Why won’t my eyes close?

Surgery can produce long-term damage to the function of the eyelids causing dry eye symptoms.  If your surgeon removes too much upper eyelid skin and underlying muscle, your eyes may not close completely, causing dry spots to develop on the cornea.  Depending of the design of the blepharoplasty, the nerves that supply the muscle that helps to close the eye can be damaged weakening the blink reflex.  This means that during a blink there may not be sufficient speed or force to cause the upper and lower eyelids to meet during the blink.  Since the eyelids move tears on the eye surface around, the net result is surface drying.

What are my treatment options?

The first line approach to treating these issues is to increase the frequency of artificial eye drops and, when indicated, ophthalmic ointment at bedtime.  If necessary, your tear drains in your eyelids can be closed temporarily with plugs to see if symptoms improve.  If these measures fail, there are some additional mechanical measures available.  Depending on the corneal status early surgical reconstruction may be necessary.

The extent of the solution depends on the severity of the symptoms and the degree of drying seen on the surface of the cornea.  Although a range of options are available, the key objective is to make the eyelids meet and to create sufficient force of eyelid closure to help spread the tears over the corneal surface.

Is this a long-term issue?

Common post-operative issues can be thought of in two broad categories: immediate and long term.  Immediate issues are post-operative issues and complications that present anytime from moments after surgery up to six months.  Long-term complications are issues that continue to persist beyond six months.  The six-month time frame is useful because a number of concerns related to difficulty closing the eye and mild lower eyelid retraction often resolve spontaneously in this time frame.  In contrast, it is Dr. Steinsapir’s experience that when these types of problems are present six months after surgery and continue to be a concern, then they often need to be addressed with a corrective surgery.

I chose an experienced surgeon, what happened?

No matter how technically superb the surgeon, surgery can tip a marginally compensated dry eye to discomfort.  Unpredictable individual factors may also contribute to a particular situation.  Dr. Steinsapir is acutely aware of the importance of eye comfort after surgery and what steps are needed to make the eye as comfortable as possible. Unfortunately, specialists lacking the training in Ophthalmology can underestimate the impact of these easily addressed issues.  For this reason, Dr. Steinsapir closely follows his patients after surgery.  Your post-operative follow-up schedule is based on how you are actually doing rather than on a scheduled based on how everyone one else has done in the past.

About Dr. Steinsapir

Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.

Because it is a versatile procedure, upper eyelid surgery can also accomplish other goals, such as creating an upper eyelid crease, opening heavy eyes, improving lash ptosis, and smoothing the skin of the eyelid platform making it more suitable for makeup. In addition, the upper eyelid lift procedure effectively leads to a reduction in skin tissue above the eye, allowing for better peripheral vision for some individuals.

Where is surgery performed and what type of anesthesia will my surgeon use?

Some doctors, like Dr. Steinsapir, maintain a dedicated procedure suite in his or her office and for healthy patients, many eyelid surgeries can be performed under local anesthesia in the office setting.  Others need to have surgery in a surgery center and this is typically done at a center or the outpatient wing of a larger hospital facility.  Dr. Steinsapir often brings his patients who need this level of service to the Surgery Center at The Ronald Regan UCLA Medical Center.  The location of your procedure varies based on the resources available to your surgeon and your unique health needs.

Eyelid surgery is very comfortable and most procedures are easily performed under local anesthesia with or without intravenous sedation.  Dr. Steinsapir advises against having eyelid surgery under general anesthesia.  To get the best possible result it is essential that the eyes can open and close to command during surgery.  If you are asleep, this is impossible and the surgical results will be compromised.  As an alternative, Dr. Steinsapir recommends having surgery under intravenous sedation where the anesthesiologist controls the level of sedation.  You would be minimally aware but still able to cooperate during surgery.  Because of the drugs used, you may not form memories of the surgery and yet you are able to cooperate during surgery, which is ideal.

What are the physical restrictions following surgery?

Before you undergo surgery, a reputable oculoplastic surgeon will ask about your medical history and perform a detail examination of the eyes and eyelids to ascertain your risk level and special considerations.  If you must be on a medication like Plavix or aspirin for medical reasons to thin your blood, your surgeon may advise you that you are not a candidate for cosmetic eyelid surgery, or may recommend a less extensive eyelid surgery.

