Procedures

Excess eyelid skin can be the result of aging or of genetic predisposition. The eyes are often the first facial feature that characterize our faces; redundant skin, puffiness, and discoloration can portray anger, tiredness, or melancholy.

Upper Eyelid
When excess upper eyelid skin interferes with one’s vision, blepharoplasty is covered by medical insurance. In other cases, upper eyelid blepharoplasty can be done to remove hooding and improve the shape of the eyes.

Lower Eyelid
Lower eyelid blepharoplasty helps to restore a more youthful and refreshed appearance by diminishing eye bags and improving dark circles.

Ptosis refers to a droopy eyelid that obstructs one’s vision. Most cases of ptosis are acquired over time and result in the eyes appearing smaller and tired. Patients often report difficulty driving or reading, and sometimes complain of headache from constantly lifting their eyebrows. There are several types of ptosis and multiple surgical procedures that can be done to lift the eyelids. In most cases ptosis repair is covered by medical insurance.

As we age the eyebrows tend to droop, and this contributes to eyelid hooding and an overall tired appearance. A brow lift elevates the eyebrows and soft tissue of the forehead to achieve a more refreshed and youthful appearance. The goal is never to make you look surprised or too tight; Dr. Siegal will evaluate you to decide on the type of surgical brow lift for which you may be a candidate. She may also suggest a non-surgical brow lift with the use of Neurotoxin (Botox).

If the eyelid margin is rotated outward (ectropion) or inward (entropion), patients can experience tearing and discomfort. While these conditions are more common in the lower eyelid they can also occur in the upper eyelid. Eyelid malposition can be a result of aging, scarring, sun damage, facial paralysis, previous surgery, or inflammatory medical conditions. Both ectropion and entropion can be corrected surgically.

MOHS
Skin cancer around the eyes is quite common and we recommend MOHS surgery for treatment. Dr Siegal works closely with a MOHS Dermatologist who will remove cancerous lesions under local anesthesia in the office. The following day Dr. Siegal will perform the reconstruction. These surgeries require an intimate knowledge of the anatomy and function of the periorbital region.

Trauma
Dr. Siegal has extensive experience in managing orbital trauma including orbital fracture repair and periorbital laceration repair.

If there is a blockage in the tear drainage system, patients may experience tearing and/or chronic discharge. In some cases the blockage can result in infection requiring oral antibiotics. The treatment for this condition is called a Dacryocystorhinostomy; in this procedure, a new pathway is created for your tears to drain through an incision on the side of the nasal bridge. A small opening in the bone is created and a thin, flexible silicone stent is placed through the lacrimal sac. The stent stays in place for 2.5 months and then is removed (without pain) in the office.

The orbit refers to the bony space surrounding the eye and its surrounding tissue/muscles. Tumors (both benign and malignant) can develop in the orbit and may result in eye bulging, double vision, ptosis, pain or numbness of the face. Based on the age of the patient and his/her medical history, imaging (CT or MRI) is typically required. Surgery can be performed to establish a diagnosis and/or treatment.

Graves’ disease is an autoimmune condition that can cause bulging of the eyes, double vision, retrobulbar pain and dry eye symptoms. Until recently, treatments for this condition required long-term use of steroids, surgery (orbital decompression), or radiation. Tepezza is a novel treatment that has changed our management of this disfiguring disease. Dr. Siegal has had great success treating patients with Tepezza.

There are several scenarios in which an eye must be removed including malignant tumors, chronic infection (endophthalmitis), trauma, and painful blindness. Enucleation and evisceration are two techniques to remove the eye; based on your needs Dr. Siegal will evaluate which would be more advantageous.

New eyelid lesions can be benign or malignant and Dr. Siegal will evaluate you to decide if biopsy is warranted. Biopsies are performed in the office under local anesthesia and take only minutes. Recurrent styes or chalazia may be the result of an inflammatory eyelid condition called blepharitis. If these bumps do not resolve with hot compresses and eyelid scrubs, they often require surgical removal. Chalazion excision is performed in the office under local anesthesia (unless the patient is a child who requires general anesthesia) and requires essentially no downtime.