- ArthritisThere are many disorders that may significantly affect the timing and degree of cosmetic eyelid surgery. Not only do these need to be recognized, but they may certainly require specific considerations and alterations in the surgical plan. Such conditions include Floppy Eyelid Syndrome (tightly correlated with sleep apnea), autoimmune thyroid eye disease, muscular dystrophies, neurologic disorders, rheumatoid arthritis, lupus, diabetes, psoriasis, and other autoimmune disorders. Interestingly, many of these conditions may be diagnosed just by looking at the eye.
- OphthalmologyFor over a decade, we wrote the board and certifying examination questions used to assess the competency of other physicians, allowing them to practice ophthalmology and oculoplastic surgery. We helped write THE definitive study book series used to train resident physicians all over the world in our area of expertise. We helped write THE definitive study book series used to train resident physicians all over the world in our area of expertise.
- Laser Eye SurgeryEyelid droop, or ptosis, may represent a weak muscle with which you were born, or it might occur as a result of repeated eye rubbing, contact lens use, trauma, eye surgery, or even just advancing age. Temporary eyelid droop is also seen with boredom, fatigue, and illness. For these reasons, in addition to decreasing the field of vision, causing eye strain, and potentially increasing forehead creases, dry eye, and headaches, a droopy eyelid is often interpreted by others as indicating disinterest, poor health, or lost youth and vitality.
- CataractsHA fillers, of which there are currently over a dozen available in the U.S., are safe and effective volumizing products that can be used to re-sculpt and reshape the face. They can be used to soften dark circles under the eyes, give a gentle elevation to fallen brows, fill in gaunt hollows in the cheeks, straighten crooked noses, and strengthen jawlines and chins. These products are injected and require no surgery. They break down to CO2 and water, and their safety profile is well known, as they have been used in eyes during cataract surgery for over 30 years. Best of all, if there is anything about them that is undesired, they are immediately dissolvable with an incredibly safe enzyme.
- Cataract Surgery
- NeurologyWe have been leaders in developing the use of cosmetic fillers and injectables, including Botox®, Dysport®, and hyaluronic acids, Restylane®, and Juvederm®. We performed the first large-scale clinical studies of Dysport® in the United States in 2004. We wrote the seminal article on the correct use of botulinum toxins in the face published in 1988. (Patrinely JR, Whiting SA, and Anderson RL: The local side effects of botulinum toxin injections. In: Jankovic, J. and Tolosa, E. (eds): Advances in Neurology: Facial Dyskinesia. New York, Raven Press, 1988, pp. 493-500). We uncovered treatment practices commonly used by many physicians responsible for decreasing the effect of botulinum toxin injections (Sami MS, Soparkar CNS, Patrinely JR, Hollier LM, Hollier LH. Efficacy of botulinum toxin type A after topical anesthesia. Ophthal Plast Reconstr Surg. 22(6):448-452, 2006).
- AutismThis 100% cotton sock filled with rice is essential for post-surgical bruising. This is carefully packed by Spectrum Fusion, a non-profit organization that is helping individuals with Autism.
- Diabetes Care
- ThyroidAutoimmune thyroid disorders are perhaps the most common autoimmune diseases in the United States, potentially affecting some 20% of all adults. Thyroid Eye Disease is what we call the eye changes seen in these autoimmune thyroid disorders. At Plastic Eye Surgery Associates, we have worked hard over the last several years to create this video series. This material is produced for people without any medical training and in a broad sense may be broken up into three general parts: understanding autoimmune thyroid disorders, understanding the impact and treatment of Thyroid Eye Disease and appreciating things that everyone can do for themselves to improve their own situation.
- MRIMost often, either a CAT scan or MRI will be ordered to more carefully define the condition. Some conditions require no treatment, others the use of radiation therapy, or surgical excision. Through the use of CAT scans and MRI and the use of operating microscopes and surgical lasers, surgery is very safe and sophisticated.
- Chemotherapy
- Radiation Therapy
- Wound CareSimple superficial defects in the eyelid may occur after minor trauma or removal of small growths. Many of these defects require nothing more than local wound care and will heal on their own in 7 to 10 days. Some simple superficial defects may require a few sutures with the same local wound care.
- Mohs SurgeryReconstruction. Complete removal of the tumor is critical to minimize the spread of cancer and risk of recurrence. Once the tumor has been completely removed, often with our dermatology colleagues who perform a Mohs surgery, reconstructive surgery is performed to make a new eyelid or repair the defect. The goals remain the same: to reconstruct the eyelid so that it functions properly to protect the eye and preserve vision and to achieve a satisfactory cosmetic appearance.
- Reconstructive SurgeryAll of our doctors are highly experienced plastic surgeons specializing in cosmetic and reconstructive surgery in the eye region and face. The eyes are the focus of the face. You’ve trusted us with your eyes, now you can trust us with your earlobes.
- BotoxDysport, Jeauveu and Xeomin, have been used safely around the world dating back to the early 1980s when our practice was among the very first to use Botox. These proteins can be highly effective in wrinkle reduction. However, the male face needs to be treated very differently than the female face. In the male, small smile lines around the eyes are often desirable, whereas the deep concentration lines between the eyebrows can give an angry appearance, the over-acting depressors around the mouth may give a down-turned, sour expression, and falling eyebrows may convey fatigue.
