Silicone Nose Implant Removal: What You Need to Know

Posted on June 11, 2026 by Donald B. Yoo, M.D.


By Donald B. Yoo, M.D., F.A.C.S. | HALO Beverly Hills, Beverly Hills, CA

Silicone implants have been used in rhinoplasty for decades, particularly in Asian countries where dorsal augmentation is one of the most common goals of nose surgery. And while silicone is easy to carve, affordable, and initially well-tolerated, it carries a fundamental limitation: it is a foreign body, and the human body never fully accepts it.

Over time, that biological reality tends to catch up with patients.

Revision Rhinoplasty with Rib and DCF of previous Silicone Implant

Why Silicone Implants Fail

The most common problems I see in revision patients who come to me with existing silicone implants are:

  • Skin thinning over the implant
  • Visible or palpable implant edges
  • Implant migration or shifting
  • Capsular contracture causing distortion
  • In the most advanced cases — extrusion, where the implant begins to push through the skin

None of these are rare. They are the predictable, long-term natural history of a synthetic material placed in a location subject to constant movement, pressure, and the body’s ongoing foreign body response. In thin-skinned Asian patients, these problems often appear sooner and are more visible than in patients with thicker skin.

When Should an Implant Be Removed?

The short answer: when it is causing problems, or when there is clear evidence it will. I do not advise patients to remove a well-positioned, asymptomatic implant simply because time has passed. But when I see skin thinning, early visibility, shifting, or signs of chronic inflammation, I recommend removal — and sooner rather than later. Waiting until the implant extrudes or the skin is severely compromised makes reconstruction significantly more difficult.

What Happens After Removal?

This is the question patients are most anxious about, and understandably so. After years with an implant, the nose has adapted to the added volume. Removal alone leaves the patient without that structure, and in many cases with scarring, skin changes, and weakened support.

In my practice, implant removal is almost always combined with reconstruction using autologous tissue — meaning the patient’s own cartilage. Depending on what is available and what is needed, I use septal cartilage, ear cartilage, or rib cartilage. For dorsal augmentation, I have largely transitioned to diced cartilage fascia, or DCF — a technique that produces a smooth, natural-feeling dorsum that integrates with the surrounding tissue and carries none of the long-term risks of an implant.

The reconstruction is tailored to what the implant left behind. Some patients need straightforward dorsal replacement. Others require more extensive work — tip support, structural grafting, and soft tissue management — particularly when the implant caused significant scarring or deformity.

Is This a One-Stage or Two-Stage Procedure?

In most cases, I perform implant removal and reconstruction in a single operation. A two-stage approach — removing the implant, allowing the tissues to heal, then performing reconstruction — is reserved for cases involving active infection or severe skin compromise where it is not safe to place new grafts immediately.

Recovery and Results

Recovery from revision rhinoplasty after implant removal is generally longer than primary rhinoplasty, because the tissues have already been through surgery and have more scarring. Swelling resolves more slowly. I tell patients to expect 12 to 18 months before they see their final result — though meaningful improvement is visible much earlier.

The results, when done well, are transformative. Patients who spent years uncomfortable with a nose that looked or felt artificial consistently describe their reconstruction as the best surgical decision they ever made.

Choosing the Right Surgeon

Silicone implant removal and revision rhinoplasty is among the most technically demanding procedures in facial plastic surgery. The combination of altered anatomy, scar tissue, compromised skin, and the need for structural reconstruction requires a surgeon with specific experience in both revision rhinoplasty and autologous grafting techniques.

If you are living with a silicone nose implant that is causing concern — or simply wondering whether yours is still safe — I encourage you to schedule a consultation. An honest assessment now is far better than a crisis later.

Frequently Asked Questions

How do I know if my silicone nose implant needs to be removed?

The clearest signs are visible changes to the skin over the implant — thinning, redness, or a shiny appearance — or a shift in the implant’s position. You may also notice the edges of the implant becoming palpable or visible, or feel that the nose has become harder or more rigid over time. Any of these warrants a consultation. That said, you do not need to wait for symptoms to become serious before seeking an evaluation. Early intervention almost always leads to a better outcome than waiting until the implant has caused significant damage.

Can I just have the implant removed without replacing it?

