Frequently Asked Questions

Eyelid Surgery

1. Will eyelid surgery change the shape of my eye?

Eyelid surgery’s primary goal is to remove extra folds of skin and pockets of fat that contribute to a tired, sad, or angry look. In general, these changes create a more youthful and refreshed appearance, not a differently shaped eye. Occasionally, if desired, a more defined upper eyelid crease may be sculpted or more upper lid skin may be exposed for a more dramatic look. Similarly, a subtle lift may be added to the outside corner of the eye if desired.

2. At what age should I have eyelid surgery?

The right time for cosmetic surgery depends more on your appearance than your age. For some people, extra upper eyelid skin or lower eyelid puffiness can begin as early as in their twenties. Most people notice some extra upper eyelid skin by their thirties or forties, and early bags under their eyes around the same time. For older individuals, eyelid surgery may contribute to a subtle facial rejuvenation with wrinkle fillers or fat transfer, or may be part of an overall facial rejuvenation when combined with a facelift or browlift.

3. How many days off from work do I need to take? Will I be uncomfortable?

Most people feel very comfortable after eyelid surgery. Most need either no pain medication or just regular Tylenol for discomfort. While they feel great, people usually don’t want to return to work until their sutures are removed 4-5 days after surgery.

4. When can I wear makeup?

Makeup can be worn on upper lids usually as soon as the sutures are out and the incisions are healed. You may wear makeup on the lower lid area the day after the surgery.

5. How long will I be bruised?

Most bruising fades by one week. Any residual bruising at that point is usually readily covered by concealers.

6. Will insurance help pay for the surgery?

Occasionally overhanging upper lid skin can be so severe that it obstructs vision. In those circumstances, the insurances may help cover the cost of the surgery.

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Rhinoplasty

1. What is rhinoplasty?

Rhinoplasty is cosmetic nasal surgery to improve the shape of the nose. It is often combined with functional nasal surgery to improve nasal breathing.

2. Does insurance pay for the surgery at all?

Insurances pay for functional surgeries. When patients have nasal obstruction due to a deviated nasal septum or turbinate hypertrophy, they may need nasal surgery to relieve their symptoms. Repair of nasal fractures are also frequently covered by insurance. Though insurances do not cover cosmetic procedures, most patients prefer to have their functional and cosmetic surgeries performed at the same time, shortening overall recovery.

3. Will my nose be packed?

Nasal packing (and its subsequent removal) is unpleasant. Luckily, unlike most surgeons, I almost never find it necessary to pack noses after surgery.

4. Does it hurt?

Most patients report more stuffiness and pressure than true pain. Patients find their pain is easily controlled by pain pills the first night, and most no longer take pain pills after 1-2 days.

5. What kind of anesthesia do I need?

Deep sedation is my choice for nasal surgery. Deep sedation allows for the patient to be comfortable and fully monitored for the utmost safety.

6. Will everyone know that I had my nose done?

The art of rhinoplasty (cosmetic nasal surgery) is to bring out the patient’s best features and give the patient a natural, non-operated look. Often that means making the nose “go away” so it blends in with the rest of the face and lets your eyes and smile take center stage. A successful rhinoplasty creates a balanced face, not an artificially beautiful nose.

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Facelift

1. What is a facelift?

Aging in the face results from more than just sagging or wrinkled skin. That’s why cutting away skin alone does not create a natural or enduring rejuvenation. Think of turning a raisin back into a grape – you wouldn’t do it by cutting away skin! Similarly, rejuvenation of the face requires treating the skin, muscles, fat, and sometimes the underlying framework independently.

A traditional facelift involves rejuvenation of the “jowls”, jaw line and neck by trimming away excess skin and tightening the underlying muscles. It is often combined with other procedures to reinflate the cheeks, strengthen the chin, or freshen the brow or eye areas. Today, however, targeted facelifts can create rejuvenation of isolated areas, such as the cheek or neckline, when those areas have aged disproportionately to the rest of the face. Choosing among these various options depends on your goals, your aesthetic, and the amount of recovery time that fits your lifestyle.

2. Does it hurt?

Unlike chest or belly surgery where you can’t help but move the incision every time you breathe or sit up, facial surgery is not really painful. While you may have swelling and bruising that you find uncomfortable or “tight,” actual pain is uncommon.

3. How long will I be bruised?

Bruising is most severe the first one to two weeks, depending on the procedure. Fat transfer, in particular, may produce longer-lasting bruising or swelling. For most procedures, I encourage patients to use a homeopathic regimen that I have found very effective in shortening recovery time.

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Fat Transfer

1. Where do you get the fat?

All fat used for facial fat transfer is taken from you. Generally, the best sources are the inner thigh, outer thigh, love handles, or belly.

2. Does the area you take fat from become smaller?

Generally, small amounts of transferred fat are all that are required in the face. Therefore, taking
this small amount of fat from a large area such as the thigh, hip, or belly is not noticeable.

3. How long does the fat last?

Transferred fat is a kind of graft. Once transferred, about half of the fat lives in its new location, and half dissolves. The fat that remains at six months generally persists for many years, and grows and shrinks naturally as your weight fluctuates. Occasionally, if less fat remains at 6 months that we would like, we would need to perform an enhancement and add a touch of extra fat at that point.

4. Does it hurt?

Fat transfer is generally not painful in the face, just “tight” or “swollen” feeling. Sometimes the belly or thigh donor site may be sore for a day or so, like the pain from a hard workout.

5. Will I bruise or swell?

Recent advances in fat transfer technique have resulted in much greater predictability and fat survival
through placing tiny droplets of fat into individual tunnels. Because of the many little pockets placed, fat transfer creates significant bruising and swelling. While most of the bruising is gone by 2 weeks, you may have some swelling remaining for over a month, especially near the lower eyelid or upper cheek

6. Can fat transfer be done with other procedures?

Yes – in fact fat transfer is often the perfect complement to facelifts or lower eyelid surgery.

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Plastic surgery by St. Louis, Missouri cosmetic specialist Dr. Mike Nayak.

Nayak Plastic Surgery
607 S. Lindbergh Blvd.
St. Louis, Missouri
63131

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