During the first part of your recovery, you will need to take it easy, avoid bending over, and immediately call your surgeon should you experience any pain, bleeding, or impaired vision after surgery.  After 24 hours, Dr. Steinsapir will encourage you to go for a walk.   Bruising and swelling are normal after surgery.  However, many find that large sunglasses hide these bruises making shopping possible even in the first week after surgery.  Most people take a full week off from work.  However, many find that within a day of surgery, they are able to handle phone calls and email without a problem.  It will be about 10 days before most people may not notice that you just had something done.  We generally advise people to wait about this long before going back to the gym.  However, because workouts vary so much, it is best to discuss your workout with your surgeon to get advice that is tailored to your particular workout.  When you see your cosmetic surgeon, he or she will go over your pre-op and recovery plans in depth, giving you instructions and making sure you have the opportunity to ask all of your questions.

What are some complications from surgery and how they are addressed?

If anyone tells you that you can’t go blind from eyelid surgery like blepharoplasty, they aren’t being honest with you.  The truth is, while this is an extremely rare complication, there is a risk of blindness from eyelid surgery.  Of course no doctor thinks this will happen to them, but the best oculoplastic surgeon will acknowledge it’s a possibility, be honest with you about this, and take precautions to minimize the risk as much as possible.

Loss of vision after eyelid surgery is general due to bleeding behind the eye called a retrobulbar hemorrhage.  If someone tells you that they have never this type of problem after eyelid surgery, then they probably have not seen enough cases, or simply lack adequate training in eyelid surgery.   Avoiding medications and herbal products that thin the blood, like aspirin and Ginko help reduce this risk.

Your doctor will have you avoid blood-thinning medications to significantly decrease the already-low risk of retrobulbar hemorrhage.  This means that, with the consent of your general practitioner or family doctor, you won’t be able to take certain prescription medications as well as over-the-counter medications like Aspirin, Ibuprofen, Advil, and Motrin.  You will also need to abstain from most herbal products for a while.  If you have been prescribed a medication by a physician specifically for the purpose of reducing the risk of clotting, such as Plavix, coumadin, or aspirin, do not stop these medications on your own.  This needs to be done under direct medical supervision.  In some circumstances, your doctors may decide that these medications cannot be stopped and this will have a bearing on going forward with elective eyelid surgery.

Other issues may be more common but are less serious.  Dry eye after eyelid surgery is very common.  This is typically because your eyes were on the dry side before surgery and eyelid swelling makes this a bit worse.  As the swelling settles down, typically the dry eye symptoms settle down to what they were before surgery.  Some complications are very specific to the type of eyelid surgery you are considering.  For this reason, it is incumbent upon your surgeon to discuss these possibilities with you at the time of consultation.  If they spend 5 minutes with you, you are being short changed of this discussion.  A detailed surgical consultation appropriate for eyelid surgery can last an hour or more.

What is the time frame before full recovery?

Generally the bruising and swelling that is common after eyelid surgery rapidly diminishes.  Most people are comfortable returning to work and social activities within seven to ten days following surgery.  Complying all your surgeon’s post-op care procedures will ensure your recovery is as swift as possible.  Generally it is about 8 weeks before the swelling in the eyelids won’t be obvious to you when you look in the mirror.

About Dr. Steinsapir

Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA.   Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.

The benefits of a forehead lift

In some instances, a forehead lift alone can freshen your face and provide you with the youthful appearance you are seeking.  The forehead lift elevates the eyebrows, reduces frown lines, and smoothes your forehead.  Eyelid surgery deals with the height of the crease, the crease structure, and eyelid and lash ptosis.  Although this can freshen your look as well, the forehead lift addresses one of the focal points of your face – one that can make the difference between looking tired and run down and looking youthful and refreshed.

A forehead lift can freshen your appearance

Dr. Steinsapir only performs endoscopic forehead lift, or closed forehead lift, as opposed to the more traditional open forehead lift.  The endoscopic forehead lift offers faster healing time and fewer negative effects like scalp numbness, hair loss, or a long scar.

The benefits of a lid lift

Blepharoplasty, also known as eyelid surgery or a lid lift, allows the surgeon to remove excess skin and fatty tissue that create the appearance of droopy, deflated eyelids.  As the fat deposits, loose skin, and drooping of the eyelids typically occur because of aging, this procedure can reverse the effects of time to restore a youthful, refreshed, and rested appearance.  Upper eyelid surgery, because it is a versatile procedure, can also accomplish other goals, such as creating an upper eyelid crease.