In most cases, removal alone is not advisable. After years with an implant, the overlying skin has thinned and the underlying support structures have been altered. Simply removing the implant typically leaves the nose looking deflated, asymmetric, or structurally compromised. In the vast majority of my revision patients, removal is performed together with reconstruction using the patient’s own cartilage — which restores natural-looking volume and support without reintroducing the risks of a synthetic material.

Will I look worse after the implant is removed and reconstructed?

Not if the reconstruction is done well. Most patients are pleasantly surprised by how natural the result looks and feels compared to what they had with the implant. Autologous cartilage — particularly diced cartilage fascia for the dorsum — integrates with the surrounding tissue in a way that silicone never can. The nose moves naturally, feels natural, and ages naturally. The transition period during healing can be uncomfortable to navigate, but the long-term result is almost always a significant improvement.

How is revision rhinoplasty after implant removal different from my original surgery?

It is considerably more complex. Scar tissue from the original surgery changes the anatomy, limits tissue mobility, and increases the risk of complications. The skin may be thinner and less forgiving. Grafting requirements are typically greater. Recovery is longer. This is why surgeon selection matters enormously — revision rhinoplasty after implant removal is a subspecialty within a subspecialty, and outcomes vary widely depending on the surgeon’s experience with both revision cases and autologous reconstruction techniques.

How long is recovery after silicone implant removal and reconstruction?

Most patients are presentable within two to three weeks, though residual swelling — particularly at the tip — continues to resolve for 12 to 18 months. Because revision surgery involves scar tissue and more extensive dissection than primary rhinoplasty, swelling tends to linger longer. I advise patients to be patient with the process and to evaluate their final result at the one-year mark, not at one month.

Does insurance cover silicone nose implant removal?

In most cases, no — implant removal is considered an elective cosmetic procedure and is not covered by insurance. Exceptions may apply if there is documented infection, impending extrusion, or a medically necessary functional component to the surgery. During your consultation we can discuss the full scope of what is needed and provide transparent pricing.

Donald B. Yoo, M.D., F.A.C.S. is a double board-certified facial plastic surgeon and Medical Director of HALO Beverly Hills, specializing in revision and Asian rhinoplasty. His office is located at 433 N. Camden Drive, Suite 970, Beverly Hills, CA 90210. To schedule a consultation, visit www.donyoomd.com.

Posted in Asian rhinoplasty, rhinoplasty | Leave a comment

Can AI tell me what I need to improve my facial balance?

Posted on June 5, 2026 by Donald B. Yoo, M.D.

AI has made many of the questions we face on a daily basis easy to answer. The way AI alogorithms frame and organize responses help us to quickly consider the pertinent issues and formulate a decision. The value of AI comes from the fact that it can compile and synthesize information much more quickly than we can alone, but when it comes to making aesthetic recommendations, some limitations do present themselves.

AI chatbots such as Gemini, Claude, and ChatGPT can measure facial proportions and compare them to established canons of ideal proportions: vertical thirds, horizontal fifths, medial canthal to alar relationship, canthal tilt, et cetera. It can even take your photos and videos and generate simulations of potential changes that would mimic these more “ideal” facial proportions. While the results image may look great enough for you to share on your Instagram and Tik Tok, it doesn’t tell the full story.

Contemporary beauty standards can’t simply be distilled into a single set of measurements or a collection of angles. The Golden Ratio should be applied within the context of an individual patient’s anatomy, ethnicity and personal beauty standards and not simply on the amalgamation of hundreds of people considered “attractive” to determine a single defining algorithm.

An easier way to contextualize this would be to determine a perfect or Golden Ratio for the length of hair that makes a woman attractive. Some women look beautiful with short hair. Some women look beautiful with long hair. Many women look beautiful with hair that hair is any length in between. Now imagine taking the measurements of all these beautiful womens’ hair, averaging them, and calling those single average measurements the optimal hair length for beauty. As silly as it sounds, a hundred years ago when plastic surgery textbooks began creating these idealized ratios, measurements and angles for facial aesthetics, that’s exactly what they did. They simply chose individuals they felt were “attractive”, made measurements of their features, and spit out average numbers that then represented the gold standard of beauty.

Fast forward to today, and AI does essentially the same thing with your facial analysis. It can measure your face, compare to other averaged measurements of people considered beautiful, and tell you what is off. While it may provide some information, it lacks the context of your individual beauty ideals, anatomy and how this truly affects your facial balance outside of simple numbers.

