Dr Andrew Tay

Yes, surgeons are constantly innovating and seeking new solutions, so this is likely,

Yes, upper eyelid ptosis can be improved in patients without any modification of the eyelid crease, either by: doing a posterior approach ptosis correction (where incisions are made on the inner surface of the upper eyelid), or by making the incision on an existing crease. However, crease modification is often useful in ptosis repair, particularly in Asian patients with absent creases, as it would significantly enhance the result, by correcting the pseudoptosis that often occurs with absent eyelid creases.

Yes, the type of procedure done may be very different, as the causes of ptosis are likely to be different. In an older patient, the ptosis is more likely to be due to stretching out or thinning of the levator muscle attachments. This can usually be corrected by re-attaching the levator muscle which will restore function. In very young patients with congenital ptosis, muscle function may be very weak and may require different procedures, for example static or dynamic slings which recruit the help of other muscles to improve eye opening.

This is possible, but unlikely. More common causes include: age previous injury or infection previous upper eyelid surgery (with excessively high creases, excessive fat removal or muscle injury) botox injections inadvertently into the levator muscle, neurological disorders and diseases that cause generalised muscle weakness (e. g. myasthenia gravis).

Symptoms of droopy eyes might include: fatigue headaches difficulty with opening the eyes sufficiently, or a reduction in visual fields. A patient with upper eyelid ptosis would have: eyes that are significantly smaller (either both or one) forehead muscle over-activity (forehead creases and elevated eyebrows) hollowing of the upper eyelid area (often due to fat retraction), and reduced visual fields (on visual field testing).

Thanks for your question. Hyaluronic acid fillers such as Juvederm and Macrolane were previously used for non-surgical breast enhancement. However, their use has been discontinued. Some of the possible risks include: • Infection. This usually occurs quite soon after the initial injections • Displacement or migration of the injected filler. The gel may move to other untended locations. For example, below the inframammary fold. • Persistent nodules that last for several years, beyond the expected lifespan of the filler.

Thanks for your question, and for sending the photo. Chin surgery, or genioplasty, changes the projection of the chin by moving it forward or backwards. Changing the length of the jaw requires a different procedure called a mandibular sagittal split osteotomy. This procedure is more appropriate when the bite (occlusion) is abnormal, meaning the teeth of the upper and lower jaws are not in proper contact. In some cases, both a mandibular osteotomy as well as a genioplasty is required for an optimal result.

Thanks for your question. Unfortunately, I’m not able to comment on the effectiveness of treatments offered by other practitioners. At present, there are 2 methods of breast enlargement that will reliably increase breast size, namely breast implants and fat injections. Breast implants offer several advantages - the outcome (size) can be chosen and visualised beforehand, using 3D imaging technology. The result is expected to remain stable for many years. However, some of the disadvantages include the surgical scar, and risks of capsular contracture and implant leakage.

There are 2 ways that you could increase breast fullness and restore lost volume, namely breast implants and fat injections. The main advantages of breast implants are that a reliable and predictable increase in size can be achieved, in a cost-effective manner. With 3D imaging technology, the post-operative outcome can be exactly visualised, allowing the patient to select the ideal implant to achieve her desired outcome. The outcome achieved is stable and will usually last for at least 10 years.

Thanks for your question, and for sending the photo. Although there appear to be differences in the size of the eye (the vertical aperture), as well as the height of the creases, it’s important to assess these with the eyes in a neutral gaze (head not tilted and looking straight ahead). If there are differences in the size of the eye, this will need to be corrected by adjusting the levator muscle in the upper eyelid (ptosis surgery). The height of the eyelid crease can be adjusted by correct placement of the skin incision, as well as by removal of small amounts of skin.

Thanks for your question. While modern breast implants are very durable and safe, it’s important to realise that they are not expected to last a lifetime. According to some studies, rupture rates are initially very low and begin to increase about 6-8 years after implantation. The chances of implants rupturing and leaking then gradually increases over time. Although rates do vary, you can expect that after 10 years, there is an approximately 10% chance of implant rupture and leakage occurring. This does vary with the type of implant used.

Hi Regina, thanks for the question and the post-op photo. There are several possible causes for ptosis that occur after upper blepharoplasty. I would start by comparing with the pre-op photo to see if there was any pre-existing ptosis and how much it has worsened. The most common cause is usually swelling and internal bruising (blood clots) that may be affecting the function of the muscles that open the eye. If this is the case, then the ptosis will gradually resolve after 2-3 months. Occasionally scar tissue may form (adhesions) and this may require surgical correction.

Gynecomastia, or enlarged breasts in men, is a fairly common condition usually caused by an imbalance of hormones. Although there are many possible causes for gynecomastia (e. g. certain types of medication, obesity, some medical conditions, excess alcohol consumption), in many cases no specific cause can be identified. In adolescents/teenagers with gynecomastia, treatment should consist of observation and regular reviews, as this condition often resolves after several years. Surgical treatment can be considered if the gynecomastia has not resolved by the early to mid-twenties.

A mommy makeover often consists of several procedures to address common issues that women who have been through pregnancy and breastfeeding faced. Typically, it includes a tummy tuck, breast lift and liposuction. The breast lift can be with or without implants. Since it involves a number of direction procedures, it tends to be more costly than other plastic surgeries out there. Hence, costs do vary with the type of procedures done, their durations, and whether a hospital stay is required. That said, a mommy makeover could range from $12,000 and be up to $25,000.

The mommy makeover refers to a combination of body contouring procedures that is done to address the physical effects experienced by many women after pregnancy and breastfeeding. These commonly include loss of breast volume or sagging breasts, enlarged nipples and areola, loose sagging abdominal skin, stretched and separated abdominal muscles and stubborn pockets of fat. The procedures commonly done as part of a mommy makeover include breast augmentation, breast lift (mastopexy), nipple reduction, abdominoplasty (tummy tuck) with the repair of the abdominal muscles, and liposuction.