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Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.
eyelid surgery
 
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This patient is a perfect candidate for upper eyelid surgery for several reasons.  She has eyebrows that are nice and high (it's harder to get the surgery right if the eyebrows are droopy).  The excess skin on her upper lids has caused a fold that hangs down on her lashes, preventing her from being able to put eyeliner on her upper eyelids.  And because of its excess, the skin in her upper lids has become crinkly.  Note the increased smoothness of that crinkly upper eyelid skin in the after picture.


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All views of this eyelid surgery patient:
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eyelid surgery
current: Left oblique
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eyelid surgery

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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
Get that advice for your own situation by emailing your photos to Dr. Denenberg.

Questioner: Can I Get Only Nose Rasping Done Instead of Full Rhinoplasty?
I like my nose, it's small & cute but the only problem I have is that from the side I have the biggest bump that is so noticeable. It makes me very insecure and I can't even take pictures of myself except from the front because the bump is that noticeable. I wanted to know if a surgeon can just shave it down instead of breaking my nose? & how much would it cost?
(Questioner submitted photos)

Dr. Denenberg's answer: Almost certainly need to narrow the bones, but that's not a bad thing!
There are a couple reasons not to just shave off the bump. First, if you just shave off the bump, it would leave a flat spot on your nose where the bump was. If the bump is like an Egyptian pyramid, and you take the top off, you are left with a flat plateau. Narrowing the bones makes the bridge of your nose normally narrow again after removing the hump. See my "Web reference" link for a morph of your nose without the hump, and more explanation of this topic.

There's another, less obvious reason not to just shave it off. When a hump is taken from a nose, it can make the nose *look* longer, as though the tip drooped down, even if the position of the tip didn't really change. The amount of that effect is different on different people, but the larger the hump, the more likely that we would consider raising the tip a little, not to make a shorty nose, or to change the character of your nose, but just so that the nose doesn't look longer to you after surgery. I made some morphs of that, too. 

Finally, in an operation that takes me about three hours, narrowing the nasal bones takes about three minutes, and it doesn't noticeably increase the swelling or bruising, so it's really a small issue.

Link to this question on RealSelf.com