Before AI Filter DY

After AI Filter DY

The other caveat of asking AI about facial balancing recommendations? AI does not make any accurate assessments of the bony and soft tissue anatomy. It’s easy to move pixels around on a digital image in 2 dimensions. Whether it’s possible to create the same effect in real life is a different story.

So for now, AI learning algorithms still have a ways to go before becoming as accurate as an experienced plastic surgeon focusing on facial balance and harmony rather than simple measurments.

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The Cost of Asian Rhinoplasty in 2026: Complete Price Breakdown, Factors and Real Examples

Posted on April 15, 2026 by Donald B. Yoo, M.D.

Primary Keyword: Asian rhinoplasty cost
Secondary Keywords: Asian nose job cost Los Angeles, Asian rhinoplasty cost LA, ethnic rhinoplasty cost, rib cartilage rhinoplasty cost, revision Asian rhinoplasty cost

Revision Asian rhinoplasty before and after using rib cartilage and diced cartilage fascia graft for natural dorsal augmentation and tip refinement
Before and After Revision Asian rhinoplasty with rib cartilage and diced cartilage fascia (DCF)

Asian Rhinoplasty Cost in Los Angeles: What to Expect in 2026

The cost of Asian rhinoplasty in Los Angeles typically ranges from:

$12,000 to $35,000+

This variation is not arbitrary. Pricing reflects differences in surgical technique, anatomical complexity, grafting requirements, and surgeon subspecialization in Asian nasal structure.

Unlike traditional reductive rhinoplasty, Asian rhinoplasty is primarily a structural augmentation procedure, often requiring cartilage grafting and advanced tip support. Whereas the goal in traditional rhinoplasty often includes removing a bump on the bridge of the nose (dorsal hump reduction) and reducing the size of the nasal tip to achieve refinement, goals that can be achieved easily achieved without the complexity of additional grafts and structural creation.

Why Asian Rhinoplasty Costs More Than Standard Rhinoplasty

Asian nasal anatomy presents distinct structural characteristics:

  • Thicker skin envelope
  • Lower dorsal height
  • Weaker lower lateral cartilage support

As a result, surgery often requires:

  • Dorsal augmentation
  • Tip projection with structural grafting
  • Cartilage harvesting (rib, septum, or ear)

These added steps increase operative time, technical complexity, and therefore cost.

Detailed Cost Breakdown (Los Angeles Market)

1. Surgeon’s Fee ($8,000 – $25,000+)

The largest cost component is the surgeon’s fee, which reflects:

  • Experience in Asian rhinoplasty specifically
  • Case complexity (primary vs revision)
  • Use of advanced structural techniques

Subspecialists in ethnic rhinoplasty typically command higher fees due to greater technical demand and outcome consistency.

2. Anesthesia Fees ($1,500 – $3,500)

Asian rhinoplasty is usually performed under general anesthesia, particularly when rib cartilage is used. Longer operative times increase anesthesia costs.

3. Facility Fees ($1,500 – $5,000)

Costs vary depending on:

  • Accredited surgical center vs private suite vs hospital
  • Duration of surgery
  • Level of staffing and monitoring

4. Cartilage Grafting (Major Cost Driver)

Rib Cartilage (Most Expensive)

  • Adds $3,000 – $8,000+
  • Required for:
    • Moderate to significant augmentation
    • Moderate to significant nasal tip/alar definition
    • Revision surgery
  • Advantages:
    • Strong structural support
    • Lower long-term complication rates
    • Most effective for achieving optimal refinement in thicker skinned patients

Septal Cartilage

  • Limited availability in many Asian patients
  • Typically used in less complex cases or for patients seeking minimal change

Ear Cartilage

  • Used for contour refinement rather than major support

Primary vs Revision Asian Rhinoplasty Cost

Primary Asian Rhinoplasty

$12,000 – $25,000+

  • First-time surgery
  • Moderate structural augmentation

Revision Asian Rhinoplasty

$20,000 – $35,000+

  • Scar tissue and altered anatomy
  • Deficient or deformed cartilage from previous surgery
  • Frequent need for rib cartilage
  • Increased operative complexity

Revision cases are consistently more expensive due to unpredictability and surgical difficulty.

