastic surgeons. Correcting this thin muscle in the delicate eye area is more frequently performed by specialists with combined training in ophthalmology and facial cosmetic surgery called oculoplastic or oculofacial surgeons. Dr. Amiya Prasad is a leading Oculoplastic Surgeon with offices in Manhattan and Garden City, Long Island.

Ptosis is defined by the positioning of the eyelid margin in relation to the pupil. Extra skin, on the other hand, can weigh down the eyelid and affect its position, which is called mechanical ptosis.

During a routine examination, Dr. Prasad will lift the extra skin in order to determine where the eyelid margin is positioned. If the eyelid margin remains low, then it is likely you have ptosis. You will require ptosis surgery to address this, as it cannot be corrected by blepharoplasty alone.

For more information, visit our website:

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

Or come to our clinic on the following address for a personal consultation today:

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

Will the Results of Eyelid Surgery be Permanent?
Will the Results of Eyelid Surgery be Permanent?

Eyelid surgery is one of the most precise and delicate types of cosmetic surgery. Eyelid skin is the thinnest skin in the body at less than half a millimeter in thickness. Dr. Amiya Prasad is leading Eyelid Surgery Specialist dedicated to helping his patients look better and maintain optimal eye health . Unfortunately many general plastic surgeons do not have extensive training and experience with eye anatomy and function which can lead to too much removal of eyelid skin creating an unnatural "surprised" look. Further, many people suffer from compromised eye health caused by the inability to close their eyes properly.

Since our faces and bodies will continue to grow and change as we age, the term “permanent”, in this case, should be rephrased to “long-term”.

Most facial procedures can be estimated to last from 5-10 years. With regard to eye surgery, the longevity of your results will depend on the age that the procedure was performed. For example, someone in their 30s who underwent a lower eyelid blepharoplasty may experience longer lasting results than that of someone who underwent the same procedure in their 60s.

In Dr. Prasad’s practice, he makes sure to help patients understand how to maximize the long-term benefits of surgery by making healthy lifestyle choices, such as getting proper sun protection, eating right and avoiding smoking. Dr. Prasad also educates his patients on the benefits of maintenance procedures such as platelet-rich plasma (PRP) treatments.

For more information, visit our website:

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

Or come to our clinic on the following address for a personal consultation today:

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

How Should I Prepare for Eyelid Surgery?
How Should I Prepare for Eyelid Surgery?

Eyelid surgery is one of the most precise and delicate types of cosmetic surgery. Eyelid skin is the thinnest skin in the body at less than half a millimeter in thickness. Dr. Amiya Prasad is leading Eyelid Surgery Specialist dedicated to helping his patients look better and maintain optimal eye health . Unfortunately many general plastic surgeons do not have extensive training and experience with eye anatomy and function which can lead to too much removal of eyelid skin creating an unnatural "surprised" look. Further, many people suffer from compromised eye health caused by the inability to close their eyes properly.

Preparation for eyelid surgery is a straightforward matter.

Check if any medications or supplements you are currently taking have any blood thinning properties, so as to prevent any excessive bleeding during the procedure.

If you have any eye allergies or eye dryness issues, continue to use the medications as prescribed by your ophthalmologist.

Make sure you have enough ice or ice packs at home for your cold compresses after surgery. Dr. Prasad advises that patients continue to use cold compresses for at least 2 days after surgery while at home.

For more information, visit our website:

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

Or come to our clinic on the following address for a personal consultation today:

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

How Can I Fix One Drooping Eye?
How Can I Fix One Drooping Eye?

Ptosis, or drooping eyelid is caused by a defective or stretched muscle responsible for lifting the eyelid called the levator muscle. Ptosis surgery is not performed by most plastic surgeons. Correcting this thin muscle in the delicate eye area is more frequently performed by specialists with combined training in ophthalmology and facial cosmetic surgery called oculoplastic or oculofacial surgeons. Dr. Amiya Prasad is a leading Oculoplastic Surgeon with offices in Manhattan and Garden City, Long Island.

Eyelid surgery is one of the most precise and delicate types of cosmetic surgery. Eyelid skin is the thinnest skin in the body at less than half a millimeter in thickness. Dr. Amiya Prasad is leading Eyelid Surgery Specialist dedicated to helping his patients look better and maintain optimal eye health . Unfortunately many general plastic surgeons do not have extensive training and experience with eye anatomy and function which can lead to too much removal of eyelid skin creating an unnatural "surprised" look. Further, many people suffer from compromised eye health caused by the inability to close their eyes properly.

