Eyelid Surgery & Oculoplastics in Fresno

Oculoplastic surgery is surgery of the eyelids, the tear drainage system and the area around the eyes. Some of it is functional, such as lifting an eyelid that's blocking your vision, or turning back an eyelid that's rubbing against your eye. Some is cosmetic, for a more rested, refreshed look. Often it's both.

We offer functional and cosmetic eyelid services, including blepharoplasty (eyelid surgery), ptosis repair, entropion and ectropion correction, and tear duct procedures. For a refreshed look without surgery, we also offer Botox and Restylane injections, and Latisse for thin or short eyelashes.

Blepharoplasty (eyelid surgery)

With age, the skin of the upper eyelids stretches and can fold down over the lashes, and the fat around the eyes can push forward, making the eyelids look heavy or puffy. Blepharoplasty removes the extra skin and, where needed, some of the fat.

• Upper eyelid blepharoplasty removes sagging skin from the upper lids. The incision sits in the eyelid's natural crease, so the scar is very hard to see once it heals. When heavy upper lids hang low enough to block your vision, the surgery is functional as well as cosmetic.
• Lower eyelid blepharoplasty reduces bags under the eyes. It can often be done from the inside of the eyelid, an approach called transconjunctival blepharoplasty, which leaves no visible scar.

What to expect

Eyelid surgery is an outpatient procedure, usually done with local anesthesia, and you may be given medicine to help you relax. Expect bruising and swelling for one to two weeks; cold compresses and keeping your head raised help. Most people are back to their usual activities in about two weeks. The last of the swelling takes longer to fade, and the final result can take a few months to show. What to do before and after blepharoplasty.

Ptosis repair

Ptosis is a drooping of the upper eyelid itself, rather than of the skin above it. It's usually caused by stretching or weakening of the muscle that lifts the eyelid, most often with age, after years of contact lens wear, or after eye surgery. Some people are born with it. Surgery tightens or reattaches the lifting muscle to raise the lid to a more natural height.

A droop that comes on suddenly, especially with double vision, a headache or a change in your pupil, can be a sign of a nerve problem. Get it checked right away.

Entropion and ectropion

• Entropion is an eyelid that turns inward, so the lashes rub against the eye. It causes irritation, redness, watering and a feeling that something's in your eye, and it can scratch the cornea.
• Ectropion is a lower eyelid that sags and turns outward, away from the eye. The eye can become dry, red and irritated, and tears can spill over the lid.

Both are most often caused by the eyelid loosening with age, and both are usually corrected with a short outpatient procedure that tightens and repositions the lid. Why your eyelashes might hurt.

Tear duct procedures

Tears drain from small openings at the inner corner of each eyelid, through a duct that empties into the nose. When that drainage system is blocked, tears well up and run down your cheek, and the trapped tears can become infected. Depending on where the blockage is, it can be treated by opening the duct, by placing a small tube to hold it open, or with surgery that creates a new drainage path into the nose (a dacryocystorhinostomy, or DCR).

Botox, Restylane and Latisse

Botox

Botox Cosmetic relaxes the small muscles that crease the skin when you frown, squint or raise your eyebrows. It softens crow's feet, the frown lines between the eyebrows, and forehead lines. Treatment is a few tiny injections that take only minutes, and most people go straight back to their day. You'll start to see a difference within a few days, with the full effect after about two weeks. It lasts about three to four months, after which the lines gradually return unless you have another treatment. Small bruises where the needle went in are the most common side effect.

Restylane

Restylane is a filler made of hyaluronic acid, a substance your body makes naturally. Injected under the skin, it fills in wrinkles and folds around the eyes and elsewhere on the face, such as smile lines. A numbing cream keeps it comfortable, and if you'd prefer, a local anesthetic injection. Treatment takes about 30 minutes, the results show right away, and they last for months, depending on the area treated. Some swelling, redness, tenderness or itching for a few days afterward is normal.

Latisse

Latisse is a prescription treatment for eyelashes that are thin, short or sparse. You brush it along the base of your upper lashes once a night, with a fresh sterile applicator each time. The results build gradually: most people notice longer, fuller, darker lashes after about two months, with the full effect at about four. When you stop using it, your lashes gradually go back to how they were.

• Apply it only along the upper lash line: not to the lower lashes, and not in the eye.
• Take out contact lenses first, and wait 15 minutes before putting them back in.
• It can make your eyes itchy or red and darken the skin of the eyelid, and it may permanently darken the colored part of the eye.
• Tell your doctor if you use eye drops for glaucoma or high eye pressure: Latisse contains bimatoprost, the same medicine as some glaucoma drops.
• Tell your doctor if you're pregnant or nursing.

Insurance

When eyelid surgery corrects a medical problem, such as upper lids that block your vision, an eyelid turning in or out, or a blocked tear duct, insurance often covers it. For drooping upper lids, insurers usually want a visual field test and photos that show how much of your vision is blocked. We can do those tests and help you find out what your plan covers. Purely cosmetic surgery, and cosmetic treatments such as Botox, Restylane and Latisse, aren't covered.

Eyelid surgery questions

Does blepharoplasty hurt?

The area is numbed, so the surgery itself shouldn't hurt. Afterward most people feel tightness and mild soreness rather than pain, which cold compresses and the pain relief your surgeon recommends will ease.

Will there be a scar?

Upper eyelid incisions sit in the natural crease, and lower eyelid surgery can often be done from inside the lid, so scars are usually very hard to see once healed.

Can I have eyelid surgery after LASIK?

Yes. Having had LASIK doesn't rule out blepharoplasty or other eyelid surgery. Ask your LASIK surgeon how long to wait after your vision correction.

What about a lump on my eyelid?

Most eyelid lumps are styes or chalazia, blocked oil glands that often settle with warm compresses. Have a lump examined if it lasts more than a few weeks, keeps coming back, bleeds, or changes the shape of your eyelid. About chalazia.