Implant vs Rib Cartilage: Cost vs Long-Term Value

Silicone Implant Rhinoplasty

Lower upfront cost

  • Shorter surgery
  • Simpler technique

However:

  • Higher risk of infection, extrusion, and long-term complications
  • Increased likelihood of revision surgery
  • Unnatural appearance long-term with thinning of nasal skin

Rib Cartilage Rhinoplasty

Higher upfront cost

  • More complex procedure

But:

  • Superior biocompatibility
  • More natural aesthetic outcome
  • Lower long-term complication rate

From a health economics perspective, structural rhinoplasty often represents greater long-term value despite higher initial cost.

What Is Included in the Cost?

Most Los Angeles practices include:

  • Surgeon’s fee
  • Anesthesia
  • Operating facility
  • Standard postoperative visits

May also include:

  • Imaging or surgical planning tools
  • Medications
  • Limited revision policy

Always confirm details with your surgical quote following consultation with your potential surgeon.

How to Choose the Right Surgeon (Not Based on Price Alone)

When evaluating Asian rhinoplasty cost in Los Angeles, prioritize:

  • Documented experience in Asian nasal anatomy
  • Consistent, natural-looking outcomes
  • Structural (not purely cosmetic) approach
  • Transparent explanation of grafting strategy

Lower-cost procedures frequently correlate with:

  • Inexperience with Asian aesthetics
  • Simplified use of rib cartilage grafts i.e. en bloc rib grafts or diced cartilage glue (DCG) grafts instead of unified tip grafting with diced cartilage fascia (DCF) grafts
  • Reliance on cadaveric rib, which has a much higher risk of resorption than your own rib cartilage
  • Use of implants
  • Limited structural support
  • Higher revision rates

Frequently Asked Questions

How much does Asian rhinoplasty cost in Los Angeles?

Most patients pay between $12,000 and $35,000+, depending on complexity and technique.

Why is Asian rhinoplasty more expensive?

It requires augmentation, cartilage grafting, and structural reinforcement, increasing operative time and technical demand.

Is rib cartilage worth the extra cost?

In the right hands, yes. It provides better long-term stability and lower complication rates, particularly in complex or revision cases. Rib cartilage, however, is simply a building block. The surgeon’s expertise and artistry are critical to using that building block to create the most aesthetically beautiful nose for your individual face.

Is Asian rhinoplasty covered by insurance?

No. Cosmetic procedures are not covered, though functional components may be partially reimbursed if medically necessary.

Final Thoughts: Cost Reflects Complexity and Expertise

Asian rhinoplasty is a highly specialized procedure requiring:

  • Structural engineering of the nasal framework
  • Ethnic preservation
  • Advanced grafting techniques

As a result, cost variation is expected and appropriate.

Patients should evaluate cost in the context of surgeon expertise, technique selection, and long-term outcome reliability, rather than viewing price as an isolated factor.

Learn more: https://www.donyoomd.com/blog/2025/11/14/whats-the-biggest-challenge-in-asian-rhinoplasty/

Before and After Asian rhinoplasty with unified rib cartilage grafts and diced cartilage fascia (DCF).
Before and After Asian rhinoplasty with unified rib cartilage grafts and diced cartilage fascia (DCF).
Before and after revision rhinoplasty with unified rib cartilage grafts and diced cartilage fascia to create a more refined and balanced nose.
Before and after revision rhinoplasty with unified rib cartilage grafts and diced cartilage fascia to create a more refined and balanced nose.
See More Before and Afters

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Red Light Therapy: Mechanisms, Clinical Applications, and Evidence-Based Considerations

Posted on March 27, 2026 by Donald B. Yoo, M.D.

Red light therapy (RLT), or photobiomodulation (PBM), has emerged as a non-thermal, light-based modality with growing support in the biomedical literature. Its clinical relevance spans dermatology, wound healing, and regenerative medicine. As interest expands, it is important to distinguish between theoretical mechanisms, demonstrated clinical effects, and the parameters required to achieve reproducible outcomes.

What Is Red Light Therapy?

Red light therapy involves exposure to visible red (approximately 620–700 nm) and near-infrared (700–1100 nm) wavelengths. These wavelengths penetrate tissue and are absorbed by intracellular chromophores, most notably cytochrome c oxidase within the mitochondrial respiratory chain.

This interaction has been associated with:

  • Increased adenosine triphosphate (ATP) production
  • Modulation of reactive oxygen species (ROS)
  • Activation of transcription factors involved in cellular repair

These mitochondrial mechanisms and downstream signaling cascades are well-described in the literature (Hamblin, 2017; Avci et al., 2013).