How will the surgeon know which procedure I need?

The primary issue in determining whether you need a lid lift, forehead lift, or both is the type of eyebrow support and shape you need.  Some individuals need just a forehead lift.  Your surgeon will assess the need to address upper eyelid issues.  In some instances people will have both eyebrow ptosis and excess upper eyelid skin and fullness and benefit from both sets of issues being addressed at the same time.

About Dr. Steinsapir

Dr. Steinsapir is a much sought after oculofacial surgeon.  He is an innovator in minimally invasive cosmetic and reconstructive procedures and has invented new methods for treating with BOTOX, Fillers, and cutting edge reconstructive eyelid and midface surgery.  He specializes in high precision eyelid surgery and is a leader in correcting prior facial and eyelid surgery, including multiply revised cosmetic eyelid reconstructions.  He attended medical school at the UCLA and completed ophthalmology residency at The University of Chicago.  He is board certified in Ophthalmology and multiple fellowship trained including three years of fellowship training in oculofacial plastic surgery at UCLA, and a two-year cosmetic surgery fellowship in Rancho Mirage.  He is widely published and lectures to other surgeons nationally and internationally.  He is an associate clinical professor of Ophthalmic Plastic and Reconstructive Surgery at the Jules Stein Eye Institute at UCLA.  His private practice is located in West Los Angeles, immediately serving the Los Angeles and Beverly Hills communities.  Additionally, individuals from all over the country and the world regularly come to Los Angeles for this expert care.  Please contact us today to learn more about evidence-based treatment options with Dr. Steinsapir for proven results.

Blepharoplasty

There are many different types of surgery for the eyelids. Blepharoplasty includes all of them; both for the upper eyelid and the lower eyelid.  If you’re suffering from eyelid ptosis, your cosmetic surgeon may recommend ptosis surgery, a type of blepharoplasty to correct the problem.  But blepharoplasty can also be used to remove fatty bulges around the eyes, and eliminate hanging skin from the eyelids. There are lots of reasons to consider blepharoplasty, both cosmetic and medical.  Dr. Steinsapir often performs blepharoplasty to correct eyelid surgeries―performed by other surgeons―that fail to meet the client’s expectations.

Ptosis Surgery

Ptosis is when the upper eyelid droops.  Before performing surgery, your surgeon will need to distinguish between excessive skin in the upper eyelid with a heavy fold and an actual fall in the eyelid margin.  Excessive skin and heavy eyelids does not indicate ptosis, however, you and your surgeon can discuss options for removing the heaviness of your lid and opening up your eyes.

Upper eyelid ptosis has a number of causes. These causes can be anything from congenital ptosis, to acquired ptosis caused by the levator muscle being cut during surgery, or most often, the levator aponeurosis muscle becomes stretched with age.  Other causes of acquired ptosis include four broad categories: neurogenic, myogenic, traumatic, and mechanical.  Because the type of acquired ptosis has a bearing on your surgeon’s approach to repairing your eyelid, it is important for you surgeon to classify and properly diagnosis the basis of the droopy eyelid.

There are two principle surgeries used to correct the position of the upper eyelid: Anterior levator resection ptosis surgery and Mueller’s muscle resection.  Anterior levator resection ptosis surgery strengthens the effect of the levator muscle, which elevates the upper eyelid.  The surgery shortens the tendon of this muscle called the levator aponeurosis and effectively elevates the eyelid making the eye look bigger.  Mueller’s muscle resection is performed from behind the upper eyelid using a special clamp called a ptosis clamp.

About Dr. Steinsapir

Dr. Steinsapir is a board certified ophthalmologist (eye surgeon) and fellowship trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology.  Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA.  Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert provider of ptosis surgery, which can be a vital part of your evidence-based treatment plan.

Common side effects of surgery

Many people become concerned when swelling in the eyelid persists for several weeks after surgery; some amount of bruising is also common following surgery, but neither bruising nor swelling are cause for concern unless they are excessive.  Remember that that it does take time to heal and many issues resolve with time.  For this reason, it is best to give the eyelid plenty of time before considering revisions to your surgery, especially if the issue is mild ptosis.  Dr. Steinsapir usually recommends six to twelve months before considering revisions.  There can be pressing reasons to operate earlier.

