Oculoplastics

It can be both, and often is at the same time. It is functional when a droopy eyelid (ptosis) or excess skin blocks part of your visual field and forces you to strain to see. It is cosmetic when the goal is to rejuvenate your look by removing bags or excess skin. The advantage of choosing a fellowship-trained oculoplastic ophthalmologist is that they address the functional issue while protecting your vision, and achieve a natural result at the same time.

When the surgery is functional, meaning a droopy eyelid or excess skin is reducing your visual field, many insurance plans cover it. This is documented with a visual field test that shows the obstruction. If the surgery is purely cosmetic, it usually is not covered. At your evaluation, we determine which case applies to you and help you with the required documentation.

Because around the eye, function and aesthetics cannot be separated. A fellowship-trained oculoplastic ophthalmologist has deep knowledge of eyelid anatomy, the tear film, and the ocular surface, and knows how to operate without compromising lubrication or eyelid closure. This lowers the risk of complications like dry eye or incomplete eyelid closure, while still achieving a natural aesthetic result.

Ptosis is a drooping upper eyelid that can cover part of the pupil and reduce your vision. It is corrected with surgery that tightens or repositions the eyelid's elevator muscle, restoring it to its normal height. It is an outpatient procedure done under local anesthesia. When ptosis affects your vision, correcting it is considered functional. It is important to distinguish it from simple excess skin, since the treatment is different.

It is the surgery that removes excess skin and bags from the upper and lower eyelids. On the upper eyelid, the incision is hidden in the natural fold and becomes nearly invisible; on the lower eyelid, it is made from inside the eyelid or just below the lashes. It rejuvenates your look, and when excess skin on the upper eyelid is reducing your visual field, it also restores function.

Constant tearing is usually caused by a blocked tear duct, the channel that drains tears toward the nose. When it becomes blocked, tears overflow and the eye becomes prone to infection. It is treated with a surgery called dacryocystorhinostomy (DCR), which creates a new drainage pathway. It is very effective at resolving tearing and preventing recurrent infections.

Most procedures are outpatient. In the first few days, you will have swelling and bruising around the eye, which is normal and managed with cold compresses and rest. Stitches usually come out between days 5 and 7. Bruising fades within 2 to 3 weeks, at which point you can get back to your social life. The scar, hidden in the natural folds of the eyelid, matures over the following months until it becomes nearly invisible.

The goal of well-done oculoplastic surgery is precisely that the surgery does not show, only the rest does: you look fresher and more natural, not operated on. Incisions are designed to hide in the eyelid's natural folds. The key is the surgeon's experience in removing just the right amount and preserving the natural expression of your eyes, without a tight or artificial look.

Most eyelid lesions are benign (like a chalazion or a cyst), but some can be tumors that require treatment. That is why any bump that grows, changes color, bleeds, or does not go away should be evaluated by an oculoplastic specialist. When necessary, the lesion is removed and analyzed, and the eyelid is reconstructed with careful attention to both function and aesthetics.