Oculoplastics or Eye plastic and reconstructive surgery is a specialized area of ophthalmology that focuses on the eyelids and the structures surrounding the eye, including problems of the lacrimal (tear) system and the orbit. Ocular reconstructive surgery is also included under this specialty – this includes aesthetic eyelid surgery, facial plastic surgery and cosmetic procedures.
Some types of oculoplastic surgery are considered both medically necessary and cosmetic. For instance, certain eyelid and periocular issues can affect a person’s appearance as well as their vision, eye comfort, and eye health.Most oculoplastic surgeries can be performed on an outpatient basis.
Oculoplastic surgery covers a wide range of procedures, including:
- Eyelid surgery, including blepharoplasty and eyelid reconstruction, for ptosis, entropion, ectropion, and eyelid tumors
- Tear duct surgery
- Orbital surgery to manage thyroid and eye disorders, tumors, and trauma
- Pediatric oculoplastic surgery to correct congenital defects and manage eye disorders in children
- Eyebrow and forehead lifts
- Facial rejuvenation (midface lift, lower face lift, facial implants)
Non-surgical treatments performed by oculoplastic surgeons include:
- Skin rejuvenation (laser skin treatments, chemical peels, home skin care regimens)
- Facial filler injections
- Botox injections in Blepharospasm and to reduce wrinkles
Eyelid surgery
Blepharoplasty, the most common type of eyelid surgery, is done through incisions following the natural lines of your eyelids. The surgeon makes the incision and then separates the skin from the underlying tissue to remove the excess fat, skin, and muscle. Sutures are then placed in the upper eyelids to close the incisions. The lower lids may not require sutures, depending upon the technique used. The procedure usually takes about two hours if both upper and lower eyelids are done together.
Tear Duct Surgery
To perform a dacryocystorhinostomy, your surgeon will make a small incision through the nose or through the skin on the inside corner of your eye and your nose. A new tear drain opening is created from the blocked sac directly into the nose.
A stent may be left in the new tear drain temporarily to keep the duct open. In some cases, the obstruction remains blocked and a permanent artificial drain is placed behind the corner of the eyelids.
Pediatric Oculoplastic Surgery
Unlike adults undergoing oculoplastic surgery, children undergoing eye surgery will nearly always require general anesthesia. Two common conditions in children that can be corrected by oculoplastic surgery are congenital ptosis and congenital tear duct obstruction. Many children who undergo oculoplastic surgery have associated syndromes and perioperative requirements. For this reason, oculoplastic surgery on a child is performed by a pediatric ophthalmologist trained in pediatric oculoplastic surgery.
In the post-operative care surgeon will likely ask you to apply cool compresses on your eyelids for the first few days. Minimal activity is usually recommended to help minimize swelling, bruising, discomfort, and postoperative complications. After the first 48 hours, you can get up and move around.
However, exercising or heavy lifting should be avoided for at least one week after surgery, and in some patients for up to two weeks after surgery. If you have stitches, they will be removed in the office a week or two after your surgery.
Oculoplastic surgeries are generally free of complications, and most patients report little discomfort during their procedure and recovery.
Non-surgical treatments performed by oculoplastic surgeons include:
- Skin rejuvenation (laser skin treatments, chemical peels, home skin care regimens)
- Facial filler injections
- Botox injections in Blepharospasm and to reduce wrinkles
