Plastic Surgeon or Ophthalmologist for Eyelid Surgery?

Question

I have severe ptosis & have severe heart problems. I wanted a facelift to fix everything, but due to my health condition that is not possible - I have heard eyelid surgery can be done with local anethestics and would reduce my risks.should I see a plastic surgeon or an ophthalmologist who does this surgery?  What's going to make me feel better about me appearance and long lasting?

Kenneth D. Steinsapir, MD · Answer

For cosmetic eyelid surgery, it is possible to have successful eyelid surgery with eye plastic surgeons, facial plastic surgeon, or general plastic surgeons.  However, you do not have routine issues. You essentially need reconstructive surgery. You have profound upper eyelid ptosis.  
You have highly complex midface issues.  In your case, I strongly recommend that you see a top oculoplastic surgeon.  There is excellent oculoplastic surgery in Columbus.  You might consider seeing Jill Foster, M.D.   There are others as well but you truly need a specialist.

Richard J. Bruneteau, MD · Answer

Both plastic surgeons and ophthalmologists have extensive training in eyelid surgery. Within these specialties, wide variations exist in both expertise and experience. For this reason, patients need to do their homework when picking a surgeon. When this approach is taken, patients optimize the probability of having an excellent result.

Rod J. Rohrich, MD · Answer

It obviously depends on the expertise of the surgeon. One can choose an Oculoplastic surgeon or a Plastic Surgeon that has experience and expertise in eyelid ptosis repair and blepharoplasty. These specialists can perform this surgery in a confident and reliable manner.

Paul S. Nassif, MD · Answer

You may see either a plastic surgeon or an ophthalmic surgeon for a consultation. They will choose to operate only after your health is thoroughly evaluated and you are determined to be a good candidate for surgery.
Local anesthesia can also cause problems with the heart. The epinephrine in the injection may be problematic. It is best to first get clearance from cardiologist. Thank you, and best of luck.

David C. Pearson, MD · Answer

Certain severe heart conditions would make surgery--even under local--a bad idea for an elective procedure. If one's heart condition requires continuous anticoagulation, for example, then the risk:benefit ratio of stopping the anticoagulants would preclude an eyelid procedure.
Given the apparent degree of ptosis in this photo, repair requires more than just blepharoplasty. An ophthalmologist with fellowship training in oculoplastic surgery would be a good place to start in terms of evaluating this more complex problem.
All the best,
--DCP

Scott Trimas, MD · Answer

If you have medical problems and even if you do not, upper and lower eyelid surgery can be performed under local anesthesia. Having surgery done by either a facial plastic surgeon or an oculoplastic ophthalmic surgeon is up to you. I would ask for references as both are qualified to perform the procedure. I hope this information helps.

Jeffrey E. Schreiber, MD, FACS · Answer

Hello - You're right about the eyelid procedures being done under local anesthesia only, and I would recommend going to a board certified plastic surgeon. The procedure may take 1-2 hours depending on what you'd like done. Also, if you have extensive upper eyelid skin that obstructs your vision you may qualify for insurance to cover this procedure. You'll first need a visual field test that can be done by any eye doctor. Bring the results with you when you visit your plastic surgeon.

Otto Joseph Placik, MD · Answer

You have multiple issues to address that would involve treating the forehead, upper lids, lower lids and cheeks. This is an extensive combination and would be difficult to perform under a locat anesthesia at one sitting. You may be better off staging and performing a limited forehead lift and upper lid blapharoptosis and dermatochalasis repair in one operation followed by a lower lit blepharoplasty, canthopexy, and midface suspension at a second date.

Dimitrios Karypidis MD, FEBOPRAS, FACS · Answer

There are multiple issues with this condition. I would suggest specialists with extensive experience in facial plastic and reconstructive surgery, not limited on the periorbital region. Although there are excellent professionals and surgeons in other disciplines (head and neck surgery,ENT, occuloplastic surgery etc) plastic, reconstructive and aesthetic surgery is in my opinion the appropriate discipline. I would also say that this is a decision to be made on an individual basis depending on the specific experience of the surgeon, rather than on searching for a single specialty.

Chris Thiagarajah, MD · Answer

There are several problems here. For one, you do as the other surgeons here have mentioned have ptosis with excess eyelid skin. To lift the eyelids on both sides and remove the skin would take approximately 30 minutes to 1 hour. Additionally in the lower eyelids you have excess skin and your lateral canthal area (side of the eyes) are droopy. To tighten that area and reduce the appearance of the puffy skin would also take roughly an hour. I would recommend anybody who commonly does the procedure. As an oculoplastic surgeon that is my bread and butter so I feel my specialty is uniquely qualified however that doesn't mean that a facial plastic or general plastic surgeon who has a lot of experience with eyelids cannot do it well either.

Plastic Surgeon or Ophthalmologist for Eyelid Surgery?

Answers (15)

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