Biological Effects on Skin and Connective Tissue

Experimental and translational studies suggest that red and near-infrared light influence multiple pathways relevant to skin physiology:

  • Upregulation of collagen synthesis via TGF-β–mediated pathways
  • Enhanced dermal remodeling and extracellular matrix organization
  • Increased angiogenesis and microcirculation
  • Reduction in inflammatory signaling

In human clinical studies, photobiomodulation has demonstrated improvements in skin complexion, collagen density, and wrinkle reduction (Barolet et al., 2016; Avci et al., 2013).

Clinical Applications

Dermatologic and Aesthetic

  • Photoaging and fine rhytides
  • Skin laxity and textural irregularities
  • Acne vulgaris and inflammatory dermatoses
  • Post-procedural recovery

Wound Healing and Regenerative Medicine

  • Chronic wounds and soft tissue injury
  • Scar modulation

Musculoskeletal and Pain Applications

  • Tendinopathy and soft tissue pain syndromes

Systematic reviews and meta-analyses suggest that PBM can improve pain and functional outcomes in soft tissue conditions, although heterogeneity in protocols remains a limitation (Tripodi et al., 2021).

Treatment Parameters and Dose-Response Relationships

A defining feature of photobiomodulation is its sensitivity to treatment parameters. Key variables include:

  • Wavelength: Determines tissue penetration and chromophore interaction
  • Irradiance (power density): Governs rate of energy delivery
  • Fluence (J/cm²): Total delivered energy
  • Treatment timing and frequency: Influences cumulative biological response

PBM follows a biphasic dose-response relationship (Arndt–Schulz law), in which insufficient energy yields minimal effect, while excessive exposure may attenuate therapeutic benefit (Hamblin, 2017).

At-Home Devices: Limitations in Context

Consumer-grade devices have improved accessibility; however, several limitations are frequently cited:

  • Lower and inconsistent energy output
  • Limited transparency in wavelength specificity and dosimetry
  • Variability in manufacturing standards
  • Lack of protocol standardization

Given the dose-dependent nature of PBM, these factors can influence reproducibility and clinical efficacy.

Clinical-Grade, In-Office Treatment: Where It Differs

From a scientific and clinical standpoint, the distinction between at-home and in-office treatment is primarily related to control of variables known to influence biological response.

  • Reproducible dosimetry: Energy delivery aligned with studied therapeutic ranges
  • Adequate irradiance: Sufficient power density for deeper tissue targets
  • Protocol standardization: Alignment with published clinical parameters
  • Integration with procedures: Use as an adjunct to lasers, microneedling, or surgery
  • Clinical oversight: Adjustment based on patient-specific variables

These factors are particularly relevant given that most high-quality studies demonstrating efficacy are conducted using controlled clinical devices.

Facial Plastic Surgery Applications

  • Reduction of postoperative edema and ecchymosis following rhinoplasty and blepharoplasty
  • Acceleration of re-epithelialization after laser resurfacing
  • Improvement in scar quality following incisional procedures

Emerging evidence suggests photobiomodulation may enhance postoperative recovery through modulation of inflammation and microcirculation.

Conclusion

Red light therapy represents a scientifically grounded modality with demonstrated effects on cellular metabolism, inflammation, and tissue repair. Its clinical utility continues to expand as higher-quality trials refine optimal treatment parameters.

While at-home devices may offer convenience, the strongest evidence base supporting photobiomodulation derives from controlled, clinical-grade applications.

References

  • Avci, P., et al. (2013). Low-level laser (light) therapy (LLLT) in skin: Stimulating, healing, restoring. Seminars in Cutaneous Medicine and Surgery, 32(1), 41–52. https://doi.org/10.12788/j.sder.0007
  • Barolet, D., et al. (2016). In vivo human dermal collagen production following LED-based therapy. Journal of Cosmetic and Laser Therapy, 18(2), 93–99. https://doi.org/10.3109/14764172.2015.1054634
  • Hamblin, M. R. (2017). Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS Biophysics, 4(3), 337–361. https://doi.org/10.3934/biophy.2017.3.337
  • Tripodi, N., et al. (2021). Photobiomodulation in tendinopathy: A systematic review and meta-analysis. BMC Sports Science, Medicine and Rehabilitation, 13, 96. https://doi.org/10.1186/s13102-021-00306-z

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Is there a difference between K beauty skincare and American skincare?

