By: Kevin R. Tomasko, Jr., MD | November 11, 2020 | Aesthetics, Blog, Kevin R. Tomasko, Jr., MD
Naturally, you would only trust an ophthalmologist to perform surgery on your eyes. Yet what about surgery around the eyes? The eyelids, sockets, brow and under-eye areas also require the expertise of an ophthalmologist. Therefore, if you need aesthetic or oculoplastic surgery, consult with your eye care specialist about the different procedures. In these procedures, improved vision and facial aesthetics intersect.

Oculoplastic Surgeons
Oculoplastic surgeons are doctors who specialize in eye-related work that changes your appearance. In recent years, they have emerged as specialists. To become an oculoplastic surgeon, a medical student must complete four years of medical school, a one-year medical internship, three years of ophthalmology residency and two years of an ophthalmologic plastic surgery fellowship. While some of their techniques generally improve facial aesthetics, others may improve or even save your vision.
Blepharoplasty, An Oculoplastic Surgery
Blepharoplasty is a surgery that repairs excess skin and fatty tissue on the upper and/or lower eyelids.
Drooping Eyelids
As we age, we not only lose collagen in the skin, but gravity also pulls everything in the body down. As the membrane known as the orbital septum begins to weaken, fat in the eye sockets to begin to push forward, causing the effect known as “bags under the eyes.” This change makes eyelids droop, changing your appearance. More importantly, however, it may impact peripheral vision when affects the upper eyelid.
To repair, a surgeon makes small incisions in the drooping eyelid to remove excess skin and fat. Once the patient recovers, these are not visible. In other cases, the lid itself may sit too low or brow tissue may also be drooping. Eye doctors help there, too, lifting the brow gently by making an incision that will be hidden by the hairline.
Ptosis
Ptosis is a condition that affects the levator muscles, which are responsible for opening the eyelids. Over time, those muscles may stretch, especially in people who wear contact lenses for decades, rub their eyes constantly or take eye drops for a long time. In worst-case scenarios, sufferers must eventually lift their eyelids manually to see. Surgeons can tighten levator muscles to restore their effectiveness, therefore improving vision.
Ectropion and Entropion
These conditions afflict mostly older people. Ectropion causes the lower lid to fall away from the eye, preventing they eye from retaining fluids. This leads to constant tears, as the eye tries endlessly to lubricate itself. An oculoplastic surgeon tightens the lower lid to resolve this issue.
With entropion, the eyelid goes the other way, rolling in toward the eye. Eyelashes rub against the surface of the eye, causing not only incessant discomfort but sometimes a dangerous corneal ulcer. Surgery corrects that condition, too.
Oculoplastic Surgery To Save Vision
Additionally, oculoplastic surgeons treat conditions that threaten your sight and general health. These include basal cell cancers on the eyelids, squamous cell cancers, sebaceous cell carcinomas that can spread beyond the lymph nodes and melanomas in or on the eye. They work with dermatologists when removing eyelid cancers, often taking off a piece of the lid and reconstructing it to preserve its functionality.
If a skin cancer invades the eye socket and has time to grow – which can happen when misdiagnosed as a sty or blepharitis – a doctor may have to remove all the contents of the socket. As a general rule of thumb, an annual eye exam is crucial to prevent this from happening, especially for older patients.
Aesthetic Procedures
Oculoplastic doctors also specialize in nonsurgical procedures. For instance, they have the expertise to inject Botox, the botulism toxin that causes paralysis of the muscles, or one of the other toxins approved for facial use to reduce the appearance of wrinkles. Because they are so well-versed on the eye area, they have the skillset and knowledge to provide optimal results. Botox and other injectibles have a rejuvenating effect on crow’s feet and wrinkles between the eyes, alongside the nose and in the forehead. Because these toxins prevent muscles from contracting, they also help patients who have facial spasms.
Oculoplastics at Horizon Eye Care
Horizon Eye Care now has two oculoplastic surgeons, Dr. Mark L. Malton and Dr. Kevin R. Tomasko, Jr. We are excited to have expanded this specialty and now have more capacity to treat our patients in need. To schedule an exam at Horizon Eye Care, use our Patient Portal or call 704-365-0555 Monday – Thursday, 8:00 a.m. to 5:00 p.m. and Friday 8:00 a.m. to 3:00 p.m.