Certain lower eyelid surgeries (primarily transcutaneous lower blepharoplasty) have a finite risk of damaging the lower eyelid.  These issues can be complex.  It is often true that when something is not right several months after eyelid surgery, the problem was evident very soon after surgery.  Because many things will show improvement over time, a period of healing is often recommended, even if reconstructive surgery will be necessary.  Treatment with medication such as steroids and simple mechanical treatment such as finger winking can help with the ultimate lower eyelid position.  In this situation especially, it’s important to wait and allow time to heal before deciding on reconstructive surgery.

Causes for concern

There are occasions when immediate action is necessary to correct a problem that may result in a much more complex reconstructive surgery down the road or immediate damage to the cornea.  These situations are unusual.  Worrisome issues that occur within the first 24 hours of surgery include bleeding, bruising that rapidly expands across the eyelid, loss of vision, or persistent or severe pain.  These types of issues should prompt an immediate call to your surgeon.  If you are not able to reach your surgeon, consider calling 911 .  It is better to be seen for something that turns out to be nothing serious than to miss something truly important.  Other issues are much less urgent and may not make themselves clear for several days or weeks after surgery.  Even when it is clear that the issue does not require immediate attention, call your surgeon and discuss the situation with the office.  Most often the surgeon will want to assess you personally and assure themselves of what is going on.

About Dr. Steinsapir

Dr. Steinsapir is board certified in Ophthalmology and has completed numerous fellowships, including three years of Orbit and Eyelid fellowships at the prestigious Jules Stein Eye Institute at the David Geffen School of Medicine at UCLA and a separate two year cosmetic surgery fellowship under the auspices of the American Board of Cosmetic Surgery.  He is widely respected for his work and has published over thirty scientific papers and eight book chapters.   He is a true innovator, having developed Microdroplet™ BOTOX®, a unique patented method for injecting BOTOX®, Deepfill™ under-eye Restylane® treatment to address the dark circle and under-eye hollow for up to a year without the need for retreatment.  Dr. Steinsapir is one of the foremost eyelid surgeons in the world.  He is on staff at the UCLA Hospital and Medical Center where he is an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute.  He is also on staff at Harbor/UCLA Medical Center where he serves as an attending surgeon.  He is in practice in West Los Angeles and is in high demand by discerning individuals from Los Angeles, Beverly Hills, and Southern California.  Many of his patients also come to see him from around the country and the world. Very few doctors offer the level of skill and expertise he brings to cosmetic surgery and aesthetic restorative surgery to address prior unsatisfactory eyelid surgery.  Please contact us today to learn more about evidence-based treatment options with Dr. Steinsapir for proven results.

Blepharoplasty, also known as eyelid surgery or a lidlift, is one of the most common cosmetic surgeries and has a remarkable track record for safety.  Because incisions are made along the creases of the upper eyelid, below the lower lashes, or from the inside of the lower lid, scarring is minimal and relatively hidden.  Complications can occur, even when surgery is performed by experienced surgeons.  Complications that can compromise the outcome of eyelid surgery can include hematoma, infection, or eyelid function problems that result from excessive skin or muscle removal, or motor nerve damage.  When the cosmetic or functional result is unacceptable, reconstructive surgery is needed to address these issues.

Potential Concerns

The traditional approach to upper eyelid surgery has been to aggressively remove skin, muscle, and fat.  The result of this outdated philosophy is “the surgical look” with a high sulcus and no upper-eyelid fold.  While some are happy with the cleaned-up appearance created by this type of surgery, a certain percentage of individuals are unhappy with the alterations caused by their changed appearance.  Unfortunately restoring the upper eyelid fold is virtually impossible.  Fillers can help soften the appearance, but restoration of the upper eyelid is not feasible as it is with repair of the lower eyelid.

Other upper eyelid issues are more amenable to corrections.  One such concern is laxity of the skin in the upper eyelid, below the upper eyelid crease.  The skin takes on a crepe appearance.  Crepe skin appears thin and dry and doesn’t hold makeup.   This can be corrected with a precision anchor blepharoplasty.

The indiscriminate removal of skin, muscle, and fat can have more serious complications than just the “surgical look.”  Over-aggressive cosmetic surgery can, result in damage to the muscles that allow the eyelid to close, shortening the upper eyelid and preventing the eye from closing.  The lower lid can also become retracted, pulling the lower lid downward.  Often, individuals come to Dr. Steinsapir with unique issues that require unique surgical solutions.  While there are complications that can’t be fully corrected, many of these issues can be improved functionally and cosmetically by a very limited number of specialized eyelid surgeons who offer these types of reconstructions.  The process starts with a detailed personal consultation.