Posted on March 24, 2026 by Donald B. Yoo, M.D.

Korean moisturizers place an emphasis on products that hydrate the skin while leaving a texture that remains light to the touch. Rather than trying to combine all the the ingredients in a single product as American moisturizers sometimes do, Korean skincare relies on a layered, multi-step approach to achieve both high hydration and skin barrier support while maintaining a non-occlusive and lightweight finish.

American skincare products tend to utilize higher levels of occlusives, which help protect dry and damaged skin, but may also feel “heavy” at times. Korean moisturizers often employ gels and gel-cream hybrid emulsions to achieve significant hydration while minimizing greasiness.

The disparity in regulatory environment between the U.S. and Korea also represents an important distinction between American and Korean moisturizers. Korea tends to have a regulatory environment more conducive to innovation and more efficient in allowing companies to translate their research and development into consumer-facing products. This allows Korean manufacturers to take advantage of unprecedented delivery systems and novel active ingredients faster than practically any other modernized country.

Why is salmon sperm showing up in skincare?

The basis of skin repair and hydration comes from the DNA fragments call PDRN (polydeoxyribonucleotide) that are isolated from salmon sperm. PDRN was originally investigated for its potential benefits in tissue repair and wound healing – such as patients with non-healing diabetic ulcers. Eventually the positive effect on cellular repair processes was applied to aesthetic medicine to improve the appearance of skin.

What are the potential benefits of using PDRN serums?

The most immediate benefit of PDRN serums is improved hydration, as the PDRN fragments are very effective at attracting and retaining moisture, creating a more dewy and luminous skin tone. With repeated use, skin texture and elasticity improves as the collagen support becomes augmented and the integrity of the skin barrier improves.

What, exactly, doesPDRN do? (Specifically, *how* does it work to promote the aforementioned benefit(s)?)

PDRN stimulate skin repair and collagen synthesis by interacting with receptors which activate fibroblast (skin cell) activity, driving the recovery of dermal injury and the synthesis of new collagen and elastin (the proteins giving firmness and elasticity to skin). Studies have also shown PDRN to have effects on reducing inflammation and redness by reducing the expression of inflammatory cytokines.

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A Guide on How to Analyze a Plastic Surgeon’s Before and After Photos

Posted on March 20, 2026 by Donald B. Yoo, M.D.

We are in an unprecedented era of visibility for aesthetic procedures. Anyone can go online and have immediate access to before and after photos, videos, and even procedure vlogs documenting the whole process from consultation to recovery. How then is a patient supposed to critically analyze this huge volume of content accurately? Read on to learn some insider information.

  1. Check the Lighting
    • You may assume the lighting conditions between the before and after photos are the same, but you’ll be suprised just how many surgeons try to pass off changes in lighting to actual surgical improvements in a patient’s appearance. Overhead lighting can accentuate shadows on a patient’s face while bright and diffuse lighting can eliminate shadows – think tear troughs and dark under eye circles, or photos showing skin quality. The best way to check for lighting is the patient’s complexion and the catchlights in a patient’s eyes. If the patient’s complexion does not look consistent from before to after photo, start being skeptical that the lighting has not stayed consistent. From there, look carefully at the reflection in the patient’s eyes. Is the light source symmetric on both sides of the face and the same as the after photos? Only when you see that can you be sure that the lighting is consistent between before and after photos.
  2. Check the Angles
    • Images should be taken from the same distance, at the same level, and same angle every time. Plastic surgeons are notorious for using facelift before and after photos where the patient has the chin down to scrunch neck wrinkles while the neck is extended in after photos to make the results look even more spectacular. The angle that a frontal view photo is taken can drastically alter the appearance of the eyes, nose and jawline to create the illusion of slimming and tapering and vice versa.
  3. Evaluate the Entire Body of Cases
    • A single successful photo is not enough to judge surgical skill. Look for:
    • Consistency: Multiple patients with similar outcomes indicate reproducibility. Ideally being able to identify before and afters of other patients with similar baseline anatomy or outcomes similar to your aesthetic ideals will bode favorably for the surgeon’s potential of success with your face.
    • Variety: A surgeon experienced with diverse facial anatomies demonstrates versatility and adaptability.

Analyzing before-and-after photos is both an art and a science. By focusing on photographic consistency, symmetry, subtle details, authenticity, and reproducibility, patients can make informed decisions while understanding realistic outcomes. Always approach these images critically, and use them as one of several tools to evaluate a surgeon’s expertise.

