Treatment of tearing in the adult and infant, correction of abnormalities related to thyroid eye disease, and rehabilitation for those who have lost an eye are all part of the spectrum of care provided by the oculoplastic surgeon.

Oculoplastic Surgery

The field of oculoplastic surgery is broad and encompasses treatment of diseases, deformities and tumors (including the eyelids, orbits, and tear drainage systems). Both benign and malignant eyelid tumors are routinely treated and, when indicated, reconstruction of the eyelid is performed to restore the natural anatomy and achieve a cosmetically desirable result.

Repair of the eyelid due to birth defects or acquired causes such as, ptosis (drooping eyelid), ectropion (eyelid turned out), entropion (eyelid turned in), and retraction (eyelid too far back), should be treated by an oculoplastic surgeon. Traumatic injury to the eyelid and bones of the face surrounding the eye will also require the specialized skills of these surgeons. Treatment of tearing in the adult and infant, correction of abnormalities related to thyroid eye disease and rehabilitation for those who have lost an eye, are all part of the spectrum of care provided by the oculoplastic surgeon.

In addition to functional and disease-related abnormalities, oculoplastic specialists perform cosmetic eyelid procedures. For all of these treatments it is important to recognize that patients are carefully screened to minimize complications and that regimens are tailored to each patient’s individual needs, with attention to maintenance of normal ocular health.


This surgical procedure involves correction of excessive, droopy eyelid skin and bagginess of the lower eyelids. Such conditions create a prematurely aged appearance and often cause an individual to look fatigued. Frequently, drooping of the upper lids can be severe enough to limit the peripheral visual field.

Why is blepharoplasty performed?

Both visual function and cosmetic appearance can be improved with blepharoplasty. Removal of excessive eyelid skin will typically expand the visual field in affected patients, as if a shade has been lifted from in front of their eyes. Cosmetically, a more youthful appearance is obtained, with patients benefiting from a less weary, sagging eyelid appearance. Drooping of the eyebrows can usually be corrected at the same time.

Why does excess eyelid tissue form?

The skin around the eyelids becomes loose and underlying tissues relax due to the effects of sun exposure, hereditary factors, gravity, diet and/or smoking. With time, gravity acts on this loosened tissue, leading to sagging. Other underlying tissue changes allow fat pads normally in the eye socket to protrude forward. This leads to bulges or “bags” forming under the eyes.

What are the symptoms related to these changes?

In addition to cosmetic effects and a limited field of vision, excess eyelid tissue can cause physical discomfort. Brow-ache and fatigue of the eyes are often related to the constant effort of lifting up the heavy, drooping eyelids with the forehead muscles. In some individuals, this action may be the source of chronic tension headaches. Also, excess upper eyelid skin can cause the eyelashes to rotate backwards and irritate the surface of the eye.

What are the results of blepharoplasty?

When well planned and expertly performed, results of a blepharoplasty can be dramatic. The ultimate result depends on the extent of work required, the healing process, and the patient’s prior health, skin condition and age. Discussion of the expected benefits and possible complications is a key part of the preoperative process. This helps patients have realistic goals, understand surgical limitations and prevent postoperative problems.

The incisions for this procedure are typically placed within the normal lid creases and folds of the upper and lower eyelids. The eyelids heal extraordinarily well from blepharoplasty, with minimal to no scarring because of their thin skin and excellent blood supply. Incision lines initially appear as faint reddish marks, which eventually fade to the point where they become unnoticeable.

It is important to have realistic goals when considering blepharoplasty.

Additional Enhancements Botulinum toxin injection

Botox™ (Allergan) injection is a safe, effective, repeatable procedure that can dramatically reduce skin creases and wrinkles caused by contraction of facial muscles. Regions of the face commonly treated include the forehead, frown lines of the nasal bridge, between the eyebrows, and crow’s-feet of the corners of the eyelids.

This drug is administered in the office as a series of injections. Botox™ is a protein that weakens and selectively inactivates the muscles that cause the skin to crease by blocking stimulations of regional nerve endings. It has long been used therapeutically in the treatment of muscular spasm and facial tic disorders.
The resulting weakness that occurs relaxes the overlying skin, and wrinkles soften and may disappear.

Because Botox™ is given only in small doses directly into the intended sites of action, it is very safe and has few adverse effects. It has no effect on the central nervous system and its local effects are limited to 3 to 4 months. The muscles injected return to normal function as the medication is metabolized.

Our Surgeons

Elizabeth A. Maher, M.D. - New York

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