By removing excess fat, skin and muscle from the upper and lower eyelids, blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes. It is typically a cosmetic procedure but can also improve vision by lifting droopy eyelids out of the patient’s field of vision.
Incisions are made along the eyelids in inconspicuous places (in the creases of the upper lids, and just below the lashes on the lower lids). The surgeon removes excess tissue through these incisions and then stitches them closed with fine sutures.
Ptosis is the drooping of the eyelid. While ptosis is usually the result of aging, some people develop ptosis after eye surgery or an injury, and some children are born with the condition.
Patients may seek treatment for droopy eyelids for cosmetic and/or medical purposes. Severe drooping may obstruct vision as the eyelid gradually droops lower and lower, eventually covering the eye. If ptosis interferes with a patient’s vision, a brief surgical procedure will be performed to eliminate the drooping. Other patients are simply bothered by the appearance of their eyelids and choose to have this common procedure performed.
Entropion & Ectropion
Entropion is a condition in which the eyelid tends to turn inward, causing irritation to the eye. Entropion can be caused by a congenital defect, aging, spasm, inflammation from another ocular disorder or scarring from a previous trauma or surgery. The cornea can be damaged if this condition is not corrected. Treatment for entropion is a brief surgical procedure with local anesthesia.
Ectropion is a condition in which the eyelid tends to turn outward, exposing the inner lid of the eyelid in either one section of the eye or across the entire lid. Ectropion can be caused by the aging process, facial paralysis, a congenital birth defect, or scar tissue from a previous trauma or surgery. Correction of the condition is completed with a brief surgical procedure in which the eyelids are repositioned.
Trichiasis is a condition in which the eyelashes turn inward and irritate the cornea or conjunctiva of the eye.
Treatment for trichiasis generally involves epilation, or the removal of the incorrectly positioned lashes. When a permanent solution is needed for recurrent or particularly painful eyelash problems, epilation with electrosurgery may be recommended.
Epilation with electrosurgery is a procedure that employs a radiofrequency device to permanently remove the follicles of the affected eyelashes. A fine-wire electrode is inserted directly into each individual eyelash follicle that is malpositioned. An electrical current is used to destroy these follicles so that hair growth can no longer occur.
Cryotherapy is reserved for cases in which the above therapies fail to cure the trichiasis. Surgically removing the lash-bearing eyelid portion may then be considered in truly refractory cases.
Browpexy Internal, Direct & Pretrichial
A Browpexy is a procedure which lifts the eyebrows through incisions in the upper-eyelids, returning the eyebrow to an aesthetically-pleasing location on the upper face. Using an internal browpexy technique, descended brow fat is reattached to the forehead through an upper eyelid incision. A direct browpexy is used for small amounts of brow ptosis with a direct incision above the brow. Pretrichial browpexy. Pretrichial browpexy is performed through a longer incision hidden along the hairline, raising the brows and smoothing the forehead. This may be done with endoscopic assistance.
Each procedure has it’s benefits and indications, and is therefore customized for each patient accordingly.
Tarsorrhaphy, Canthoplasty & Canthopexy
Tarsorrhaphy is a procedure in which the eyelids will be partially sewn together in order to narrow the palpebral opening. Tarsorrhaphy is usually performed when the eyelids become weak and can no longer close or blink effectively, which may lead to corneal and other eye problems. Temporarily sewing the eyelids partially together will help protect the eye until more permanent measures can be taken. Permanent tarsorrhaphies may be performed for chronic eyelid or eye problems.
Canthoplasty is a surgical procedure which is used to create an upward slant in the outer corner of the eyelid, or to correct a drooping or dystopic appearance in this portion of the eyelid.
Canthopexy is a surgery which lifts the external corners of the eye when they are sagging, eliminating a tired appearance, and restoring a more youthful look around the eyes. It is similar to a canthoplasty but involves slightly less intervention.