Addressing drooping eyes is a routine procedure that Dr. Prasad is extremely familiar with. If the drooping eye is caused by extra skin (referred to as “dermatochalasis”), a unilateral blepharoplasty is performed. If the drooping eye is caused by ptosis, then ptosis surgery is performed. Meeting with a specialist and getting a proper diagnosis is absolutely essential to determine which procedure is right for your case.

For more information, visit our website:

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

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

Browlift Versus Blepharoplasty - Which is Best for Sagging Eyelids?
Browlift Versus Blepharoplasty - Which is Best for Sagging Eyelids?

Eyelid surgery is one of the most precise and delicate types of cosmetic surgery. Eyelid skin is the thinnest skin in the body at less than half a millimeter in thickness. Dr. Amiya Prasad is leading Eyelid Surgery Specialist dedicated to helping his patients look better and maintain optimal eye health . Unfortunately many general plastic surgeons do not have extensive training and experience with eye anatomy and function which can lead to too much removal of eyelid skin creating an unnatural "surprised" look. Further, many people suffer from compromised eye health caused by the inability to close their eyes properly.

If you have excess skin over your eyes, it is vital to determine what is causing it. Is the excess skin caused by the eyebrows drooping, which causes the skin from below the brow to lie on top of the eyelid? Is the excess skin caused by the thinning and stretching of the eyelid skin itself? Or is it a combination of both?

When evaluating a patient whose concern is excess skin over the eyes, Dr. Prasad looks for descent of the eyebrows called brow ptosis, and excess skin over the eyelids called dermatochalasis.

During diagnosis, Dr. Prasad will try to determine from his patient if the eyebrow position is drooping more than it did in the past, he will then also try elevating the brows in order for the patient to see if it looks better for them.

Generally speaking, if there is brow ptosis, then it is likely that there is dermatochalasis as well. For the treatment for sagging eyelids, blepharoplasty is usually the solution, or part of the solution. Brow lifts, on the other hand, only becomes an option if there is brow ptosis present. Thus, the answer to brow lifts versus blepharoplasty is dependent on the source of the skin and the patient’s desired appearance.

For more information, visit our website:

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

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

Or come to our clinic on the following address for a personal consultation today:

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

What is Eyelid Surgery Recovery Like When Performed by Oculofacial Plastic Surgeon Dr. Amiya Prasad
What is Eyelid Surgery Recovery Like When Performed by Oculofacial Plastic Surgeon Dr. Amiya Prasad

Eyelid surgery is one of the most precise and delicate types of cosmetic surgery. Eyelid skin is the thinnest skin in the body at less than half a millimeter in thickness. Dr. Amiya Prasad is leading Eyelid Surgery Specialist dedicated to helping his patients look better and maintain optimal eye health . Unfortunately many general plastic surgeons do not have extensive training and experience with eye anatomy and function which can lead to too much removal of eyelid skin creating an unnatural "surprised" look. Further, many people suffer from compromised eye health caused by the inability to close their eyes properly.

The eyelid surgery recovery process begins with a solid foundation that is based on proper diagnosis, meticulous execution of the procedure, and immediate and attentive care during the post-operative process.

After the surgery, patients are advised to apply cold compresses during the day (20 minutes on, 20 minutes off) for the first 48 hours. A prescribed antibiotic ophthalmic ointment is given to the patient as well.

Dr. Prasad’s patients have often reported no discomfort during the recovery process and can usually return to work after 1 week.

For more information, visit our website:

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

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

What is the Difference Between an Eyelid Lift, Blepharoplasty, and Ptosis Surgery?
What is the Difference Between an Eyelid Lift, Blepharoplasty, and Ptosis Surgery?

Ptosis, or drooping eyelid is caused by a defective or stretched muscle responsible for lifting the eyelid called the levator muscle. Ptosis surgery is not performed by most plastic surgeons. Correcting this thin muscle in the delicate eye area is more frequently performed by specialists with combined training in ophthalmology and facial cosmetic surgery called oculoplastic or oculofacial surgeons. Dr. Amiya Prasad is a leading Oculoplastic Surgeon with offices in Manhattan and Garden City, Long Island.

