Oculoplastic surgeons are ophthalmologists (eye doctors) who have completed subsequent fellowship training in periocular and facial plastic surgery. Oculoplastic surgeons have a special expertise in treating plastic surgical problems that can impact visual function and ocular comfort. Typical problems treated involve: the eyelids the surface lining (conjunctiva) of the eyelids and eyeball the muscles that move the eye the soft
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It’s now 5 straight weeks in which I’ve performed a reconstructive ptosis surgery on a patient who had undergone two and sometimes three prior failed eyelid surgeries. My rule of thumb is simple: I don’t do the same surgery twice if it failed the first time. One of the most recent patients who had recalcitrant ptosis of the upper lid
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Most of the literature published on tear drain surgery (DCR; Dacryocystorhinostomy) supports a higher success rate when the surgery is performed from the outside, rather than from inside the nose. This is probably partly due to the fact that non-ophthalmologists are more likely to do the surgery from inside the nose, if that is a region where they typically operate.
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The Eyelid Crease, and it’s cousin, The Eyelid Fold, can be the most important element of a patient’s face. It can be the dominant feature of facial ethnic identity. And some times the crease is just gone. How? What makes the crease? The eyelid crease is formed by the attachment of the levator palpebrae muscle, the main elevator of the
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Last Monday, I had the pleasure of lecturing to the maxillofacial surgery residents at Emory on preoperative evaluation and surgical techniques for upper and lower blepharoplasty. It was a time for reflection, and for appreciating how my technique is constantly evolving and individualized for patients. As an ophthalmologist, the most important element of blepharoplasty is preserving function. Some patients simply
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Often the most challenging oculoplastic surgical problems may appear to be quite simple to the untrained eye. Reconstruction of the inner corner of the lower eyelids certainly comes to mind. The smallest amount of wound contracture leads to lower eyelid malposition, as demonstrated below: The left lower eyelid has previously had a tumor excision and reconstruction with a skin
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Believe it or not, one of the most challenging surgeries for many cosmetic surgeons to perform is lower lid blepharoplasty. What makes it so difficult? The main hurdle involves repositioning of the eyelids on the outside corner (the “lateral canthus”) during the surgery. Placing the lids too high leads to failure of upper eyelid closure. Placing them too low or
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Ptosis repair, the process of lifting the upper lids, is somewhat of an artform. All of the most respected surgeons in the oculoplastic field will tell you that the surgery can still be frustrating, even when one is at the top of their game. Why is that? It turns out that the main lifting muscle of the eyelid can undergo degeneration…
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Fortunately for us, cosmetic surgeries of the eyelids rarely challenge us as often as these reconstructive cases. Yesterday I performed a very challenging reconstruction of the inner corners of both eyelids. The patient had multiple attempts to reconstruct his eyelids after cancers were removed prior to visiting my office. The surgery was complicated because there was complete loss of tissue
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Botox and Xeomin are similar injectable medications containing botulinum toxin. They paralyze portions of the muscles that cause wrinkles. How do I make sure to hit the proper muscles? How do I know where to inject? What kinds of problems are going to be helped? The diagrams below will help answer some of those questions. The muscles that I
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Ptosis (droopy eyelid) repair is relatively reliable, with about a 90% chance of good outcome with a single surgery for most types of problems. Patients generally don’t complain of significant discomfort, nor do they experience significant swelling. Below is a recent preoperative / postoperative picture set that shows just how minimal the degree of swelling usually is after one week.
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