One year after cancer removal and reconstruction, a patient with basal cell carcinoma (now disease-free) returned for followup evaluation. Happily, there was no visible recurrence of carcinoma. Her story started with a non-healing ulcer of the right lower lid. This…
Blepharoplasty, Brow lifting, Cosmetic, Uncategorized
4 Lid Blepharoplasty: Proper Incision Placement
by josephwalrathmd •
There is not a week of office visits that goes by without at least one patient presenting with inappropriately-placed upper lid incisions from prior surgery. Within the past week, there were two such notable patients: The first patient manifested lid crease…
Dr. Walrath
The reviews are in!
by josephwalrathmd •
The Good, The Bad, and The Funny: Recent Patient Reviews I am listing eighteen recent consecutive patient reviews of my practice, as I think they provide a pretty good sense of our priorities as a practice, including not just my…
Pediatric, Ptosis
“Lazy Eyelid” Repair
by josephwalrathmd •
Some children are born with significant droop of one or both of the eyelids, known as “congenital ptosis”. Adult-onset droop is usually known as “involutional ptosis”, and basically means that a tendon has been stretched that needs to be tightened up. Congenital…
Cosmetic, Cosmetic Reconstruction, Ectropion, Eyelid Malposition, Reconstruction, Tearing
Fixing the multi-operated eyelid
by josephwalrathmd •
This 62 year old woman came from the Midwest for relief from the following problems: tearing and irritation on the left side. Her story started in 2010, when she underwent bilateral lower lid cosmetic blepharoplasty. Since then, she has had three…
Reconstruction, Tumor
Two stage lid reconstruction: when the whole eyelid is lost from cancer
by josephwalrathmd •
Occasionally, a skin cancer turns out to be significantly larger than is thought at first glance. As a matter of course, for eyelid tumors, a dermatologist trained in the “Mohs technique” (in which tumors are removed layer by layer and evaluated to ensure…
Blepharoplasty, Cosmetic
Asian blepharoplasty
by josephwalrathmd •
The term Asian blepharoplasty generally refers to an upper eyelid procedure to remove excess tissue that pays special attention to the upper lid skin fold and crease of the Asian eyelid. Of course, there are countless crease and fold configurations…
Cosmetic, Filler
Injectable fillers: Enough is Enough!
by josephwalrathmd •
I’ve spent the past month chasing eyelid filler. Hyaluronic acid facial fillers (Restylane, Juvederm, Belotero) are often injected in the “tear trough” to try to lessen the shadows (from excess lid tissue or a prominent lid-cheek junction). When injecting in…
Blepharoplasty, Cosmetic, Eyelid Malposition
Choosing your eyelid surgeon
by josephwalrathmd •
It turns out that a lot of surgeons perform eyelid surgery, including: ophthalmologists, dermatologists, otolaryngologists, plastic surgeons, and others. So why would you choose an oculoplastic surgeon, a surgeon who has trained in ophthalmology first, then in eyelid and eye…
Blepharoplasty, Cosmetic, Ptosis
Ptosis repair and 4-lid blepharoplasty: postoperative course
by josephwalrathmd •
The preoperative evaluation, postoperative course, and 3 month result of a patient are described in this post. This patient complained that her upper lids are interfering with her vision. As can be seen below, the upper lid on the…