Carolina Eyecare Physicians | Laser Cataract Surgery | Best Eye Doctors in Charleston

Facial Cosmetic Surgery

Facial Cosmetic Surgery

At Carolina Eyecare Physicians, our doctors not only provide the eye care but also provide oculoplastic surgeries such as surgical ptosis correction and blepharoplasty. Do you want a more youthful appearance, or have droopy, saggy eyes been blocking your vision? Blepharoplasty or ptosis repair may be for you!

Patients who have undergone blepharoplasty and ptosis repair often report that the surgery has changed their lives for the better. They look younger, they feel younger, and they no longer have to deal with the frustration of droopy eyelids getting in the way of their vision.

Dr. Gene Howard and Malissa LaRoche, PA-C have the experience and talent to help you achieve a more awake, youthful appearance! If you have any questions about blepharoplasty or ptosis repair, give us a call and we will schedule you a consultation with one of our doctors to see if surgery is right for you.

Blepharoplasty (Eye Lid SUrgery)

Blepharoplasty is a type of surgery that repairs droopy eyelids and may involve removing excess skin, muscle, and fat. As you age, your eyelids stretch, and the muscles supporting them weaken. As a result, excess fat may gather above and below your eyelids, causing sagging eyebrows, droopy upper lids, and bags under your eyes.

Besides making you look older, severely sagging skin around your eyes can reduce your side vision (peripheral vision), especially the upper and outer parts of your field of vision. Blepharoplasty can reduce or eliminate these vision problems and make your eyes appear younger and more alert.

However, in some cases, the surgery may be necessary to remove overhanging skin folds to improve the function of the upper eyelid, as well as to improve vision. A visual field test is performed to determine if the surgery is medically necessary.

You might consider blepharoplasty if droopy or sagging eyelids keep your eyes from opening completely or pull down your lower eyelids. Removing excess tissue from your upper eyelids can improve your vision. Upper and lower lid blepharoplasty can make your eyes appear younger and more alert.

Blepharoplasty may be an option if you have:

  • Baggy or droopy upper eyelids
  • Excess skin of the upper eyelids that interferes with your peripheral vision
  • Excess skin on the lower eyelids
  • Bags under your eyes

You may undergo blepharoplasty at the same time as another procedure, such as a brow lift, face-lift or skin resurfacing. Lower lid blepharoplasty is almost always done for cosmetic reasons.

Your Surgical Experience

Your surgery will be performed in an outpatient setting. Ultimately, this means that our patients can go home directly following their procedure, with the help of a driver. Patients are usually given mild sedation from IV medication to ensure that they are comfortable. There is usually no need for general anesthesia or a breathing tube. Please plan on being at the center for a few hours for the entire process.

After Your Procedure

Following the procedure, patients are observed for a short time before they are allowed to go home. The first two days following surgery should be spent relaxing with the head elevated and applying ice packs. (If you don’t have an ice pack, you can also use frozen peas). Apply the cold compress to the area(s) 30 minutes on and 30 minutes off for the first 48 hours and then 4 times daily, until your follow-up appointment. This will help keep swelling to a minimum. You will be seen by Dr. Howard’s team one to two weeks following your procedure to ensure you are healing properly.

Before & After - Blehparoplasty

Hoyle1 Before Hoyle1 After
Levator Advancement & Upper Lid Blepharoplasty
GIrelan Before GIrelan After
Upper Lid Blepharoplasty & Cosmetic Lower Lid Blepharoplasty with CO2 Laser on Both Eyes
GMayer Before GMayer After
Right Side Levator Advancement with Upper Lid Blepharoplasty on Both Eyes
CBoone Before CBoone After
Upper Lid Blepharoplasty & Cosmetic Lower Lid Blepharoplasty on Both Eyes
ABohem Before ABohem After
Levator Advancement, Upper Lid Blepharoplasty & Cosmetic Lower Lid Blepharoplasty with CO2 Laser
GIrelan2 Before GIrelan2 After
Upper Lid Blepharoplasty & Cosmetic Lower Lid Blepharoplasty with CO2 Laser on Both Eyes
BRobinsonBefore BRobinson After
Upper Lid Blepharoplasty & Cosmetic Lower Lid Blepharoplasty with CO2 Laser on Both Eyes

Ptosis (Droopy eyelids)

Ptosis is when the upper eyelid droops over the eye. The eyelid may droop just a little, or so much that it covers the pupil (the black dot at the center of your eye that lets light in). Ptosis can limit or even completely block normal vision. Children and adults can have ptosis. Fortunately, this condition can be treated to improve vision as well as appearance.

Adults get ptosis (called involutional ptosis) when the levator muscle stretches or separates away from their eyelid. This can be caused by aging or an eye injury. Sometimes ptosis happens as a side effect after certain eye surgery. Rarely, diseases or tumors can affect the eyelid muscle, causing ptosis.

Your ophthalmologist will find the cause of your ptosis in order to recommend treatment. They will do a complete eye exam, and may also want you to have blood tests, X-rays, or other tests. The ophthalmologist will likely recommend surgery to help the eyelid muscle work better.

Ptosis surgery is done as an outpatient procedure in your ophthalmologist’s office. Local anesthesia will be used to numb your eye and the area around it. Sometimes, the surgeon may only need to make a small adjustment to the lid’s lifting muscle. Extra skin from the eyelid also may be removed to help the eyelid lift properly. For more severe ptosis, the levator muscle may need to be strengthened and reattached to the eyelid. As with any type of surgery, there are possible risks and complications with ptosis repair. Your ophthalmologist will discuss these with you.

Before eyelid surgery, be sure to tell your ophthalmologist about all the medicines you take. Include all prescription and over-the-counter medications, vitamins, and supplements. It is important for your eye surgeon to know if you take aspirin (or aspirin-containing drugs) or blood thinners, or if you have a bleeding problem.