About Dr. Steinsapir

Dr. Steinsapir is a much sought after oculofacial surgeon.  He is an innovator in minimally invasive cosmetic and reconstructive procedures and has invented new methods for treating with BOTOX, Fillers and cutting edge reconstructive eyelid  and midface surgery.  He specializes in high precision eyelid surgery and is a leader in correcting prior facial and eyelid surgery, including multiple revised cosmetic eyelid reconstructions.  He attended medical school at the UCLA and completed ophthalmology residency at The University of Chicago.  He is multiple fellowship trained including three years of fellowship training in oculofacial plastic surgery at UCLA, and a two-year cosmetic surgery fellowship in Rancho Mirage.  He is widely published and lectures to other surgeons nationally and internationally.  He is an associate clinical professor of Ophthalmic Plastic and Reconstructive Surgery at the Jules Stein Eye Institute at UCLA.  His private practice is located in West Los Angeles, immediately serving the Los Angeles and Bevery Hills communities.  Additionally, individuals from all over the country and the world regularly come to Los Angeles for this expert care.

Asian eyelid surgery is a specialized type of eyelid surgery that, like other cosmetic eye procedures, is truly an art form.  How is it an art?  Consider how the best eye plastic surgeon must not only have education, training, and experience; he or she must also have the keen ability to perceive subtle characteristics that make your eyes and entire facial structure distinctive, the talent to design a treatment plan that addresses these features, and the skill to provide natural results and a fast healing time.  When one considers the complexity of cosmetic eyelid surgery, it is no wonder why it’s essential you seek a surgeon who individualizes your treatment.

What Should I Know about Ptosis and Asian Eyelids?

For whatever reason you seek treatment for Asian eyelid ptosis, first know that there is science-based treatment available that can improve your condition.  Please also understand that your treatment must be individualized for you as we discussed above.  The best cosmetic surgeon for you will be one who is a leader in Asian cosmetic eye surgery with a solid reputation and proven results.  Ptosis can affect anyone, and effective treatment must correct existing problems by enhancing the natural qualities of your eyelid contour.  In other words, correcting ptosis of the Asian eyelid is in no way about “westernizing” the eye, so talk to your doctor about his or her treatment philosophy to find someone who can establish the right results for you.

How Is Ptosis Treated?

With ptosis what we observe is a heavy or drooping eyelid.  This can cause aesthetic problems like asymmetry and even cause challenges with communication when people are focused on your eyelid ptosis rather than what you are saying.  It can also impede your peripheral vision and cause dissatisfaction with your appearance.

Any good treatment will be customized for your condition, goals, medical history, and unique features.  This may include eyelid surgery to remove excess upper eyelid skin, which corrects the imbalance of forehead activation needed to elevate this extra tissue.  You may be a candidate for a forehead lift that helps to brighten your eyes’ appearance and balance out your whole face.  Anchor blepharoplasty is another type of upper eyelid surgery that can correct ptosis of the eyelashes.  The right and best option for you can only be determined at a personal consultation with a leading oculofacial surgeon.

Schedule Your Consultation Today

For differentiated results that optimize your natural features and facial qualities, consider how Dr. Steinsapir can help.  Dr. Steinsapir practices oculofacial cosmetic surgery in Los Angeles and Beverly Hills.  Individuals travel from across the United States and world to benefit from his exceptional treatment practices.  Dr. Steinsapir is an eyelid specialist with expertise in treating Asian eyelid concerns like ptosis.  Contact us today to learn about how Dr. Steinsapir’s background and an individualized approach can be the perfect match for your eyelid concerns.

Upper eyelid surgery before and after photo

The Importance of Care: Never Be Too Careful!

The best eyelid surgery is always performed conservatively, as an over-aggressive treatment can cause a “surgical look,” which is often marked by no fold and a high sulcus.  What does conservative eyelid surgery mean?  Your doctor strives for natural results that fit your facial features and emphasize your qualities.  The best eyelid surgeon also strives to preserve as much of your natural muscle and tissue as possible.  This has many benefits, including:

• It adds to the naturalness of your results.
• It reduces the already-small risk of complications.
• It makes revisional eyelid surgery a more straightforward and successful process should you for any reason wish for further treatment in the future.
• It makes your healing process as swift as possible.

