What is Oculoplastics?
The term oculoplastics refers to cosmetic, or "plastic
surgery" involving the eyes and the surrounding bones, skin,
and tissue. Surgery encompasses two major areas: reconstructive surgery
(procedures done to correct congenital defects, developmental problems,
and deformities caused by accidents, infections, tumors, or disease)
and cosmetic, or aesthetic surgery (performed to enhance a person's
appearance by changing inherited characteristics, minimizing the effects
of aging, and reshaping and restoring normal body structures).
Most aesthetic surgeries can be performed on an outpatient
basis. They generally take only a few hours and require no overnight
hospital stay. During the procedure, local anesthesia is often combined
with sedatives to assure that you are comfortable. If general anesthesia
is used, you will be asleep during the procedure. On average, most
aesthetic surgery patients can return to work within approximately
seven days.
Some common surgeries and eye disorders that the doctors
treat are blepharoplasty, ptosis, entropion, and ectropion.
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Our Surgeon
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Dr. Lynnette M. Watkins is a
board-certified ophthalmologist who specializes in oculoplastic
surgery. This specialty includes plastic, cosmetic and reconstructive
surgery of the eyes and face, including surgery of the eyelids,
tear ducts, orbits, removal of tumors and lesions, brow lifts,
bulging eyes, facial contouring and lifts, and laser resurfacing
of wrinkles.
This subspecialty of ophthalmology is uniquely specialized
in that there are very few cosmetic surgeons who are also
board-certified ophthalmologists that perform surgeries of
the eye and facial region.
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Blepharoplasty
Eyelid surgery to improve the appearance of the eyelids is termed
"blepharoplasty." When a significant cosmetic defect results
or when the excess skin is interfering with peripheral vision, surgical
correction may be undertaken. In some instances, the upper or lower
lids alone are repaired; in other cases upper and lower lids of both
eyes may require surgery. Blepharoplasty surgery is usually an outpatient
procedure performed under local anesthesia with sedation, if desired.
The goal of eyelid surgery is to reduce the "baggy" or sagging
tissues, which may include skin, muscle, and fat pockets. Sutures
are used to close the skin incisions and are usually removed within
the first postoperative week. During the first week, antibiotic is
applied to the eyelids and strenuous activity should be minimized.
Discomfort is usually minimal after surgery. Blepharoplasty surgery
can provide both cosmetic and functional improvement with minimal
risk of serious problems.
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Ectropion
It is an outward turning of the lower eyelid away from the eye. This
may occur as a normal consequence of aging in some individuals but
can also result from various inflammations as well as chemical and
thermal burns. The diagnosis of ectropion is usually readily apparent
- all or part of the lower lid is drawn away from the eye. When the
tear drainage punctum at the nasal corner of the lid is turned outward
significantly, tears seem to overflow the lid. Many cases of age-related
ectropion can be left untreated providing there are no troublesome
symptoms such as excess tearing, burning and irritation, no threat
to the health of the cornea and no significant cosmetic deformity.
When indicated by an of the latter mentioned complications, surgery
can be performed under local anesthesia as an out-patient, or even
in-office procedure.
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Entropion
It is an inward rotation of the lid (usually lower lid) such that
the lashes tend to rub against the eye. Most cases of entropion result
from the normal consequences of aging. Other cases include certain
eyelid inflammations, infections or injuries. The entropion may be
constant or intermittent. Symptoms include irritation, foreign body
sensation, tearing, discharge and blurred vision. It is usually apparent
by direct inspection that the lower lid edge has turned inward. In
cases due to infections and inflammations, treatment of the underlying
cause usually improves or eliminates the entropion. Some mild cases
of entropion can simply be treated by nightly taping of the lower
lid to the cheek to pull the lid margin and lashes into the normal
position. More severe cases, especially with significant risk of lash
irritation to the eye, require surgery to restore the lid to its proper
position.
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Ptosis
Ptosis is the term for drooping of the lid (usually refers to upper
lid). This can occur from neurologic, neuromuscular, or mechanical
causes as well as from injuries or aging changes. Ptosis can also
occur following routine cataract surgery. Ptosis may affect one or
both eyes and can be very asymmetrical depending on the underlying
cause. When a neurological disorder is present, symptoms typically
include visual complaints independent of the droopy eyelid. Difficulty
reading and driving are common complaints. Raising the entire brow
with the muscles of the forehead and scalp may cause headaches and
eyestrain as well. The most common treatment for ptosis is surgical,
and there are a number of possible approaches. The goal is to tighten
the muscles so that the lid is elevated to match the lid on the other
side, but with a minimum of scars and side effects. Neurologic and
neuromuscular cases often either improve spontaneously or respond
to treatment of the underlying cause.
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