Oculoplastics

The East Michigan Eye Center invites you to learn more about your options in Oculoplastic surgery. If you would like to ask questions or make an appointment for a consultation, please call us at 810-238-3603

Blepharoplasty

As we mature, the delicate skin around the eyes can appear puffy, saggy, or droopy. Eyelid skin stretches, muscles weaken, and the normal deposits of protective fat around the eye settle and become more prominent. The surgical procedure to remove excess eyelid tissues (skin, muscle, or fat) is called blepharoplasty.

Blepharoplasty can be performed on the upper eyelid, lower eyelid, or both. The surgery is performed for either cosmetic or functional reasons. Sometimes excess upper eyelid tissue obstructs the upper visual field or can weigh down the eyelid and cause the eyes to feel tired. Most often, people choose blepharoplasty to improve their appearance by making the area around their eyes firmer. When blepharoplasty is performed to improve vision rather than for cosmetic reasons only, the costs may be covered by your health insurance plan.

Blepharoplasty for the lower eyelid removes the large bags under the eyes. It is unusual for third-party payers to cover lower-lid blepharoplasty.

The surgery is usually performed on an outpatient basis and can take one to three hours. Upper-eyelid incisions are made in the natural crease of the lid, and lower-lid incisions are made just below the lash line. A procedure for lower-lid blepharoplasty, known as transconjunctival lower-lid blepharoplasty, removes or redistributes excess fat through an incision inside the lower lid. The incisions are closed with fine sutures.

Swelling, bruising, and blurry vision are common after blepharoplasty. Stitches are removed three to five days after surgery, except in the case of transconjunctival blepharoplasty, where the self-dissolving sutures require no removal.

Possible complications associated with blepharoplasty include bleeding and swelling, delayed healing, infection, drooping of the upper or lower eyelid, asymmetry, double vision, and dry eye, to name a few. It is important to note that the puffiness of the fat pockets may not return, but normal wrinkling and aging of the eye area will continue.

Browlift

Sun, wind, and gravity affect the skin and muscles of the face over time. One of the most noticeable aspects of aging is a progressive drooping of the eyebrows. This can cause wrinkling of the forehead from raising one’s eyebrows as well as vertical wrinkles or furrows between the eyebrows. Sometimes the eyebrows or excess eyelid tissue can obstruct vision.

A browlift (also called a forehead lift) elevates the brow, smoothes forehead skin, and can remove vertical lines between the eyebrows. Incisions are made in inconspicuous places, either behind the hairline, in one of the forehead wrinkles, or immediately above the eyebrows. If an endoscope (a small tube with a fiber-optic light) is used, the incisions can be very small. After the muscles are tightened and excess skin is removed, the incision is closed with sutures. The operation is usually performed on an outpatient basis under either monitored anesthesia care (MAC) or general anesthesia.

Swelling and bruising, common after a brow- or forehead lift, begins to subside in seven to 14 days. Numbness and itching are common during the healing process. Sutures, staples, or clips are removed within seven to 14 days after the surgery. Incisions in the hairline may damage hair follicles and result in some hair loss.

Chalazion

A chalazion is a swelling in the eyelid caused by inflammation of one of the small oil-producing glands located in the upper and lower eyelids. A chalazion is sometimes confused with a stye, which also appears as a lump in the eyelid. However, a stye is an infection of a lash follicle and forms a red, sore lump. Chalazions tend to occur farther from the edge of the eyelid than styes and tend to “point” toward the inside of the eyelid. Sometimes a chalazion can cause the entire eyelid to swell suddenly, but usually there is a particular tender point.

When a chalazion is small and without symptoms, it may disappear on its own. If the chalazion is large, it may cause blurred vision. Chalazions are treated with any or a combination of the following methods:

Warm compresses help to clear the clogged gland;
Antibiotic ointments may be prescribed if bacteria infect the chalazion;
Steroid injections may be used to reduce inflammation;
Surgery may be used to drain a large chalazion if it does not respond to other treatments. The procedure is usually performed under local anesthesia in your ophthalmologist’s (Eye M.D.’s) office.

