Malar Crest / Lower Eyelid Bag Direct Excision

Hi this is Dr. Young Seattle Plastic Surgeon. What were treating today are called malar crests and malar mounds They are the bags under the eyes maybe not directly under the eyes but really more inferior to that. We're going to show you a pictures of that and explain how we're doing it. The approach that we're doing is a direct excision. of the malar mounds and crests. There's other ways to treat that. You can do a mid-facelift, fat injections, and other type of facelifting techniques. to get at the malar crest and malar mounds. What I'm going to show you now is a drawing here. What we're doing is a geometric line excision of the malar crests. Now when you see these things come over and they mound up over here, as you can see that this is part of his nose. We're going to take this skin and muscle and close it Essentially, this is what you end up with. When he sits up, you no longer see those. coming over and creating these mounds of tissue underneath the eye. Now, back over here you can see some of his eyelashes and eyelid eyes are more up here, but these are malar crests essentially malar mounds. essentially what that is, its the orbicularis oculi or the eye muscles that surrounds the eye that closes and blinks the eye. and that kind of comes over as you can see when he sits up, its more like ...this. It comes over the smiling muscles. And essentially there are a lot of different ways to treat it. You can do a midface lift and excise some muscle here. But those can cause problems. Sometimes to best treat these malar crests... .. is to directly excise the malar crests and mounds with the qualification that there is a direct incision line there. ...which most people don't necessarily like. In order to hide that better We created a geometric line pattern that breaks up that straight line (or avoids a straight line) Now typically people will see anything that is about point seven centimeters in length and anthing longer than that. So if its longer than that you would benefit from breaking up that straight line And the shape that I'm specifically talking about is a straight line. Anything longer than point seven centimeters, about that long Will be seen by a person as a noticeable shape. And picked out really easily. That's why we're going to break up that straight line. into multiple patterns so its not as easily seen. So we're going to show you in a little bit. Thank you! So what we've done here is excised that pattern that we had drawn out earlier. And we included a cuff a muscle and what your seeing here is muscle And here your seeing some fatty tissue. And what we're going to do is bring this together. This is going to come over here and we're going to bring this together Its going to close really nicely into that patter. And its pretty straight forward. We've excised and included a cuff of a muscle. We're just going to close right now. Thank you.