Carefully planned eyelid surgery is not a simple matter of removing skin, muscle, and fat without discretion; it is an art form that must preserve your eyelid function as well as natural characteristics, while enhancing the contour, shape, and facial balance.
Surgery Designed for Your Own Eyes

To obtain the best results, do not seek an assembly-line type of procedure where you seek the identical treatment someone else received, because optimal results are always customized for you.  This means that your ideal surgery will be planned meticulously by an oculoplastic surgeon with years of experience, prestigious education and fellowship, and proven results.  Types of eyelid surgery include blepharoplasty, canthoplasty, double eyelid surgery, and other very specialized types of cosmetic eyelid surgery for which you may be a candidate.

Choosing the Best Surgeon

Learn everything you can about your potential eye cosmetic surgeon’s background, including education, credentials, fellowship training, professorships, leadership and teaching, practice, and research experience.  Also be sure to assess how comfortable you are with your surgeon, taking into account how confident you are in his or her abilities, how easily you can openly and honestly converse, whether what your doctor says make sense to you, and even whether you simply get along.  Look carefully at the surgeon’s before and after eyelid surgery photos, keeping in mind that these are the examples of the physician’s best work.  Make certain that you choose a specialist who has treated a wide variety of eyelid concerns with an emphasis on minimally invasive surgery for natural and safe results.

Now Consult with the Best

Dr. Steinsapir is an international leader in diverse cosmetic eyelid surgeries customized for each person’s unique eyes.  With great experience in cosmetic eyelid surgery, reconstructive eyelid surgery, Asian eyelid surgery, corrective eyelid surgery, and other specialized eyelid and facial needs, Dr. Steinsapir can help you achieve the balanced results you desire.  Please contact us today to find out how upper eyelid surgery with Dr. Steinsapir in Los Angeles, Beverly Hills, and UCLA can make the difference you are looking for.

Treatment Options for the Canthal Angle

There are different approaches to correcting problems with the canthus, and the treatment you get should be individualized for your needs.  Only a highly skilled surgeon who specializes in oculofacial plastic surgery and has the technical skill and artistic eye should perform this procedure, as the revisions must be made with precise control of the contour’s shape and position.

Canthopexy Basics

The canthopexy is a shortcut procedure in which a supportive suture is used to cinch the lower eyelid, reinforcing the eyelid’s position.  There are also more elaborate ways to accomplish this such as with a coronocanthopexy.  The aim here is to tighten the outer corner of the eyelid (more technically called the lateral canthal tendon) without actually taking it apart surgically.  The problem with these procedures is that they do not provide the posterior vector of support that is needed to correct many lower eyelid issues.

Given the concerns with this procedure, why do some still use this shortcut?  The main reason is that many surgeons who do cosmetic eyelid surgery are not fellowship trained in eyelid surgery.  They actually lack the training and experience to perform this technical procedure.

Canthoplasty: Definitive Treatment for the Eyelid Corner

The canthoplasty, on the other hand, is the definitive procedure for reforming the outer corner of the eyelids.  This procedure is often used as part of other eyelid surgeries and is a better option for tightening the lower eyelid.  Here the lateral canthal angle is used as a point of entry to perform other procedures from behind the eyelid so that scarring is not visible, and the angle too is corrected surgically.  At this time your doctor can precisely control how tight the eyelid will be as well as where the lateral canthal angle is positioned.  A qualified eye plastic surgeon will be able to perform this procedure readily, while a generalist typically doesn’t possess the kind of specialized knowledge needed to create a symmetric, aesthetically pleasing outcome.

Correcting Prior Canthal Surgery

With the proliferation of surgeons attempting canthal surgery without the appropriate training, skill and experience, there is a recent epidemic of unsatisfactory results from these shortcut procedures.  The good news is that virtually all of these can be improved with revisonal surgery by an experienced eyelid specialist like Dr. Steinsapir.

