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Complete eye health includes healthy eyes and healthy eyelids. Common eyelid problems include excessive eyelid skin and droopy eyelids (ptosis). Ptosis can cause eye discomfort, limit vision, and affect appearance. Fortunately, it can be identified and corrected appropriately. This is often covered by medical insurance if the symptoms are affecting your lifestyle. Surgery to improve the appearance of the eyelids is called blepharoplasty. The goal of the procedure is to remove extra skin, muscle, and fat to achieve a more youthful appearance. Early in Dr. Doxanas’ career he recognized the role of the eyebrows which accentuates upper eyelid abnormalities. Failure to recognize eyebrow changes compromised surgical results. As such, the eyebrows and the eyelids are considered as a functional unit. Anatomic studies have identified the eyebrow fat pad in the lateral 2/3 of the brow as an important factor in brow contour and fullness. Patients with prominent low-set brows generally have a more pronounced brow fat pad. As such, the transeyelid brow elevation procedure was developed. In conjunction with a standard blepharoplasty, and through the same eyelid crease incision, the brow is addressed. Dissection is carried above to the eyebrow allowing debulking or sculpting of the brow fat pad and elevation. A second or separate procedure for brow elevation are therefore avoided. This combined procedure is a much more efficient means of brow elevation, much less expensive, and less invasive than the standard option. Attention to the eyebrow position will result in a more youthful and permanent result.
Dr. Doxanas is a Board certified ophthalmologist with a special interest in eyelid surgery. Fellowship trained in eyelid surgery, he is also certified by the American Society of Ophthalmic Plastic and Reconstructive Surgery. Practicing for over thirty years, he specializes not only in the functional, but cosmetic anomalies of the eyelids. Pioneering new approaches to eyelid surgery, he wrote a book, Clinical Orbital Anatomy and contributed approximately 40 additional scientific articles and chapters, most of which are related to eyelid abnormalities.
Approaches to lower eyelid surgery are now tailored to the patient’s concerns. Previously all lower eyelid surgery was addressed through a standard incision under the lashes extending all the way across the lower eyelid. However, closer evaluation of patient’s requesting eyelid rejuvenation has a combination of issues: fat herniation, redundant skin or eyelid laxity. The traditional approach is not indicated for fat herniation and may aggravate those patients with lower eyelid elasticity. As such, separate procedures were created for each specific problem.
Dr. Doxanas uses a different approach for fat removal. Herniation or prominent lower lid fat is familial tendency aggravated by aging. Without creating a skin incision, these fat pockets are approached through a small button hole incision in the inside of the eyelid. As such, eyelid edema and puffiness can be eliminated without external scarring. If redundant skin is more of a problem, then a traditional transcutaneous approach is used. This generally requires a minimal skin removal but can be more extensive based on the doctor’s determination. If redundant skin or festoons are of primary concern, these can be removed directly. Excessive skin removal may result in eyelid contour or eyelid malpositions and is such avoided.
It is important to have an ophthalmologist trained in eyelid surgery perform these techniques. Dr. Doxanas is a certified by the American Society of Ophthalmic and Reconstructive Surgery. He has received the prestigious Lester T. Jones award for significant contributions to the understanding of ophthalmic plastic surgery. This extra training allows a greater level of understanding of anatomic concept which will maximize success and enhance patient satisfaction with all eyelid abnormalities.