Eyelid surgery is one of the most precise and delicate types of cosmetic surgery. Eyelid skin is the thinnest skin in the body at less than half a millimeter in thickness. Dr. Amiya Prasad is leading Eyelid Surgery Specialist dedicated to helping his patients look better and maintain optimal eye health . Unfortunately many general plastic surgeons do not have extensive training and experience with eye anatomy and function which can lead to too much removal of eyelid skin creating an unnatural "surprised" look. Further, many people suffer from compromised eye health caused by the inability to close their eyes properly.

An eyelid lift generally refers to a surgical procedure done to address excess skin and fat around the eyelids.

Blepharoplasty refers to a surgical procedure done on the upper and lower eyelids to address excess skin, fat, and other anatomical issues. A patient can choose to undergo either an upper or lower eyelid blepharoplasty, or both.

Ptosis surgery refers to a surgical procedure specifically done to correct the position of the eyelid margin in relation to the pupil. Such procedures include levator muscle advancement, levator resection, and frontalis sling.

For more information, visit our website:

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

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

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

Can I Fix Ptosis Without Surgery?
Can I Fix Ptosis Without Surgery?

Ptosis, or drooping eyelid is caused by a defective or stretched muscle responsible for lifting the eyelid called the levator muscle. Ptosis surgery is not performed by most plastic surgeons. Correcting this thin muscle in the delicate eye area is more frequently performed by specialists with combined training in ophthalmology and facial cosmetic surgery called oculoplastic or oculofacial surgeons. Dr. Amiya Prasad is a leading Oculoplastic Surgeon with offices in Manhattan and Garden City, Long Island.

Ptosis is caused by physical conditions affecting the levator muscle of the eyelid. Since this is an anatomical problem, surgery is your best option to correct this type of issue.

In some cases, an eye drop can be used to temporarily lift an accessory muscle called Mueller’s Muscle about 1-2mm, in order to make the eye appear more open. However, this is usually done for aesthetic purposes such as posing for photography, and is not meant for long-term use.

For more information, visit our website:

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

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

How Can I Tell if I Need Blepharoptosis or Blepharoplasty?
How Can I Tell if I Need Blepharoptosis or Blepharoplasty?

Ptosis, or drooping eyelid is caused by a defective or stretched muscle responsible for lifting the eyelid called the levator muscle. Ptosis surgery is not performed by most plastic surgeons. Correcting this thin muscle in the delicate eye area is more frequently performed by specialists with combined training in ophthalmology and facial cosmetic surgery called oculoplastic or oculofacial surgeons. Dr. Amiya Prasad is a leading Oculoplastic Surgeon with offices in Manhattan and Garden City, Long Island.

Eyelid surgery is one of the most precise and delicate types of cosmetic surgery. Eyelid skin is the thinnest skin in the body at less than half a millimeter in thickness. Dr. Amiya Prasad is leading Eyelid Surgery Specialist dedicated to helping his patients look better and maintain optimal eye health . Unfortunately many general plastic surgeons do not have extensive training and experience with eye anatomy and function which can lead to too much removal of eyelid skin creating an unnatural "surprised" look. Further, many people suffer from compromised eye health caused by the inability to close their eyes properly.

Determining whether you need blepharoptosis repair or blepharoplasty depends on the position of the eyelid in relation to the pupil.

It is a common occurrence for ptosis to be missed because a plastic surgeon assumes that performing blepharoplasty will automatically improve the appearance of drooping eyelids. This results in the eyelids still looking droopy, with the addition of the patient looking tired.

For purpose of clarity, prospective patients must familiarize themselves with the following terms:

• Dermatochalasis refers to excess skin over the eyelids, which causes hooding and a tired-looking appearance.
• Blepharoptosis refers the eyelid margin being lower than it should be.

It is not uncommon for some patients to have both dermatochalasis and blepharoptosis, which can sometimes be a challenge when creating a proper diagnosis and surgical plan.

During the initial examination, Dr. Prasad will lift up the excess skin to see whether the eyelid margin improves or not. If the eyelid margin is still low, then it is safe to assume that the patient has eyelid ptosis, which can be corrected with the proper surgery.

For more information, visit our website:

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

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

Will My Eyesight Change After Ptosis Surgery?
Will My Eyesight Change After Ptosis Surgery?

