Oculoplastics / Cosmetic Lid & Mid Facial Surgery

We offer BOTOX® Cosmetic and Xeomen® injections for cosmetic as well as medical indications such lid twitching and blepharo-spasms. Also, lid surgery of all types.

Lower Eyelid Blepharoplasty

Blepharoplasty, also known as eyelid surgery, is a surgical procedure that improves the appearance of the eyelids by tightening muscles and tissue or removing excess fat and skin. A lower eyelid blepharoplasty is used to treat the following:

  • Under-eye bags
  • Drooping lower eyelids
  • Excess skin
  • Fine wrinkles
  • Circles under the eye

A lower eyelid blepharoplasty can be performed on adult men and women alike and offers a younger, more refreshed look that reflects across the whole face.

Blepharoplasty is one of the most commonly performed facial plastic surgery procedures. The popularity of this procedure reflects the importance of the eyes in perfecting overall appearance. If the appearance of the eyes causes a patient to be unhappy, they may want to consider lower eyelid blepharoplasty to improve their look and boost their confidence through a safe procedure with minimal downtime.

The Lower Eyelid Blepharoplasty Procedure

The lower eyelid blepharoplasty procedure is performed with either local or general anesthesia. The method or procedure to be used will be determined by the amount of fat that needs to be removed, the location of the fat and how tight to make the eyelid. The procedure typically takes from 45 minutes to an hour.

There are several different surgical approaches that can be used in a lower eyelid blepharoplasty. They are as follows:

Transconjunctival Lower Lid Blepharoplasty

Often chosen when no skin needs to be removed, a transconjunctival lower lid blepharoplasty creates an incision on the inside of the lower eyelid, leaving no visible scar or other evidence of the surgery.

Transcutaneous Lower Lid Blepharoplasty

A transcutaneous lower lid blepharoplasty is performed with a subciliary incision, also known as a pinch technique, to remove protruding fat and excess skin.

Transconjunctival Arcus Marginalis Release

A transconjunctival arcus marginalis release moves the fat within the lid to maintain some volume in the soft tissue. It prevents the ridge of orbital bone from becoming too prominent, which causes the eyes to look hollow and the face to appear older.

After the lower eyelid blepharoplasty procedure is performed, the incisions are closed with sutures and usually wrapped in gauze to allow the area to heal.


Sculptra® Aesthetic Facial Injectable

Sculptra® Aesthetic injectable is used to reverse the signs of facial fat loss that occur with aging. By restoring collagen, which decreases as the body ages, it fills out shallow-to-deep wrinkles and folds that run from the sides of the nose to the corners of the mouth (nasolabial folds). It is not appropriate for use in the eye and lip areas.

Sculptra Aesthetic’s main component is an alpha hydroxy acid called poly-L-lactic acid (PLLA), which is a safe and long-lasting synthetic (artificially created), biocompatible (can be used harmlessly in the body), biodegradable (able to be broken down by the body) substance. PLLA has been used for more than 20 years in many surgical products, including dissolvable sutures and soft-tissue implants.

Treatment And Results Of Sculptra Aesthetic Facial Injectable

Sculptra Aesthetic injections are designed to be a one-time treatment. A patient can have up to 4 injection sessions, which are spread 3 weeks apart. When injected into shallow-to-deep folds and lines, the additional collagen that is produced smooths them out, and adds volume to the skin. Results of Sculptra injections vary but, in a clinical study, their effects were shown to last for up to 2 years in most patients.


Eyelid Retraction

An eyelid retraction is another form of eyelid malpositioning, which can affect either the upper or lower eyelid or both eyelids. Eyelid retraction occurs when the eyelid pulls away from the eye. Since a larger portion of the eye is exposed, symptoms of eyelid retraction may include irritation and dryness of the eyes, pain, or a wide-eyed appearance.

Treatment Of Eyelid Retraction

Conservative treatments for eyelid retraction will usually be the first course of action and may include the use of lubricants such as artificial tears or an ointment. If that does not provide relief of the symptoms or if the patient is very uncomfortable with the appearance of the eyes, surgery will be considered.

Depending on the location and severity of the retraction, the surgeon will determine the best type of procedure for your needs. Grafting techniques may be used to strengthen and reposition the lid, these include:

  • Hard palate grafts
  • Free tarsal grafts
  • Spacer grafts

In other cases, skin tissue and fat are relocated or removed to improve positioning.


Revision Eyelid Surgery

After undergoing an eyelid surgery, or blepharoplasty, if the results are not up to the patients expectations, it can be disappointing. It is always prudent to wait a few months, after the procedure, to determine how the eyes will truly look once the swelling has gone down and healing has taken place. If a patient is still not satisfied at that point, however, a consultation can help them explore their options for an eyelid revision procedure.

Complications that may occur after a blepharoplasty procedure, include some of the following:

  • Lower eyelid retraction
  • Discomfort or pain
  • Blurry vision
  • Exposure keratopathy
  • Lack of symmetry

Every patient and each case is different. In cases of overcorrection, in which too much tissue was removed, the remaining eyelid skin can often be redistributed to improve the result. When an undercorrection is the problem and not enough tissue was removed, another blepharoplasty procedure may need to be performed to achieve the patient’s desired appearance.

For more information about our Procedures and Diagnostic Services, please call us 610-525-5100 or contact us today.