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My upper eyelids feel heavy and it feels like the skin is sagging. Do I need an upper blepharoplasty or browlift?

Posted on March 10, 2026 by Donald B. Yoo, M.D.

The periorbital area includes the upper eyelids and the eyebrows, and the interplay between the two anatomic units is important in creating a comprehensive rejuvenation to the eyes. For most patients the eyebrow position looks most aesthetically pleasing when the lateral aspect is level or slightly higher than the medial aspect, and the body of the eyebrow sits at or slightly above the supraorbital rim or brow bone. When the eyebrows are positioned higher than the brow bone it can lead to a startled or surprised appearance, while a position inferior or lower than the brow bone can contribute to an stern, angry or aged appearance. When the eyebrows are ptotic, the eyebrow skin may encroach on the upper eyelids or displace the upper eyelid skin inferiorly to create a hooded and heavy appearance to the upper eyelids.

When assessing the upper eyelids, the eyebrows must first be evaluated for their relative position. Once the normal position of the eyebrows has been established, then the surgeon may accurately assess the degree to which the upper eyelid skin is lax or redundant and can make a precise measurement in terms of the amount of skin removal. When the eyebrows are ptotic or droopy at their medial aspect, then an endoscopic browlift, direct browlift or coronal browlift may be indicated, depending on the patient’s anatomy and aesthetic goals. When the lateral brow is ptotic without accompanying ptosis of the medial brow, a temporal browlift may be most appropriate.

A temporal browlift involves incisions behind the temporal hairline bilaterally, and when executed precisely will not result in any change to the appearance of the hairline or alopecia. Within 3-6 months hair will typically grow through the incision and camouflage it completely. Through this hidden incision skin may be removed and dissection performed down to the orbital rim to release the connections tethering and pulling down on the brow. The same incision can be used to create further dissection into the midface and cheeks to perform and endoscopic facelift. In that instance suspension sutures are used to elevate the soft tissue and skin along the midface and, depending on the patient, the lateral canthus of the eyes, along with the brow/upper eyelid complex. In a temporal browlift the suspension sutures secure the mobilized skin/muscle/fascia flap to the deep temporalis fascia, creating a more open and refreshed appearance to the eyes. The elevation of the brows and brow skin allow for elevation of the supratarsal crease even when upper eyelid skin has not been surgically removed.

Before and after temporal browlift
Before and After Temporal Browlift

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What is the difference between upper blepharoplasty, double eyelid surgery and Asian blepharoplasty?

Posted on February 20, 2026 by Donald B. Yoo, M.D.

All these terms refer to specific types of upper eyelid surgery, which are some of the most commonly performed aesthetic procedures worldwide. Upper blepharoplasty encompasses double eyelid surgery and Asian blepharoplasty as it involves surgical reshaping of the upper eyelids, whether for functional or purely aesthetic reasons. Traditional upper blepharoplasty involves removal of excess skin and fat which often become excessive with age and begin to encroach on the visual fields, sometimes even causing deficits in peripheral vision. Incision design typically follows the naturally occurring upper eyelid crease, where it will heal as a difficult to detect thin line.

Before and After Upper Blepharoplasty

Under the umbrella of upper eyelid surgery then comes double eyelid surgery and Asian blepharoplasty. Double eyelid surgery refers to upper blepharoplasty in patients that either lack a defined upper eyelid crease (supratarsal crease) or have asymmetry of the upper eyelid creases. In these patients the crease can be surgically created or reinforced by anchoring the crease internally with sutures underneath the skin. Incision design in these cases follows the desired crease shape and height and the orbicularis and/or skin is secured to the tarsal plate or levator aponeurosis (muscle that opens the eyelid) to cause the upper eyelid to fold and crease in the desired line. Double eyelid surgery can be performed on patients of all ethnicities.

Asian blepharoplasty represents a slightly more narrow of patients as during Asian blepharoplasty the goal often involves creating or enhancing the upper eyelid fold, but may also involve changing the height or shape of the supratarsal crease, height of the upper eyelid margin, and the appearance of medial and lateral canthi. During Asian upper eyelid surgery and Asian blepharoplasty excess skin may or may not be present, and the focus tends to to be on creating a brighter and more aesthetic appearance to the eyes.

