LEARN, SHOP & CHAT ABOUT PLASTIC SURGERY, BEAUTY AND ANTI-AGING





Mehryar (Ray) Taban, MD
Expert Profile



User Photo For: mytaban
Mehryar (Ray) Taban, MD
Oculoplastic surgeon | Views: 53038


Friendname: mytaban
Business Name: TabanMD
Website: www.TabanMD.com
 
Location: 435 N Roxbury Dr, #104
Beverly Hills, CA 90210
United States
Telephone: 310-278-1839
Languages Spoken: English




Post a reply Ask Mehryar (Ray) Taban a question Return to Mehryar (Ray) Taban's homepage



Ask An Expert > Mehryar (Ray) Taban Message Board > can a mid face lift do anything to reduce appearance of proptosis
AUTHOR MESSAGE
Default User Photo
lulu71
,
can a mid face lift do anything to reduce appearance of proptosis
I have slightly bulging eyes due to combination of possibly thyroid and very high myopia on eyes that were large prior to either problem. MRI reveals no thryoid involvement but because I have hashimotos Dr's say it may contribute. Eyes don't seem to be changing. I am 37. Borderline for orbital decompression - some Dr's will do it, others say my eye problem is too mild. proptosis is 19 and 20 mm. eyes dry but only on waking and in the wind. Eyes don't bulge noticeably out of sockets as such, because they have pushed the eyelids outwards, rather than much retraction so main problem is under eye hollows and puffy lids. Would a midface lift help the appearance of proptosis at all..and even possibly reduce the dry eye a little by reducing the 'pull' of the sagging cheek on lower eyelid? In hope!!


drgrossman
Plastic surgeon
New York, NY
United States
View My Professional Profile
  July 22, 2011 10:17 AM

A midface lift will not help, in fact may hurt you more. What you need is permanent fat grafting to the lower lid and cheek area and even eye brows. This will definitely improve your appearance and I am stating this even without your photos being posted, which BTW would help.
Good luck from NYC


lulu71
additional bits..  July 22, 2011 2:04 PM

Thank you very much for taking the time to answer my question...can I be cheeky and ask your opinion on the surgery proposed?

The full surgery proposed is: spacer graft (taken from roof of mouth) to one eye which is slightly larger, mid face lift, then fat transfer to the hollows under the eyes (i think the surgeon mentioned over the eyes too). In tandem with these other procedures, do you still feel a midface lift could possibly be something likely to have an adverse affect...it was actually me that requested the inclusion of it...rather than the surgeon, so if its not a sensible thing to push for, i'm glad i asked.


drgrossman
Plastic surgeon
New York, NY
United States
View My Professional Profile
  July 22, 2011 2:10 PM

In my opinion no one should have a midface lift. Fat transfer, in experienced hands can create more and better results with practically no risks. The eyes should get so much better as well, so postpone the graft. That procedure should be reserved for some one after a disaster of some kind.
Good luck


lulu71
  July 22, 2011 2:19 PM

Thank you very much for your kind help :)

I must admit, I don't like the idea of the palette graft. Final quick question..can fat transfer do anything at all to assist the very slight dry eye I have caused by the proptosis ? I know that seems an odd question but i wondered whether, with more fat in the under eye area (the area that currently seems hollow)the lower lid might be very slightly pushed upwards to cover the eye a little more. Thank you so much.


mytaban
Oculoplastic surgeon
Beverly Hills, CA
United States
View My Professional Profile
proptosis and midface lift  July 22, 2011 3:12 PM

If you have proptosis, midface is unlikely to help. Imagine a belt on a big belly; that belt will slip down! The same thing for the lower eyelid in relation to the eye. Orbital decompression is a better answer. Also, note that the dry eyes will get worse with age.


lulu71
  July 22, 2011 3:25 PM

Oh Dear. How Depressing...! But better I know now and take it into account before possibly making a mistake...thank you very much for your advice.


drgrossman
Plastic surgeon
New York, NY
United States
View My Professional Profile
  July 22, 2011 3:41 PM

fat grafting when done correctly may very well help the dry eye indeed.


lulu71
proptosis and under eye hollow  July 23, 2011 11:31 AM

I have now added a photo. i have quite high cheek bones and what appears to have happened over the last few years is that the fat pad either from the cheek bone or just under the eye has slipped downwards. This makes the proptosis look even worse by leaving a hollow and the cheek bulging underneath. I have no loss of fat or aging elsewhere on the face and no drooping, its just the cheek...in fact I'm not even sure if its the cheek pad or fat from under the eye thats slipped down creating what looks like a bulging cheek. I don't really understand it as I have real aging, drooping or fat loss elsewhere on the face. Perhaps proptosis can somehow dispalce under eye fat :/
I would favour the safer option of fat transfer, but feel because of this sagging fat, if the whole hollow area is filled, because the concave part is so considerable, I am going to end up with very strange looking face and wondered if it would be sensible to somehow lift this opad of fat that has drooped down. many thanks for any nice advice!

Attached Media

Photo:

proptosis and under eye hollow



drgrossman
Plastic surgeon
New York, NY
United States
View My Professional Profile
  July 23, 2011 12:32 PM

Fat does not sag, it's loss of it that makes tissues look saggy.




 



 

Welcome to the Ask An Expert section of our website! Our network of board certified physicians can answer any questions that you may have regarding plastic surgery, skin care, dermatology and other conditions. Popular topics include tummy tuck, liposuction, rhinoplasty, acne scars, facelift, breast augmentation and more. This frequently asked questions section is opened to everyone and you need to set up an account with Makemeheal before you can ask your own question. This service is absolutely free and is available to those who are interested in learning more about a particular cosmetic procedure, treatment or product.

Before asking a question, we recommend you to browse through our existing collection of questions and answers to ensure that the question you want to ask have not already been answered by our highly experienced experts. This will help you save time and get an answer more quickly. When asking a new question, we recommend you to be very detailed so that our experts could formulate a more precise & professional answer.

Of course, this service is not a substitute for a doctor visit or a consultation with a plastic surgeon or cosmetic dermatologist. The answer you will find here only serve as initial directions of thoughts and not as specific instructions. You should remember that it is utterly important to consult a skilled specialist prior to scheduling any type of treatment in order to get acquainted with possible contraindications. Only a one-on-one meeting will enable your cosmetic surgeon to properly evaluate your condition, conduct examinations and explain their results.