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Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.
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Views of this eyelid surgery patient:

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She had one of the largest collections of fat underneath the skin of the eyelids that I've seen.  She had those large attractive eyes that were partially hidden by the fat protrusions.

The bulges are easy to see.  In most people, excess fat also resides in the upper eyelids, but only in the inner corner of the upper eyelid, adjacent to the nose.

During the upper eyelid surgery, besides the removal of excess skin, the fat that makes the little bulge next the nose is removed as well.


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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: Do I need a revision rhinoplasty?
I like everything about my new nose but the tip. Im 20 months post op and I'm not thrilled about the tip. It's very round and sort of droopy. Especially in pictures. At my last follow up, my doctor acknowledged that the skin underneath the nose was a little loose but even with the new procedure, there's a chance it'll still look the same way it does now. He claims there's no way to get rid of the skin. Thoughts?
(Questioner submitted photos)

Dr. Denenberg's answer: It doesn't look like loose skin to me.
I have to say, I've never seen a case where drooping at the bottom of the nose there is loose skin hanging down. It's either cartilage or scar tissue.

This far after surgery, if the nose is still too big, you're looking at a revision. There are a couple of pieces of good news for you, though. It appears, from these photos, that the size is the result of strong cartilages under the skin, and a revision where reduction in size is the goal is more predictable than some other changes we try to make.

I would try to elevate the entire tip of your nose -- that's key -- narrow the tip, bring the whole nose back closer to the face, lower the bridge to match the new position of the tip.

Link to this question on RealSelf.com