Professional Reviews

After 10 years of Eye Plastic Surgery Practice I began to notice that patients on whom I had performed lower lid bag removal early in my practice had recurrence of their bags despite no significant weight gain.

They also had deeper set, smaller looking eyes, significantly more upper lid depression, and brow droop.

I concluded that this was due to further displacement of orbital fat from below the eye into the lower lid complex.

I determined to secure this displaced fat back underneath the eye. This lifted and brought forward the eyes, the upper lids, and the brows, returning them to their natural, youthful positions.

Also, I saw the necessity of tightening the entire lower lid and upper cheek tissues, by performing a deep plane midface lift through tiny incisions just above the outer eyelid corners, over the lateral orbital rims.

This resulted in eliminating lower lid skin folds and fluid accumulation, with no lower lid skin incisions.

The combination of securing displaced orbital fat back under the eyes, and tightening the entire lower lid / upper cheek tissues, is the Bright Eyes MD Procedure.

Unique to this procedure is literally moving the eyes up and forwards, making them look larger and more prominent, filling the upper lids without resorting to filler or fat injection, lifting both nasal and lateral brows from underneath without skin incisions, and tightening and lifting the lower lids and upper cheeks, resolving folds and fluid, without the need for lower lid skin incisions.

Virtually no Plastic Surgeons realize that the aging process makes the eyes sink down and back in the eye sockets, making them look small and beady.

Consequently, they do not perceive that small, deep-set eyes are a cosmetic problem, and so do not seek to correct it.

The conventional eyelid they perform does not stop or reverse the eye aging process, and if anything makes it worse over time.

I, Dr. Garbutt, am a Board Certified Eye Surgeon as well as a UCLA Fellowship trained Orbito-Facial Plastic Surgeon, and have the exact training needed to do this more complex surgery, which is really an orbit based surgery as opposed to just an eyelid surgery.

Although I have taught this procedure to Plastic Surgeons who have referred to me, and those who have come to my office to see it performed, and given lectures on it to Plastic Surgeons, I find that they might try it once, and then abandon it as being too time-consuming and difficult. This is true even of Eye Plastic Surgeons I know in Southern California.

As far as I know, I am the only surgeon in the US who does this procedure on a routine basis.

If you have undereye / lower eyelid bags and are considering filler to hide the depression underneath the bags, you need to know that fillers:

1. do not go away even after 15 or more years;

2. expand over time up to twice the original volume;

3. cause water retention around the filler, causing fluid folds under the skin;

4. enzyme injections to remove the filler are typically only marginally successful, and the enzyme often thins the skin making, it like crepe paper.

Attempting to tighten the skin with laser to reduce the bags may look good initially, but ultimately leads to thinner skin with loss of skin elasticity, recurrence of bags, and possible fluid retention.

Using fat transfer is better than filler, but simply makes the tissue below the bulge thicker, does not stop the bulge from progressing, requiring more fat transfer, ending in upper cheeks that look inordinately fat.

If the surgeon offers to remove the fat bulges, is he simply going to remove the fat, and not do anything to secure the remaining fat so it does not continue to progress?

Will the eyes be lifted and brought forward to their youthful position?

Will the upper lid depressions have to be corrected with filler or fat transfer?

Will the brows require a separate lift procedure?

Will incisions in the lower lid skin be required?

Will the upper cheeks be lifted and tightened to fill in volume underneath the bags, and reduce any fluid retention from filler, or the cumulative effect of laser and chemical peels ?

If the answers to the above questions are unsatisfactory, you should choose the new standard in cosmetic eyelid surgery, the Bright Eyes MD procedure.