All About Oculofacial Plastic Surgery

September 08, 2022


Contributing Author: Dr. Jaclyn Gurwin, MD

In recent years, oculofacial plastic surgery has become one of the most popular forms of cosmetic surgery, with an increasing number of patients choosing cosmetic eyelid surgery to create a more youthful appearance. Oculofacial plastic surgery is a sub-specialty of ophthalmology with focus on  the health of the eyelids, orbit (eye socket), tear ducts, and other tissues surrounding the eye. Although oculofacial plastic surgery is frequently required for medical reasons, many elect to have certain oculoplastic procedures for solely cosmetic reasons.

The eyelids and periorbital regions are extremely complex, intricate, and delicate structures that play an important role in preserving sight and protecting the eye itself, which is why it is important to seek out an ASOPRS-trained oculofacial plastic surgeon for these nuanced surgeries.

If your doctor has recommended oculofacial plastic surgery, you may be wondering what it entails and how it can help you. Continue reading to learn more about some of the most performed oculofacial plastic surgeries and what to expect during and after the procedure.

What Is Oculofacial Plastic Surgery?

Oculofacial plastic surgeons treat various disorders, including drooping upper eyelids, blocked tear ducts, thyroid eye disease, orbital fractures, eyelid lacerations and eyelid and orbit cancers. Oculofacial plastic surgeons can also treat under-eye bags and reverse signs of aging with injectables and surgery. An oculofacial plastic surgeon can evaluate and recommend the best treatment options. 

Oculofacial plastic surgeons are ophthalmologists who specialize in cosmetic and reconstructive surgery of periorbital and facial tissues, such as the eyelids, eyebrows, forehead, cheeks, orbit (the bony chamber surrounding the eye), and lacrimal (tear duct) system. They understand the intricacies of performing cosmetic and reconstructive eye surgery while preserving visual function.

Types of Oculoplastic Surgeries

When it comes to issues affecting the eyes and surrounding areas, an oculofacial plastic surgeon can provide various medically necessary and cosmetic services. Some of the most common procedures include:

  • Upper Eyelid Blepharoplasty – This can be either cosmetic or functional in nature. If purely cosmetic, its purpose is to rejuvenate the eyes by removing excess skin and fat from the upper eyelids. If functional in nature, its purpose is to improve the visual field (peripheral vision) of the patient.
  • Lower Eyelid Blepharoplasty – This is considered cosmetic in nature. Its purpose is to rejuvenate the eyes by removing excess skin and removing and repositioning orbital fat to create a more youthful lower eyelid contour.
  • Eyelid biopsies – Eyelid lesions can be benign or malignant. If there is a conern about an eyelid lesion, it is important to have it evaluated with a possible excisional or incisional biopsy with an oculofacial plastic surgery. If the biopsy proves to be cancerous, eyelid skin cancer is treated by surgically removing the tumor (typically via Mohs surgery) and subsequently reconstructing the eyelid. Complete removal of eyelid cancer is critical to reducing the risk of recurrence or spread of cancer.
  • Orbital fracture evaluation and repair – Orbital fractures only sometimes need to be repaired. An oculofacial plastic surgeon will be able to evaluate the fracture and determine the need for repair. If it requires repair, an implant may need to be inserted at the time of surgery to cover the fracture.
  • Orbital tumor surgery – The eye socket is a complex space that contains the globe, extraocular muscles, fat, vessels, nerves, and connective tissues. Orbital tumor surgery is complex and many different approaches are possible depending on the location of the tumor.
  • Cosmetic facelift surgery – A facelift is a cosmetic surgery that makes a face appear younger. The procedure can reduce sagging or excess skin on the cheeks, jawline, and neck and other age-related changes in the face.
  • Facial procedures (injectables and facial fillers) – Botox is injected into various locations in the face, most frequently the forehead, glabella and lateral orbicularis (crow’s feet) to help weaken the muscle function and decrease wrinkles. Facial fillers are injected into various locations in the face to smooth and conceal wrinkles and add facial volume. These procedures are typically performed in the office, sometimes using topical numbing medication.

