Portland Oculoplastic Surgeons

Eye Very Dry and Tears After Frontalis Suspension Ptosis Correction, Normal?

I had frontalis suspension operation on my right eye in Feb 2011 but the eye still feel very dry and open a bit wide now (after nearly one year), it tears in sleep and awakes me, very uncomfortable and a bit painful. Very frustrated, if I have known this, I will not have the operation. Want to ask doctor : any treatment, supplement/vitamins to cure tearing eye ? Thank you

Frontalis slings are performed on patients with ptosis who have decreased or poor movement of their levator muscle (the one that normally opens the eyelid). This mainly is done for patients with congenital ptosis, ptosis due to 3rd cranial nerve paralysis or progressive muscle weakening diseases. The procedure is basically a compromise. In order to get the eyelid up, if must be attached to the frontalis muscle (the one that raises the eyebrow). Since it is attached to the frontalis muscle, it makes closure of the eye more difficult. The eye may not close all the way especially when sleeping. Spontaneous blinking during the day is also limited to a variable degree.

Options for comfort include: frequent use of lubrication (artificial tears, Natures Tears Eye Mist if drops are too hard or inconvenient to use, or something similar) during the day. Using lubricating eye ointment when sleeping helps keep the eye from drying out at night. There are moisture chambers that act like a green house to keep the eye from drying out at night which can be used with the ointment. Wearing protective sun glasses with side protectors keeps the eye more comfortable from the evaporative effects of bright sunlight and wind.

It sometimes seems counterintuitive to wet an eye that is tearing. What is happening is the eye is drying out, the corneal nerves are telling the brain the eye is drying out and to make extra tears to keep the eye moist and protected.The discomfort is due to the drying.

Surgical options include relaxing the upper eyelid to a lower position or raising the lower eyelid to decrease the amount of opening with or without lowering the upper eyelid.

John D. Ng, MD

Portland Oculoplastic Surgeon

Sculptra Nodules Under Eyes - Looking for Colorado Sculptra Expert

July 2008 I had Sculptra injected under my eyes. Visible nodules developed within 3 weeks, though I massaged as instructed. They are still visible, I look like I have double bags (due to the nodules pushing out the skin above my cheeks), and are still painful (3 years later). I need to find a Colorado Doctor I can trust to help me fix this. I phoned my provider's office last month & was told "Sculptra doesn't last more than 2 yrs. She won't see you!!!!" Can anyone help me?

Hi Sue17 in Colorado,

Sculptra nodules can be seen under the thin eyelid tissue for a number of reasons and if agranulomatous response occurs, these lumps are unlikely to resolve in any other way then surgical resection. I posted pre and post op pictures of a woman I treated for this condition previously on the “realself” website and they should be attached to this post. As you can see, the result was excellent and the patient was quite relieved to have the deformity gone.

Joel Cohen, MD in your area has written some excellent articles regarding filler use as well as their complications and management. Best wishes
for a successful resolution to this problem.

Roger A. Dailey, MD, FACS

Roger A. Dailey, MD

Portland Oculoplastic Surgeon

Is Juvederm Safe?

I want to get Juvederm injections for the laugh lines around my mouth. Is Juvederm safe? What should I know about the safety of Juvederm?

When prescribed by a properly qualified and trained doctor and injected in an appropriate medical setting, Juvederm dermal fillers have proven to be extremely safe.

Roger A. Dailey, MD

Portland Oculoplastic Surgeon