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SURGICAL REJUVENATION OF THE UPPER FACE Cosmetic Eyelid and Facial Surgery
Modern research tells us the eye is our most captivating feature. For many, the first signs of aging occur in or around the eyelids. As we are often judged by our appearance, eyelid rejuvenation has become the most popular cosmetic surgical procedure performed in the United States. Rejuvenation of the eyes may involve surgery on the eyebrows, the eyelids, or the facial skin. Because the eyes are the focal point of facial expression, restoring their appearance can give the entire face a youthful and refreshed look. Endoscopic Forehead and Eyebrow Lifting Drooping of the eyebrows "pushes" extra tissue into the upper eyelid, accentuating the appearance of excess eyelid tissue. As one attempts to compensate for this condition by elevating the forehead, deep lines and even headaches may develop. Sagging eyebrows may be returned to their natural youthful position with a revolutionary technique known as endoscopic brow lifting. This outpatient procedure uses tiny telescopes, introduced through small incisions hidden behind the hairline, to elevate the eyebrows and eliminate deep forehead and "frown" lines, while avoiding many of the problems associated with traditional brow lifting techniques. Cosmetic restoration of the eyebrows helps most patients look and feel better. Blepharoplasty Excess tissue in the eyelids makes our eyes appear aged and tired. Using a technique known as blepharoplasty, the eyelids may be carefully sculpted, removing or repositioning sagging tissues to create a brighter, more youthful look. Upper blepharoplasty is performed through a fine incision hidden in the eyelid's natural fold, while lower blepharoplasty is often carried out through the inside of the eyelid, thus avoiding visible scars or telltale signs of surgery. As a specialist in Ophthalmic Plastic Surgery, Dr. Biesman has a special understanding of the complex relationship between the eye, the eyelids, and the underlying facial structures. He is thus uniquely qualified amongst cosmetic surgeons to design an operation that will not only produce the best aesthetic result, but will also preserve your eye's safety and health. RECONSTRUCTIVE SURGERY OF THE EYELIDS AND FACE Blepharoptosis (Drooping of the Upper Eyelid) Treatment of ptosis involves surgical elevation of the drooping eyelid. Ptosis repair may be performed in children or adults as an outpatient procedure. Due to the complex nature of this condition, adjustment of the lid position during the initial healing phase may be necessary. Ptosis repair can improve a patient's appearance, vision and quality of life. Entropion and Ectropion (Turning of the Eyelids) With aging, following injuries or surgery, and with certain medical conditions, the eyelids can become unstable. When this occurs, they may turn inward, causing the eyelashes to rub against the eye (entropion) or outward so that the lid no longer protects the eye (ectropion). Entropion and ectropion both cause redness, irritation, excessive tearing and pain. If left untreated, scarring of the eye and blindness can result. Fortunately, unstable eyelids can be repaired with a short, highly successful outpatient surgical procedure that requires a minimal recovery period. . Tumors of the Eyelids and Face The nature of a growth cannot be determined by its symptoms and appearance alone. Enlargement, itching, bleeding or irritation may occur with both benign and malignant tumors. Skin cancers arising on the eyelids and face become progressively larger and may even threaten the eye. Most do not spread elsewhere in the body, although malignant melanoma is a major exception to this rule. Surgery is the treatment of choice for most skin cancers arising on the eyelids and face. When treated early, most skin cancers can be cured. Any growth that changes in size, color or appearance should be evaluated by a specialist. Thyroid Eye Disease (Graves' Disease and the Eye)
Graves' disease is characterized by a "staring", bulging, or wide-eyed appearance produced by inflammation and swelling of the fat, muscles and other tissues behind the eye. While medical specialists and researchers do not understand the cause of Graves' eye disease, we know that patients who smoke are more severely affected than are nonsmokers. Smokers with Graves' disease are strongly encouraged to stop smoking! The eyes improve in appearance in some patients and remain disfigured in others. When the changes do not resolve, reconstructive surgery may be performed on the bony eye socket, the muscles controlling movement of the eyes, and/or the eyelids to restore a more normal appearance. Surgery is performed once the thyroid blood tests have been normal and the appearance has remained stable for 6-12 months. Orbital Tumors (Growths in the Eye Socket) A tumor of the eye socket should be suspected in anyone with a single prominent or protruding eye. Orbital tumors may be benign or malignant and may originate within the eye socket itself or the surrounding bone or sinuses. In addition to pushing the eye forward, these growths may cause double vision, visual loss or pain. Once a tumor is identified, biopsy may be required to determine the best treatment. Special tests such as CT and MRI scans are required to provide as much information as possible about the tumor. Injury of the Eyelids, Tear Ducts and Face Complex facial injuries can pose a challenge to the reconstructive surgeon. Lacerations of the eyelids, tear ducts, and facial skin and fractures of the delicate facial bones must be repaired properly to restore normal appearance and function. Special knowledge, training and expertise are required to repair these injuries. Dr. Biesman is not only experienced in treating facial trauma, but also has special expertise in the use of lasers and other techniques to improve the appearance of wounds that have not healed with an acceptable functional or cosmetic result. In the event of an emergency, Dr. Biesman is available for after-hours consultation. Excessive Tearing Infants Excessive tearing from one or both eyes at birth is a common problem. Affected children have persistent crusting and discharge that can cause irritation of the skin and even interfere with visual development. Most children with this condition improve without surgery in the first year of life. When the tearing persists, a straightforward outpatient procedure is usually recommended. The success rate is extremely high and, once cured, the risk of recurrence is minimal. Adults Tearing can also develop in adulthood. The most common causes of tearing in adults include allergy, inflammation of the eye itself, narrowing or blockage of the natural tear drainage system, and age-related laxity of the lower eyelids. Treatment of tearing requires identification of the underlying cause followed by appropriate medical or surgical therapy.
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Blepharoptosis
(or simply ptosis) may be present from birth (congenital ptosis) or can
develop as a result of aging, eye injury or surgery, and certain
medical, neurologic, and muscular disorders. Ptosis may be mild,
moderate or severe. In advanced cases the affected eyelid droops so far
that vision is impaired. This can produce amblyopia ("lazy
eye") in young children and in adults can impair one's ability to
perform routine tasks such as reading, watching television and driving.