Your Surgical Experience

Your surgery will be performed in an outpatient setting. Ultimately, this means that our patients can go home directly following their procedure, with the help of a driver. Patients are usually given mild sedation from IV medication to ensure that they are comfortable. There is usually no need for general anesthesia or a breathing tube. Please plan on being at the center for a few hours for the entire process.

After your Procedure

Following the procedure, patients are observed for a short time before they are allowed to go home. The first two days following surgery should be spent relaxing with the head elevated and applying ice packs. (If you don’t have an ice pack, you can also use frozen peas). Apply the cold compress to the area(s) 30 minutes on and 30 minutes off for the first 48 hours and then 4 times daily, until your follow-up appointment. This will help keep swelling to a minimum. You will be seen by Dr. Howard’s team one to two weeks following your procedure to ensure you are healing properly.

Tearing

The eye needs a constant supply of fluid (or tears) to retain health and function. There is a delicate balance between, too little, and too much fluid.

There are several reasons why your eyes may water excessively. The most common reason is a reflex to dryness of the cornea or surface of the eye. This type of tearing can be alleviated simply with artificial tears to stop the reflex from occurring or with punctal plugs to decrease the rate of drainage of the tears.

Another common cause of eye-watering is a blockage in the outflow of tears from the eye. Normally, we make tears that moisturize our eyes. Excess moisture finds its way to pores in the inner corner of our eyelids and then into tiny drains that empty into the nose. When these drains are blocked, tears run down our cheeks, sometimes all day long.

Dr. Howard has specialized training to find the blockage and open the drains, reducing or eliminating this tearing. He has perfected a surgical technique (Dacryocystorhinostomy) that bypasses the blocked drains. Patients quickly regain their normal appearance because this delicate technique accesses the blockage through the nostril only, leaving no visible signs of skin bruising or swelling by one day after the surgery.

Procedures to alleviate watery eyes vary according to your specific needs. The specific plan is determined after an exam in the office where the tear drainage pathway is examined very closely. These procedures are covered by medical insurance.

RECONSTURCTIVE PROCEDURES

Skin cancer can occur anywhere on the skin, but it usually occurs in sun-exposed areas. One of the most exposed areas of the body is the face, including your eyelids.

Skin cancers usually first appear as painless bumps or nodules. There may be ulcerations of the area, bleeding, crusting, and distortion of the skin. Oftentimes, cancer can appear very benign. As a result, it is important to have any suspicious areas biopsied as soon as possible to determine whether cancer is present. Early detection of skin cancer is an important factor in its treatment. Be sure to discuss any eyelid lesions, no matter how “normal” they may seem, with your doctor.

Treatment of skin cancer on or near the eyelids involves the complete removal of the cancerous spot. Sometimes the cancer can extend under the surface of the skin, and its true borders can be much larger than they appear. It is very important to remove all the cancerous tissue to decrease the likelihood of a recurrence or spread of the cancer.

MOHS surgery is often used by a skilled dermatologist to remove skin cancers. Following the removal, the eyelid will need to be reconstructed. This is important not only for the area to look normal, but to function normally as well.

The area surrounding the eyes is an area with complicated structures that lie beneath the skin surface such as tear ducts, muscles, tendons, and support structures for the eyelids. The goal of surgical reconstruction is to preserve the function of the eyelid, protect the eye, and obtain the best cosmetic appearance possible. Dr. Howard works very closely with the MOHS surgeon to ensure the cancer is completely removed and the area is reconstructed properly.

Orbital Surgery

When benign and cancerous tumors behind the eyeball must be removed, important structures can be injured in the removal process. As this type of surgery requires highly specialized training, few oculoplastic surgeons, neurosurgeons, or head and neck otolaryngologists are qualified to perform it. Fortunately, Dr. Howard has extensive training and more than 20 years of experience in the removal of these types of tumors.

During your consultation, Dr. Howard will review CT or MRI scans and thoroughly explain all of your treatment options.

Accidents happen and sometimes the bottom (floor) of the eye socket gets broken or fractured. This “blowout” fracture can result in permanent double vision and cause the affected eye to sink back into the socket. Ultimately, this can make it look smaller than the opposite eye.

Dr. Howard specializes in the delicate repair of these fractures, resulting in a much stronger eye socket.

thyroid eye disease

Thyroid eye disease is often a condition related to an auto-immune disorder that affects the thyroid gland in the neck. Generally, it occurs in conjunction with a thyroid disorder called Graves’ disease. The disease can affect nearly all the tissues that surround the eye. It causes these tissues to swell and changes their ability to function properly. Most patients who have thyroid eye disease have hyperthyroid (too much thyroid hormone in the blood), but those who have hypothyroid (too little thyroid in the blood) or euthyroid (normal thyroid levels in the blood) can be affected as well.

What are the Symptoms of Thyroid Eye Disease?

  • Bulging of the eyes
  • Pain, especially with movement
  • Dry, irritated eyes
  • Double or blurred vision
  • Light sensitivity
  • Redness (bloodshot eyes)
  • Swelling that impacts the optic nerve and can lead to vision loss
  • Colorblindness

There are many different treatments that can deal with the manifestations of thyroid eye disease. These can range from mild procedures to major surgery. The specific cure will depend on the exact problem and the extent to which it is occurring.

Your options will be discussed with you during your detailed consultation with Dr. Howard. These procedures are typically covered by insurance.

Blepharoplasty
Ptosis

Meet Your Providers

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Cosmetic and Reconstructive
Eyelid and Facial Surgery
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Cosmetic and Reconstructive
Eyelid and Facial Surgery
Orbital and Tear Duct Surgery

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