Oculoplastic and Reconstructive Surgery

Oculoplastic and Reconstructive Surgeons draw on expertise gained from treating patients' eyes and surrounding musculature and tissues, including the tear drain and orbit. They are adept at recognizing how small surgical changes can significantly improve a person's appearance and expression.

They understand subtleties of the facial areas' convergence zones, skin tension, and fat deposits. They know how to achieve desired results without overcorrecting – which can make a face appear unnaturally taut or give a person a look of perpetual surprise.

Functional Blepharoplasty

Functional Blepharoplasty restores normalcy to an eyelid that has been altered by excess skin that interferes with vision.. Functionally, the patient may complain of visual problems and eyestrain related to heavy upper eyelid tissue.

The skin of the upper eyelids may rest across their eyelashes and block their vision, making them feel like they are looking through their lashes. Patients may report that they can improve their vision by elevating the flaps of skin with their fingertips.

Ptosis is defined as drooping of the upper lid, partly covering the pupil. Ptosis causes a tired, sleepy appearance and reduces vision. Ptosis repair is intended to provide a more youthful, vibrant appearance as well as to improve your sight. Ptosis repair is usually performed by an ophthalmologist who specializes in eyelid surgery. Ptosis repair requires extensive experience.

Ptosis is corrected by tightening the levator muscle. The function of the levator muscle is to raise the eyelid. Ptosis repair is performed through an incision in the normal crease in the upper lid.

Ectropian Repair

Ectropion is the medical term used to describe sagging and outward turning of the lower eyelid and eyelashes. The margin of the eyelid and the eyelashes evert (turn out). This rubbing can lead to excessive tearing, crusting of the eyelid, mucous discharge and irritation of the eye.

Ectropion surgery involves tightening the muscles of the eyelid and its attachment to restore the eyelid to its more normal position. The procedure can also help to improve a more normal youthful contour to the eye.

Brow Lift

A brow lift is a common cosmetic procedure in which the soft tissue and skin of the eyebrows and forehead are elevated. Brow lifts also can be done for medical reasons: A severe brow droop can directly obscure a person's upper visual field, and a drooping brow can contribute indirectly to hooded eyelids, which also obscure vision. Facial trauma affecting the forehead also can necessitate a brow lift.

Eye Lid Reconstruction

The goal of reconstructing eyelid defects is to restore the normal anatomy and function of the eyelid. This can be a challenging endeavor, especially with larger defects and those that involve the lateral and medial canthi. Various reconstructive techniques have been developed and the choice of technique will often depend on what portions of the eyelid are missing and the size of the defect.

Lacrimal Drainage Repair

Lacrimal drainage surgery is called dacryocystorhinostomy (DCR) and can be performed in different ways. One type of operation is an external DCR where an incision is made on the side of the nose, where eyeglasses might rest. A small amount of bone is removed to permit a new connection between the lacrimal sac and the inside of the nose. Small plastic tubes are sometimes inserted at the time of surgery to help keep the newly created opening from scarring shut during the healing process. The tubing is removed a few months after surgery.

Another type of operation uses a special instrument called an endoscope. The endoscope is a small tube with a fiberoptic light that facilitates the creation of a new opening into the nose. Various types of laser have also been used to perform the DCR operation.

In extreme cases where the tear duct cannot be reopened or repaired, an artificial tear duct can be implanted. The artificial tear duct is called a Jones tube and is implanted behind the inner corner of the eyelid to drain tears into the nose.

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