In our weekly Post Your Face column, Dr. Robert Freund answers readers' cosmetic surgery questions, and shows them how they'd look if they underwent the enhancement. To post your own face, visit

The Patient's Question: I don't like the dark patches that are appearing on my skin. Also, my eyes are beginning to droop -- they are puffy with dark circles.

The patient before (left) and after (right) hypothetical hyperpigmentation treatment, a neck lift, and and eye lift. Courtesy Photo

Dr. Freund's Answer: Everyone wants clear, porcelain skin so I'll address this issue in depth. Facial hyperpigmentation, or darkening, can be the result of genetics, aging or sun exposure. In some cases it's a sign of a more hidden systemic illness so make sure you see an experienced dermatologist initially.

If the pigmentation is a cosmetic problem, you have several choices:

1. Hide it with great make-up or cream base is the safest, cheapest and easiest way to correct these problems.

2. Erase it topically with Retin-A or Hydroquinone, which are both prescription creams or gels that will cause melanin granules to disperse. In other words, they will even out your skin tone. Both medications can make you very sun sensitive, so sun block is essential.

3. Blast it away with lasers or intense pulsed light devices. Both are administered by doctors, or in some cases, by nurses or spa technicians. Your safest bet is to find a dermatologist who has a lot of experience with these methods. A treatment will run between $400-$1,200 and certain ones may require several days of downtime.

In the "After" photo, I've given you an idea of how you might look after a face and necklift, as well as an upper eyelid blepharoplasty (eyelift). The primary objective here is to remove the excess fat under your chin and on your neck. While there are many different types of facelifts, I recommend a vertical lift to the cheek area.

This will ease the marionette lines around your mouth and also add volume to your cheeks, thereby creating a three dimensional improvement. The cost should range from $9,000 to $15,000. Downtime will be 7-21 days.

Respectfully submitted,

Robert Freund, MD, FACS

The health or medical information in this article is for informational purposes only and is not intended to be used as a substitute for professional medical advice, diagnosis or treatment. Please consult your doctor or a qualified healthcare provider with any questions.