Seek Treatment with the Best

If you are seeking canthal surgery or would just like to learn more about whether it may be a good solution for your concerns, we invite you to a no-risk consultation with Dr. Steinsapir, a cosmetic eyelid surgeon in Los Angeles.  Dr. Steinsapir is a caring physician who attended medical school at UCLA, trained in ophthalmology at The University of Chicago, then completed a two-year fellowship in orbital surgery at the UCLA’s renowned Jules Stein Eye Institute, where he also completed a one-year fellowship in oculofacial plastic surgery.  Following this is also did a cosmetic surgery fellowship in Rancho Mirage.  He is now a leader in the field of eyelid surgery, providing minimally invasive solutions with the goal of achieving a balanced, natural result.  Please contact us today to learn more.

This may be a little confusing given that we recently discussed why a facelift and smoking should not go together.  This is not a contradiction, but a function of the way different tissue areas respond to surgery.  The eyelids have much better circulation than the healing sites of a facelift, and thus they are better able to tolerate the surgery than the facial skin.

This news will come as a relief to smokers who must have surgery for health problems like basal cell carcinoma of the eyelid or severe eyelid ptosis that compromises vision.  Smokers who can benefit from the confidence of an improved aesthetic can also be glad at this news.

As a smoker, why can I have some surgeries but not others?

Why shouldn’t smokers have optional facelift surgery when they can have eyelid surgery?  You should already know that smoking is horrible for your health, and one of the problems is that smoking compromises the healing capacity of the skin. The skin undermining necessary for the facelift can challenge the healing capacity of skin that is compromised by smoking.  In contrast, many eyelid surgery procedures can be performed without challenging this healing capacity.

A Word on Quitting at the Right Time

While it’s okay for most smokers to receive eyelid surgeries like blepharoplasty, canthoplasty, and double eyelid surgery, and while we also support your desire to quit, it’s important to know that you should not quit too close to your treatment.  This is not meant as an endorsement of smoking; we of course want you to quit smoking for your own good.  However, it takes time for the lungs to recover, so when you decide to quit, you should not do so right before the eyelid surgery.

When you quit smoking, your lungs go through a healing process and it will take some time for them to recover.  Your lungs need to be in good shape during your surgery, but your vascular recovery will take some time, as will lung recovery.  Your lungs will require a full eight to twelve weeks to begin their recovery; before then, you’ll have a lot of mucus in your lungs as your body repairs them, and this is not a good time for you to have a surgery.  If you want to both quit and seek eyelid surgery, talk to your oculoplastic surgeon about the timing of these two helpful steps.  He or she can help you determine how long before or after your surgery it is appropriate to quit smoking.  As most eyelid surgery is elective, meaning you can choose when to have eyelid surgery, the answer to this situation is simply schedule your eyelid surgery so you give your lungs the appropriate time to recover in advance of the elective surgery.

How Eyelid Surgery and Quitting Smoking Can Expand Your Options

Eyelid surgery can improve your confidence, aesthetic message, and the way people interact with you.  This newfound confidence and other benefits will broaden your ability to engage in life.

Quitting smoking empowers you by improving your health, helping you to look better and live longer, and boosting your self-esteem by overcoming an destructive addiction.  Even if you are a light smoker or new smoker, the damaging impacts of smoking lead us to encourage you to quit.  By quitting smoking you will be taking one of the most positive steps you can take for your health and the health of your loved ones.  Quitting smoking is one of the best things you can do for yourself.  Yes, it is more important than any cosmetic surgery we can perform for you.  We urge you to find a way to quit that works for you.

If you’ve decided to quit smoking, congratulations!  We wholeheartedly support you.  Quitting is not easy (otherwise nobody would smoke), but there are resources available to help you quit.  Your internist, family doctor, or gynecologist can often assist you with medical resources for smoking cessation. The State of California has a website of resources to assist and encourage you: www.tobaccofreeca.com

Consult with an Expert in Cosmetic Treatment

We advise you to consult with a cosmetic surgeon who specializes in eyelid surgery and complimentary treatments with natural, balanced results that are tailored to your individual needs.  Dr. Steinsapir is such a cosmetic surgeon in Los Angeles who is esteemed as one of the top cosmetic surgeons in California and beyond.  He specializes in minimally invasive eyelid surgery and other cosmetic procedures that offer fast healing time and can be customized to your unique situation.  If you are a smoker with eyelid concerns, we invite you to a no-risk consultation with Dr. Steinsapir today.  He can discuss both your short-term and long-term treatment options, and help you find an aesthetic solution to meet your goals.  Please contact us to learn more about Dr. Steinsapir’s quality treatment plans.