The decision to have cosmetic surgery is one only you can make for yourself. But if you have decided to go ahead with this, it is essential that you find a top-quality surgeon.

One thing to do is to get recommendations. Talk to patients who have had the same type of cosmetic surgery you are considering. Ask if they felt prepared enough, if they were satisfied with the results. Ask them how the procedure felt, and about their recovery process. Ask to see pictures of how they looked prior to the cosmetic surgery.

Interview at least three prospective plastic surgeons. Make sure you feel comfortable with them. Look at before-and-after pictures of actual patients of theirs. Ask them to tell you about potential risks and how they try to minimize the risks. Ask them how many times in a given year they do the type of cosmetic procedure you are considering.

Another important step is to check a doctor’s credentials. In the United States and Canada, there are several organizations that provide certification in plastic surgery or dermatology:

• The American Board of Plastic Surgery (ABPS) – this organization certifies doctors in plastic surgery.
• The American Board of Facial Plastic and Reconstructive Surgery (ABFPR) – this organization certifies doctors in facial plastic and reconstructive surgery.
• The American Board of Plastic Surgery (ABPS) – this group certifies doctors in plastic surgery for the body and face.
• The American Board of Dermatology – this group certifies doctors in the field of skin care
• The Royal College of Physicians and Surgeons of Canada – this group certifies doctors in facial plastic and reconstructive surgery.

Cosmetic surgeons may also belong to organizations that set standards for their members to meet. When interviewing a cosmetic surgeon, ask about which groups they belong to, as well as the procedures they follow to stay current with the latest developments in cosmetic and plastic surgery.You will also want to talk about cost. Since most cosmetic procedures are not covered by insurance, you will have to come up with your own way to pay for the surgery. Obviously, you should never pick a surgeon just because they are the cheapest in price.

Many people want to improve the appearance of their neck without having to resort to their concept of a facelift. Getting rid of their neck wattle would return them to a younger look and be able to wear ties, turtlenecks or jewelry more comfortably. The fear of a facelift is a near universal one. Whether one feels that they are too young or too old for surgery, do not have time for any significant recovery, or cannot afford it, many potential patients are drawn to any procedure or method that offers an alternative.

Some fuller necks or neck wattles may benefit from targeted treatment just to the neck. Such neck rejuvenation, known as submentoplasty, only works on the neck removing fat and tightening muscles. No incisions are around the ears are needed unlike traditional facelift surgery.

As we age, definition and smoothness under the chin and along the jaw line is lost. This occurs due to fatty deposits, weakening muscles and the appearance of loose skin. This results in the obliteration of a sharp neck angle, where the neck and chin meet. Often this just becomes a straight line angling obliquely down from the chin to the lower neck.

Neck skin is different from the rest of facial skin. It generally has much more elasticity and can actually contract or shrink upward after being released from the underlying muscle and fat. Given that the neck skin lies on the underside of the chin, many would think that it would fall downward and hang more after being released. But this does not generally occur unless one’s neck skin is paper thin.

The submentoplasty procedure is done through an incision under the chin. First, fat removal in the neck is done with liposuction. This is followed by midline platysmal tightening and wide freeing of the neck skin from the muscle. Whether liposuction alone or the complete submentoplasty procedure is needed will depending on the age of the patient and the quality and amount of loose neck skin that is present.

Younger patients (less than age 35), who generally have more skin elasticity and have a skin wattle because of too much fat underneath the skin, usually just need liposuction only. Middle-aged patients (ages 35 to 55) have fat deposits also but in addition have a loose or split plastysmal neck muscle and skin. This requires the full submentoplasty method of treatment. Older patients (age 55 and over) almost always need extensive neck recontouring and a facelift is needed where loose skin is actually removed.

In my Indianapolis plastic surgery experience, I have found that adequate neck rejuvenation for many patients requires some version of a facelift. But age is a key factor in determining the suitability of a submentoplasty. In patients under age forty-five, about half of them can get good results with a submentoplasty and avoid a facelift. Over the age of forty-five, however, that number drops to less than one in ten. And over the age of fifty-five that numbers drops to essentially zero.

While submentoplasties are a primary treatment for certain neck issues, it can also be used as a secondary tuck-up after a facelift. Some facelifts, particularly with really saggy necks, will often get some rebound relaxation in the submental region which is furthest from the point of skin pull way back at the ears. A submentoplasty allows further neck refinement when the results of the facelift begin to relax.

A submentoplasty is a simple one hour procedure that is done as an outpatient. Other than wearing a chin strap for a few days, recovery is quick being one week or less.