- Brow LiftWhen the brow towards the nose droops, this is called medial brow ptosis. This can lead to an unintended angry or scowling appearance. This is neither a good place for dermal fillers nor for the botulinum toxins. Surgery is the only solution. Options include a central endoscopic brow lift from the hairline, direct removal of forehead tissue right above the eyebrow or within a forehead wrinkle line, or a re-suspension with procerus muscle-weakening through an eyelid crease incision.
- Eyelid SurgeryIn this light, we find it bewildering when patients come to our practice distraught over prior eyelid surgery and report that their surgeon told them, “I don’t know what went wrong. I do exactly the same surgery for everyone.” In part, this explains why 50-70% of what we do every month is re-operating the work of others.
- LiposuctionNot surprisingly, blepharoplasties and related eyelid surgeries are among the top three most commonly performed cosmetic surgical procedures both in Houston and across the United States, ahead of brow lifts, facelifts, and liposuction, but usually falling behind breast augmentation/reduction and rhinoplasty (nose surgery). Even so, according to the American Academy of Plastic Surgeons, the average, busy plastic surgeon performs 23 eyelid surgeries or blepharoplasties each year; roughly one every other week. Compare this experience to ours, where our doctors typically perform over 20 blepharoplasties and eyelid surgeries each week, or more than 1,000 / year, every procedure carefully customized to each individual’s needs, since there are many different “types” of blepharoplasty.
- Breast AugmentationLike everyone else in every other walk of life, it is difficult for a plastic surgeon who “specializes†in the whole body from liposuction of the thighs to abdominoplasty to breast augmentation to rhinoplasty and facelifts to stay current on eyelid techniques. Show us a surgeon who truly follows the specialty journals and regularly attends specialty conferences in each of these areas, and we’ll show you a surgeon who has no time for patient care. Even facial plastic surgeons may be challenged. Many surgeons also fall into a “comfort zone†of using techniques in which they initially trained, and it becomes difficult for a person seeking a surgeon to balance decades of experience against the use of old techniques. Some commonly seen outdated, problematic techniques include excessive removal of lower eyelid fat during blepharoplasty, attempting to raise the lower eyelid by tightening the outer corner, and the use of free fat grafts into the lower eyelid.
- Rhinoplasty
- Plastic SurgeryIf you would like to consult with Dr. Patrinely and Dr. Soparkar about a plastic surgery procedure, contact us today. We offer services in
- Face LiftLike an upper eyelid lift, filler injections, facelift, midface suspension, or canthoplasty (changing the angle of the outer corners of the eyes). Skin wrinkles of the lower lid or corner of the eye can be treated with Botox injections, skincare, or chemical peel.
- BlepharoplastyBefore weight and gravity can conspire to sag the delicate skin around your eyes. An Upper Eyelid Lift (Blepharoplasty and/or ptosis repair) can reverse these processes by removing excess skin, sculpting eyelid fat, and possibly tightening the muscle that controls eyelid height, leaving a more youthful, awake, and alert appearance. If you feel great, but your friends occasionally ask if you are tired, sick, or angry when you aren’t, you might benefit from an upper eyelid lift.
- Abdominoplasty
- Nose Surgery
- Lip AugmentationGalderma’s first FDA approved dermal filler designed for lip augmentation and to correct upper lip wrinkles (perioral rhytids).
- Cosmetic SurgeryInternationally known for their prodigious work on an intimate understanding of Thyroid Eye Disease and Complex Orbital Reconstruction. They are internationally recognized innovators and leaders in BOTOX and facial filler injection techniques as well as cosmetic surgery revision. 50% of procedures in our practice are revisions of other people’s work.
- Forehead LiftStrictly speaking, brow lifts and forehead lifts are a little different. A forehead lift raises the entire forehead from eyebrows to the hairline, smoothing out the wrinkle lines in between. Whereas the focus a brow lift is to raise and/or reshape the eyebrows and there may or may not be an effect on the forehead creases. Both forehead and brow lifts can help to smooth out and open up the upper eyelids, creating a more youthful, awake and alert appearance.
- Skin CancerSkin cancer often involves the skin of the eyelid or adjacent face. Usually, skin cancers appear as painless elevations or nodules. Occasionally, the eyelashes are distorted or missing. There may be ulcerations of the involved area, along with bleeding, crusting, and/or distortion of the normal skin structure. Excessive sun exposure is the single most important factor associated with skin cancers on the face. Although, skin cancers may also be hereditary.
- Dermatology
- Chemical PeelsThe upper eyelid blepharoplasty procedure can be performed alone or in conjunction with other procedures such as a brow or forehead lift, lower eyelid blepharoplasty, upper eyelid ptosis repair, and dermal fillers for facial augmentation and enhanced definition. Fine wrinkles and deep creases can be treated with Botox injections, skin care, lasers, and chemical peels.
- Skin CareExercise, good nutrition, ample water intake, and daily skincare are essential for maintaining healthy, youthful-appearing skin. We can help both men and women develop individualized, time and cost-efficient skincare programs, designed specifically for each person’s unique needs.
- PsoriasisThe eyelid tissues are among the thinnest and most sensitive in the entire body. Many problems affect the eyelids first and most profoundly. Systemic allergies, for example, may cause severe changes in the eyelid skin that are subtle to the uninitiated observer and visible nowhere else. However, most wound healing problems are predictable and should be carefully considered prior to any surgical plan. Prior irradiation or chemotherapy, severe sun exposure, Rosacea, sebaceous hyperplasia, diabetes, Psoriasis, vascular disease, autoimmune disorders, heart disease, high blood pressure, scarring, previous nearby surgeries, hundreds of medications and supplements, and numerous skin conditions are all common causes of potential wound healing problems.
- Allergies