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  • Chris Thiagarajah MD

Oculoplastic Surgeons and Eyelid Lifts: How to choose a plastic surgeon to perform a cosmetic eyelid



Eyelid surgeries are the most common cosmetic plastic surgery procedure that is performed in the United States. Additionally, eyelid lifting (also known as blepharoplasty) is also done for medical purposes to help patients see a better field of vision by removing the excess skin that is blocking their vision.

How does one choose a plastic surgeon specialist to perform cosmetic eyelid surgery? There is a subspecialty of surgeons called oculofacial plastic surgeons. Their speciality is involved in the eyelid, eye socket and tear duct. The vast majority of surgeries that they perform are in the eyelid. Members of this specialty are fellows of the American Society of Ophthalmic Plastic Surgeons (www.asoprs.org) . It is a select specialty with a few hundred members in the country dedicating their surgical career to the eyelids.

As an ASOPRS member (eyelid specialist), my practice is focused on the eyelid, its cosmetic appearance and function in relation to vision. When I perform a cosmetic eyelid procedure, appearance and shape of the eyelids, the eyelid fold, safety of the procedure and minimization of dry eyes are the four most important considerations that I take when performing the surgery. I will review how as an ASOPSR specialist, performing this procedure is done from the position as an expert not as a practioner who performs this procedure among a hundred other procedures such as tummy tucks and lipo.

Shape of Eyelid

The shape of the eyelid is critical during a blepharoplasty or cosmetic eyelid procedure. Different muscles that raise and lower the eyelid determine eyelid shape along with other structures in the eyelid. Performing eyelid lifting as an oculoplastic specialist (ASOPRS) member is different in that careful attention is taken towards the shape of the eyelid. A rigorous oral and written exam is performed to vet surgeons to the precise anatomy of the eyelid to allow membership in this society.

The Eyelid Fold

Many of us have seen patients who’s eyelid fold has been damaged from blepharoplasty. This can be from making the eyelid fold too high, eliminating the eyelid fold or making a second fold in the eyelid. As eyelid specialists we are knowledgeable about the anatomy of the eyelid and what creates the eyelid fold. Part of the surgery is knowing how to maintain the eyelid crease in a natural way. This is the advantage of an ASOPRS oculoplastic surgeon.

Safety of the Procedure

The biggest advantage of having an ASOPRS oculoplastic surgeon is to have a reduction in the complications of the procedure. Oculoplastic surgeons commonly fix problems with eyelid surgery in the community as specialists. By having a cosmtic eyelid lift with an ASOPSR oculoplastic surgeon, your risks of vision loss, dry eye, eyelid retraction are minimized compared to a surgeon who dabbles in the procedure. Additionally, one of the most important things I do, is turning away patients who are not candidates for the surgery. Someone who is not a good candidate is not only going to be unhappy most likely but may risk damage to their vision in untrained hands.

Minimization of Dry Eyes

One of the biggest risks of eyelid surgery is post operative dry eyes. ASOPSR oculoplastic surgeons are uniquely trained to identify patients who are at high risk for postoperative dry eyes. Additionally, they are trained to identify patients who are at a higher risk for their dry eyes to get worse after the procedure. This is done via a slit lamp exam. If a doctor is to perform eyelid surgery and has not performed a slit lamp exam on yourself, I would be very cautious as you have not been properly examined by the doctor before surgery. Once a patient has bad dry eye after the procedure, there are a few things that can be done to help them but the best plan to to identify and not operate on these patients beforehand.

What are the three questions you should ask your cosmetic eyelid surgeon before surgery?

  1. Are you an eyelid specialist (oculoplastic surgeon)?

  2. Are you a certified eyelid specialist (member of ASOPRS)

  3. Have you done more than 2000 eyelid surgeries?

If the answer you want to get to all of these questions is yes.If the answer is no, keep moving forward for a better trained more experienced surgeon. Your eyes deserve it!

About Dr Thiagarajah

Dr Thiagarajah is a board certified oculoplastic surgeon. He is a member of the American Society of Oculoplastic Surgeons (ASOPRS). He was an attending at Georgetown University in Washington D.C teaching eye surgery residents where he won teacher of the year award among other accolades before coming to practice in Denver. He performs eyelid, tear duct and eye socket surgery at his offices in Denver, Littleton, and Vail. Dr Thiagarajah’s interest is cosmetic along with reconstructive eyelid surgery. Blepharoplasty

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