Dr Barry Eppley is a board-certified premiere plastic surgeon in Indianapolis, Indiana where he practices at his Ology Spa locations at Clarian North Medical Center in Carmel Indiana and at Clarian West Medical Center in Avon Indiana.( http://www.eppleyplasticsurgery.com ) He writes a daily blog on plastic surgery, spa therapies, and medical skin care at http://www.exploreplasticsurgery.com. Dr. Eppley can be heard weekly on his radio show, Doc Chat, on WXNT 1430 AM every Saturday afternoon.

“Double eyelid” is applied to describe Asian eyelids where there is a defined upper eyelid fold above the eyelashes with and exposed eyelid platform. There is great variation in eyelids and not every eyelid has a double fold. The fold is created by a crease at the top of the eyelid platform under the fold. This crease represents a defined attachment between the eyelid skin and the tendon that raises the upper eyelid. The Double fold creates definition in the upper eyelid and it is generally considered desirable in both men and women. For women, the defined platform also creates a protected place to apply make up and further beautify the eyes.

Will Asian Double Eyelid Surgery “Westernize” My Eyes?

Double eyelid surgery is not about westernizing the eyes, which is a common mischaracterization. Both the double eyelid and its absence are common in Asian people. Some people who don’t have a double eyelid wish to obtain one, but they worry that this means they have to “westernize” their appearance. This is not an accurate depiction although this was how the surgery was characterized in the past and is sometimes described in articles where the writer does not understand the purpose of the surgery. Double fold surgery aims to create a natural appearance by creating a well defined upper eyelid fold. This is accomplished by creating a low crease and removing a small amount of skin, while leaving the rest of the eye’s natural appearance intact. Unfortunately, there are practioners who make the crease too high and take too much skin and this type of poorly designed surgery can harm the appearance. The key is to go to an very experienced eyelid surgeon who has thoroughly mastered the procedure and understands what needs to be accomplished. The goal is the conservation of normal eyelid structure while providing complementary eyelid definition in accordance with what you desire your eyes to look like.

Creating a Double Fold

There are two basic ways to create a double fold. Suture methods are common in Asian countries and utilize temporary stitches to that make an upper crease. The threads always eventually fail, which means that they are not the best option for those seeking permanent. In double eyelid surgery, the doctor removes some tissue to form a defined crease in the eyelid at the top of the eyelid platform. It is a critical goal of the surgery to maintain the essential Asian character of the upper eyelid while at the same time adding an eyelid crease to form a defined upper eyelid fold.

Many of these surgeries can be performed in the office under local anesthesia. Recovery is about 10 days before all bruising and most noticeable swelling has resolved. Most stitches are removed at 1 week for most individuals three tiny stitches are left at the crease for about 3 weeks to help make a permanent crease. By about 10 days after surgery most people will not be aware that you just had surgery.

What If My Eyes Are Small?

An eye’s size is usually measured by how much of the white area, otherwise known as the sclera, can be seen. Eyes that appear small may be the result of upper eyelid ptosis, or “droopy” lids, or they may mean you have deep set eyes. Depending on your condition, the surgical approach will vary. Often the double eyelid surgery makes the eyes appear larger by adding definition and naturally framing the eye with aesthetic contours. As always, the best approach is a flexible one that relies on a careful physical examination and weighing the options to choose the best method. There is no standard surgery or procedure for small eyes – surgery must always be adapted to the individual circumstances.

What about My Other Asian Eyelid Concerns?

If you are worried about other issues including asymmetry or a tired look, these are again best addressed on an individual basis. All aesthetic reconstructive eyelid surgeries must be tailored and adapted for the unique characteristics of your eyelid. For this reason, it’s best to find a doctor who specializes in eyelid treatment and who has helped people with widely varying eyelids obtain the best possible results. There are certainly procedures besides the double eyelid surgery that may be right for you and a doctor who understands the anatomy and variations in Asian eyes will be able to help.

Taking the First Step

Now that you know a bit more about double eyelid surgery and Asian eyelid surgery, call for a consultation rather than try to make sense of all the information and misinformation on the internet. Remember, a consultation does not obligate you to go through with any procedure, and it will give you an excellent opportunity to seek personalized advice from an experienced professional.

As a specialist, Dr. Steinsapir has extensive experience with eyelid surgery in Los Angeles and has helped many people obtain their desired results with Asian Double Eyelid Surgery. Contact us today for an individualized approach that will help you realize your personal goals.