Ptosis, or drooping eyelid is caused by a defective or stretched muscle responsible for lifting the eyelid called the levator muscle. Ptosis surgery is not performed by most plastic surgeons. Correcting this thin muscle in the delicate eye area is more frequently performed by specialists with combined training in ophthalmology and facial cosmetic surgery called oculoplastic or oculofacial surgeons. Dr. Amiya Prasad is a leading Oculoplastic Surgeon with offices in Manhattan and Garden City, Long Island.

After ptosis surgery, most people see an improvement in their vision, due to the improvement of the eyelid position in relation to the pupil. Patients often report that the world looks “brighter” and that they no longer feel the strain of keeping their eyes open.

Glasses may be worn, if needed, after surgery. However, Dr. Prasad advises patients to wait at least one week before wearing contact lenses. During this time, an antibiotic ointment is placed on the eyelids and therefore may interfere with the effect of your contact lenses.

After a week, patients may resume wearing contact lenses, provided that they consistently and liberally use lubricating eye drops, in order to prevent eye dryness. Since the eye is more open, the tear film may need supplementation. It is also advisable to check your contact lens prescription several months after the surgery, as drooping eyelids may have caused a very mild astigmatism.

For more information, visit our website:

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

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

What is the Cost of Ptosis Surgery?
What is the Cost of Ptosis Surgery?

Ptosis, or drooping eyelid is caused by a defective or stretched muscle responsible for lifting the eyelid called the levator muscle. Ptosis surgery is not performed by most plastic surgeons. Correcting this thin muscle in the delicate eye area is more frequently performed by specialists with combined training in ophthalmology and facial cosmetic surgery called oculoplastic or oculofacial surgeons. Dr. Amiya Prasad is a leading Oculoplastic Surgeon with offices in Manhattan and Garden City, Long Island.

The cost of any surgery, in general, in based on the following factors: (1) surgeon’s fee, (2) anesthesia, (3) facility costs, and (4) aftercare.

Surgical procedures should not be likened to commodities such as electronic goods. Properly executed surgical procedures are the product of meticulous study, preparation and technical expertise by a surgeon, and the result of your surgery is something that you will live with for a long time. Understanding that the cost of delivering a high level of care usually gives patients a better understanding of how we arrive at our fees.

For more information, visit our website:

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

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

Plastic Surgeon, Ophthalmologist, or Eyelid Specialist for Eyelid Surgery?
Plastic Surgeon, Ophthalmologist, or Eyelid Specialist for Eyelid Surgery?

Eyelid surgery is one of the most precise and delicate types of cosmetic surgery. Eyelid skin is the thinnest skin in the body at less than half a millimeter in thickness. Dr. Amiya Prasad is leading Eyelid Surgery Specialist dedicated to helping his patients look better and maintain optimal eye health . Unfortunately many general plastic surgeons do not have extensive training and experience with eye anatomy and function which can lead to too much removal of eyelid skin creating an unnatural "surprised" look. Further, many people suffer from compromised eye health caused by the inability to close their eyes properly.

Eyelid surgery is performed by several specialties. Financial interests, however, have caused quite a bit of inter-specialty rivalry and controversy, wherein one group of surgeons claims superiority over another.

As an Oculofacial plastic surgeon with more than 20 years of experience, Dr. Prasad routinely performs advanced revision surgery on people from all over the world. These people have usually had their initial surgery done by board-certified surgeons of several specialties. It is important to emphasize that within every specialty performing eyelid surgery, there is going to be variability in the surgeon’s technical skills, artistry, expertise and experience.

Dr. Prasad also stresses that communication between you and your surgeon is extremely important when you’re considering surgery. Choose a surgeon who will spend time with you and understand your personal aesthetic values and what you want to see improved.

Dr. Prasad advises that you choose a specific surgeon, rather than choosing a specific specialty for your procedure.

For more questions and answers regarding eyelid surgery please check our frequently asked questions page on our website at http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/eye-lift-questions-answers//eye-lift-questions-answers/

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

How Does the Recovery for Eyelid Ptosis Correction Surgery Compare to That of Blepharoplasty?
How Does the Recovery for Eyelid Ptosis Correction Surgery Compare to That of Blepharoplasty?