Asian Blepharoplasty Asian Eyelid Surgery Before and After

Learn more: https://www.donyoomd.com/services-surgical-asian-blepharoplasty.php

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What is the difference between ptosis repair and upper blepharoplasty when it comes to upper eyelid surgery?

Posted on February 14, 2026 by Donald B. Yoo, M.D.

Patients often get confused about what ptosis is, which makes sense since even the pronunciation can be a little confusing. For starters, the “p” in ptosis is silent, so it sounds more like toe-sis, and refers to the upper eyelid margin (the part containing eyelashes) as it crosses the iris (colored part of your eye). For most patients the eyelid margin will cover the same amount of iris on both eyes. In these patients, the the eyelids will appear symmetric if the upper eyelid crease, or supratarsal crease, is symmetric in terms of height and shape. If the supratarsal crease is different in the right vs left eye, then the eyelid may still appear asymmetric. For this reason it is important to distinguish the source of asymmetry when the upper eyelids appear uneven.

Right Upper Eyelid Ptosis

Some patients will have ptosis in both upper eyelids, resulting in a sleepy or droopy appearance to the upper eyelids. In these cases, ptosis repair may be performed on both sides to create a brighter, more open and more “awake” appearance. The eyes looks brighter after a ptosis repair since the amount that is able to reflect off the eyes is increased, creating a greater light-reflex. It is the distance from the light reflex to the lid margin that surgeons measure to determine the presence and extent of ptosis. This margin-reflex distance, or MRD, will typically be 4-5 mm, and less than 4 mm usually indicates some degree of ptosis. Ptosis repair can be performed to one eye, or both eyes to create greater symmetry, and may be performed in isolation or in combination with upper blepharoplasty. In the presence of excess upper eyelid skin, fat, or upper eyelid crease asymmetry, upper blepharoplasty provides a powerful avenue for surgeons to optimize eyelid symmetry.

Upper Blepharoplasty with Ptosis Repair
Revision Upper Blepharoplasty with Supratarsal Fixation

Achieving optimal symmetry to the upper eyelids requires a surgeon with an eye for detail and with a precise surgical technique to comprehensively address all the aspects of your eyelid anatomy that may be causing asymmetry.

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Is there a way to make my uneven eyelids more symmetric?

Posted on January 28, 2026 by Donald B. Yoo, M.D.

Eyelids can appear uneven for a few different reasons. The most common reason concerns the upper eyelid fold, or the supratarsal crease, which can be influenced by the amount of redundant skin (dermatochalasis), asymmetry of brow position, ptosis (or droopy eyelid), and position of the globe within the orbit. Even in the absence of these other findings, many people naturally have a supratarsal crease that has a slightly different height and shape on one side relative to the other.

The upper eyelid crease normally forms from a connection between the distal fibers of the levator aponeurosis into the eyelid skin. This muscle (levator) is responsible for opening the upper eyelid, and when open the interdigitations between the levator and skin create a distinct fold, or supratarsal crease. The height of this fold depends on the individual’s specific anatomy, with some people having a high, deep crease while others have very low or shallow creases. The strength of the connection between the levator and skin typically determines the depth of the crease, while the size of the tarsal plate (fibrous structure providing shape to the upper eyelid) often contributes to the crease height.

So what to do if you have asymmetric upper eyelid creases? Some of you may have already discovered eyelid tape or eyelid glue, which essentially modifies the height and shape of the crease mechanically. Unfortunately eyelid tape and glue are often visible, and are rarely a permanent solution. The permanent solution involves creating or reinforcing the connection between the levator aponeurosis and skin in a symmetric and durable fashion across both eyelids. Fortunately, upper blepharoplasty with supratarsal fixation is designed to accomplish exactly this by using sutures to anchor the levator and skin to create a specific height and shape to the upper eyelid crease.

Upper blepharoplasty with supratarsal fixation

In addition to securing the upper eyelid crease, a meticulous surgeon will assess for other factors causing asymmetry and address those during upper blepharoplasty surgery, including the amount of excess skin hanging over the crease and the amount of fat in the upper eyelid. An important consideration to skin removal during blepharoplasty is to ensure that the eyes are still able to close fully and naturally, and this can be precisely measured by the surgeon during the procedure.

Revision Upper Blepharoplasty with Supratarsal Fixation

When performed properly, upper blepharoplasty with supratarsal fixation will create a refreshed and symmetric appearance to the eyelids, while preserving of all their natural function and beauty.

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