Are You a Candidate for Oculofacial Plastic Surgery?

Before making a surgical recommendation, the surgeon will conduct a thorough examination of the patient. Ideal candidates should be in good physical and mental health with realistic expectations of their outcomes. 

Preoperative evaluation of the candidates for oculofacial plastic cosmetic surgery is critical and cannot be overstated. In addition to helping determine the specific procedures required for the candidate, evaluation can also provide patients with the opportunity to voice their concerns and have questions answered. Furthermore, the initial visit provides a setting to prepare individuals for surgery and inform them about risk benefit analysis, ensuring a smoother recovery.

Getting Ready for Oculofacial Plastic Surgery

The oculofacial plastic surgeon must identify the source of the problem before making a surgical recommendation. Sudden-onset droopy eyelids, for example, could indicate a serious condition such as a stroke, brain tumor or neuromuscular disease, so it is pivotal to be examined by a trained specialist to rule out these serious conditions prior to surgery. Eyelid abnormalities can also be caused by heredity, aging, orbital disease, thyroid disease, trauma, or previous surgery.

Your surgeon will work with you to develop a treatment plan tailored to your specific requirements. After determining the best course of action, your surgeon will walk you through the surgical procedure and what to expect. You will also be given written instructions outlining the pre-operative requirements, medications to avoid, and other post-operative care instructions.

What to Expect During the Procedure

Depending on procedure, it may be performed in either the provider’s office or an outpatient surgical facility. You may be given sedation or local anesthesia, depending on the type of surgery you are having. Sedation will put you to sleep during the procedure, whereas with a local anesthetic you will be awake but the area will be numb so you don’t feel any pain. Your surgeon may use special contact lenses on the eyes during surgery. These lenses protect the eyes by shielding them from the bright lights used during surgery. Most patients can resume work and social activities two weeks after surgery.

What to Expect After the Procedure

It’s common to experience mild pain, bruising, and swelling after surgery. You may also experience increased tears, sensitivity to light and wind, and blurring of your vision for the first few weeks. Your surgical team will provide specific instructions to follow, such as:

  • Apply cold packs to the affected area to relieve swelling and bruising. 
  • Avoid any physical activity that could raise your blood pressure.
  • Avoid consuming alcohol and certain medications for at least one week after surgery. 
  • No swimming or submerging in a bathtub for 2 weeks after surgery.
  • Administer artificial tears to relieve dry eyes.
  • Prop your head up with a few pillows or use a recliner when sleeping for about one week after surgery to prevent swelling.

Your recovery time will be determined by your specific condition and the type of surgery you had. Furthermore, you may be required to see your surgeon for a follow-up visit seven to ten days after the procedure. If you had stitches, you might have them removed during this visit or they might dissolve on their own.

Are There Any Risks Associated With Oculofacial plastic Surgery?

Like any other surgeries, oculofacial plastic surgery carries an element of risk. Blurred vision and transient bruising and swelling are among the minor side effects that are to be expected. The good news is that these symptoms are temporary since they resolve on their own as part of the body’s natural healing process. Other risks, although rare, include vision loss, infection, double vision, overcorrection or undercorrection, or a cosmetically undesirable result. 

Should You Have Oculofacial plastic Surgery?

The decision to undergo oculofacial plastic surgery is extremely personal, and it’s important to weigh the benefits of achieving your goals against the potential risks and complications of oculofacial plastic surgery. Therefore, discussing all concerns with your surgeon during your pre-surgical consultation will be beneficial. 

Oculofacial plastic surgery combines advanced training in ophthalmology with specialization in cosmetic and reconstructive surgery. Choosing a provider that can take the time to understand your concerns and goals can make your journey a highly personalized and satisfying experience. 

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Here at OOMC, our patient’s well-being is our priority. Our dedicated team of surgeons and staff always makes an effort to create a safe and secure environment where you can easily access care comfortably and confidently.

Contact one of our centers nearest to you for further information.

Corneal Associates of New Jersey

Kremer Eye Center

Ludwick Eye Center

Omni Eye Services

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