Chalazions usually respond well to treatment, although some people are prone to recurrences. If a chalazion recurs in the same place, your ophthalmologist may suggest a biopsy to rule out problems that are more serious.

Ectropion

Ectropion is an outward turning of the lower eyelid, most commonly caused by aging, although eyelid burns or skin disease may also be responsible.

Normally, the eyelids help lubricate and cleanse the eye during blinking. An eyelid that is drooping and has lost contact with the eye can cause dry eyes, excessive tearing, redness, and sensitivity to light and wind.

Surgery can be performed to tighten the eyelid and return it to its normal position. The eyelid can then protect and lubricate the eye properly, so that irritation and other symptoms subside.

Eyelid surgery to repair ectropion is usually performed on an outpatient basis and under monitored anesthesia care (MAC). Following surgery, your ophthalmologist (Eye M.D.) may prescribe antibiotic ointment and will instruct you to avoid heavy bending, lifting, and straining for sev

Entropion

Entropion is an inward turning of the eyelid and lashes toward the eye, usually caused by relaxation of the eye muscles and tissue due to aging.

Entropion usually affects the lower lid. The skin and eyelashes rub against the eye and cause discomfort and tearing. The irritated eye can produce mucus and become red and sensitive to light and wind. If entropion is not treated, rubbing of the skin and eyelashes can lead to infection or scarring of the eye, which can cause vision loss.

Surgery can be performed to tighten the eyelid and return it to its normal position. The eyelid then protects the eye properly, and irritation and other symptoms subside.

Eyelid surgery to repair entropion is usually performed on an outpatient basis under monitored anesthesia care (MAC). Following surgery, your ophthalmologist (Eye M.D.) may prescribe antibiotic ointment and will instruct you to avoid heavy bending, lifting, and straining for seven days.

Eyelid Surgery

Eyelid surgery is a common method of treatment for entropion (inward turning of the eyelid), ectropion (outward turning of the eyelid), ptosis (drooping of the eyelid), and some eyelid tumors.

Eyelid surgery is usually an outpatient procedure performed under local anesthesia. Risks of surgery are rare but can include bleeding, infection, and eyelid asymmetry due to uneven wound healing. Differences in healing between the eyes may cause some unevenness after surgery.

After eyelid surgery, bruising or a black eye is common but resolves quickly. It may be difficult to close your eyelids completely, making the eyes feel dry. This irritation generally disappears as you heal. Serious complications are rare but can include vision loss, scarring, and infection. To most people, the improvement in vision, comfort, and appearance after eyelid surgery is very gratifying.

Ptosis

Ptosis is drooping of the upper eyelid. The eyelid may droop only slightly or it may cover the pupil entirely. In some cases, ptosis can restrict and even block normal vision.

Congenital ptosis, or ptosis that is present at birth, requires treatment in order for normal visual development to occur. Uncorrected congenital ptosis can cause amblyopia or “lazy eye,” which is an impaired visual development. If left untreated, amblyopia can lead to permanently poor vision.

Except in mild cases, the treatment for childhood ptosis is usually surgery to tighten the levator muscle, the muscle that lifts the eyelid. In severe ptosis when the levator muscle is extremely weak, the lid can be attached or suspended from under the eyebrow so the forehead muscles do the lifting. Whether they have had surgery or not, children with ptosis should be examined annually by an ophthalmologist (Eye M.D.) for amblyopia, refractive disorders, and associated conditions.

Ptosis in adults is commonly caused by separation of the levator muscle from the eyelid as a result of aging, cataract or other eye surgery, an injury, or an eye tumor. Adult ptosis may also occur as a complication of other diseases such as diabetes that involve the levator muscle or its nerve supply.

If treatment is necessary, it is usually surgical. Sometimes a small tuck in the levator muscle and eyelid can raise the lid sufficiently. More severe ptosis requires reattachment and strengthening of the levator muscle.

The risks of ptosis surgery include infection, bleeding, and reduced vision, but these complications occur very infrequently. Although improvement of the lid height is usually achieved, the eyelids may not appear perfectly symmetrical. In rare cases, full eyelid movement does not return.

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