Ptosis, or drooping eyelid is caused by a defective or stretched muscle responsible for lifting the eyelid called the levator muscle. Ptosis surgery is not performed by most plastic surgeons. Correcting this thin muscle in the delicate eye area is more frequently performed by specialists with combined training in ophthalmology and facial cosmetic surgery called oculoplastic or oculofacial surgeons. Dr. Amiya Prasad is a leading Oculoplastic Surgeon with offices in Manhattan and Garden City, Long Island.

Eyelid surgery is one of the most precise and delicate types of cosmetic surgery. Eyelid skin is the thinnest skin in the body at less than half a millimeter in thickness. Dr. Amiya Prasad is leading Eyelid Surgery Specialist dedicated to helping his patients look better and maintain optimal eye health . Unfortunately many general plastic surgeons do not have extensive training and experience with eye anatomy and function which can lead to too much removal of eyelid skin creating an unnatural "surprised" look. Further, many people suffer from compromised eye health caused by the inability to close their eyes properly.

The recovery period from the surgical correction of one of the most common types of ptosis does not significantly differ from that of a standard upper eyelid blepharoplasty. In some cases, however, swelling may last longer, depending on specific issues occurring during, after, or in relation to the surgery.

For more information about the eyelid ptosis surgery procedure please visit our site at
http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/eyelid-ptosis-surgery/

Or come to our clinic on the following address for a personal consultation today:

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

After Ptosis Correction Surgery, Will My Eyelid Look the Same as Before?
After Ptosis Correction Surgery, Will My Eyelid Look the Same as Before?

Ptosis, or drooping eyelid is caused by a defective or stretched muscle responsible for lifting the eyelid called the levator muscle. Ptosis surgery is not performed by most plastic surgeons. Correcting this thin muscle in the delicate eye area is more frequently performed by specialists with combined training in ophthalmology and facial cosmetic surgery called oculoplastic or oculofacial surgeons. Dr. Amiya Prasad is a leading Oculoplastic Surgeon with offices in Manhattan and Garden City, Long Island.

This answer is largely based on the objective of the surgery. If you are having ptosis surgery on both eyes, then elevating the height of the eyelids should improve the general appearance of your eyes. If you have unilateral ptosis (ptosis affecting only one eye), Dr. Prasad ensures to match its symmetry and shape with your other eye, in such a way that they will look the way they did before you developed ptosis.

For the complete info about the ptosis correction surgery please check our website at http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/eyelid-ptosis-surgery/

Or come to our clinic on the following address for a personal consultation today:

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

Once I've Had Ptosis Surgery, Will I Need Any Other Treatment?
Once I've Had Ptosis Surgery, Will I Need Any Other Treatment?

Ptosis, or drooping eyelid is caused by a defective or stretched muscle responsible for lifting the eyelid called the levator muscle. Ptosis surgery is not performed by most plastic surgeons. Correcting this thin muscle in the delicate eye area is more frequently performed by specialists with combined training in ophthalmology and facial cosmetic surgery called oculoplastic or oculofacial surgeons. Dr. Amiya Prasad is a leading Oculoplastic Surgeon with offices in Manhattan and Garden City, Long Island.

Several factors influence whether or not you will need another ptosis correction surgery: (1) the type of ptosis you have, (2) the age when you had the procedure, (3) changes related to aging, and (4) the elasticity of your own tissues.

For example, a child who has congenital ptosis may have surgery to correct it before the age of six, and then may need to have another surgery done in their teen years or young adulthood.

The more common type of ptosis, like aponeurotic ptosis or levator muscle dehiscence, happen later on in life due to the thinning of the levator muscle, which is responsible for lifting the eyelid. The procedure required to address this type of ptosis can last for years without needing any additional or follow-up surgery. Ptosis surgery may only require some enhancement during the first few months or year if there are any issues with height, symmetry, or contour.

For further information regarding ptosis and surgery please check our website at http://prasadcosmeticsurgery.com/prasad-face-eyes/eyelifts/eyelid-ptosis-surgery/

Or come to our clinic on the following address for a personal consultation today:

Manhattan, New York City: 61 E 66th St, New York City, NY 10065 * (212) 265-8877

Garden City, Long Island: 901 Stewart Ave, Suite 206 – Garden City, NY 11530 * (516) 742-4636

Find the Videos, Producers, & Vloggers You Want Faster