close-up of brown eyes

–The Eyes Have It”

Wednesday August 6th, 2014

It’s often said that the eyes are –windows to the soul”. It is therefore paramount, as plastic surgeons, we especially maintain a sacred covenant with our eyelid surgery patients. One of the earliest aspects of facial aging occurs with our eyes. And this was my first personal experience with plastic surgery. Excess upper eyelid skin and puffy lower lids results in a tired look. Unfortunately, most of the traditional cosmetic eyelid procedures are excessive and may result in a distorted –deer in the headlights” appearance. Early in my career I innovated the –LJO” brow lift which only lifted the tail or outer brow to diminish the lateral upper lid hooding. This 10 minute procedure avoids the vast array of forehead and endoscopic lifts that often results in permanent distortion. More recently, I discovered advanced methods that naturally restored volume to empty orbits (eye sockets) which reverses the sunken look typical of the aged eyes. The patient pictured below is a result of combining the –LJO” brow lift and eyelid surgery along with stem cell enhanced fat grafting. I believe that this combination is unique to my practice.

aged-eyes before and after

What is particularly challenging are the lower lids. Removal of excess skin and/or lateral repositioning may result in a permanent distortion which may not be correctable. Restoration of youthful lower lids is perhaps the most challenging procedure that I perform in the face. Although this very grateful patient has been a patient for decades, she was wise to request multiple consults prior to surgery.

eye lids before and after

Unfortunately, the general public equates plastic surgery strictly with cosmetic surgery procedures. As a plastic surgeon, I have perhaps performed more corrective eye surgery procedures than the vast majority of plastic and or opthalmologic surgeons in the U.S. Medicare and most insurance policies pay for upper eyelid/brow ptosis surgeries if the visual compromise is documented by peripheral visual field testing by an eye doctor.

male eye lids before and after

One of the most common procedures that I perform on my male patients is a combination of the –LJO brow lift” combined with eyelid surgery. Although insurance does not cover lower eyelid surgery, the patient may save up to 50% of the fee for the lower lids if performed with the upper lid surgery. These procedures are performed under local anesthesia with minimal sedation and a short recovery time. As reflected by my fellow Marine pictured above, our eyes are truly –windows to our soul” Semper Fi!

brow lift before and after

The above patient is a good example of combining a gentle