Our practice offers cosmetic eyelid and facial aesthetic services for our Orange County area patients. We specialize in oculoplastic eyelid surgery as well as nonsurgical facial aesthetic procedures such as BOTOX®, Restalyne, and Juvaderm. We also provide eyelash enhancement with LATISSE®.
What is an oculoplastic surgeon?
Ophthalmic Plastic and Reconstructive Surgery is a specialized area of ophthalmology that deals with reconstructive and cosmetic surgery of the eyelids, the lacrimal (tear) system, the orbit (the bony cavity surrounding the eye), and the adjacent face. An ophthalmic plastic and reconstructive surgeon is an ophthalmologist (medical doctor and eye surgeon) who has completed additional training in plastic surgery as it relates to the eyes and their surrounding structures.
Ira A. Vidor, MD is the oculoplastic eye surgery expert at Beach Eye Medical Group. He is one of less than 500 physicians nationwide who have completed a fellowship accredited by the American Society of Ophthalmic Plastic and Reconstructive Surgery. Dr. Vidor’s expertise lies in providing specialty care for all oculoplastic conditions including droopy and scarred eyelids, blocked tear ducts, tumors around the eye, thyroid eye disease, orbital diseases, surgical eyelid rejuvenation, and nonsurgical facial rejuvenation such as Botox, dermal fillers, and laser resurfacing.
At Beach Eye Medical Group we want to help you see better but we also want to help you look better. We offer various dermal fillers to help your appearance. Are you struggling with aging lines and wrinkles? Below are some of the cosmetic procedures offered at Beach Eye Medical Group.
Blepharoplasty – Lid Lift/ Treating Droopy Eyelids and Eyelid Bags. As we age it is very common for skin on and around your face and eyes to start sagging or dropping. Because the skin muscles in the eyelid areas are much more thin than the other facial skin it is understandable why eyelid skin may start to droop. Of course cigarette smoking and overexposure to the sun’s UV radiation will worsen this condition. As the tissue around your eyes weaken, the skin and muscles in the upper eyelids will start to sag and can even cover the lashes. The lower lid skin can bunch up, fat can bulge forward forming bags and grooves, and weakened lid tendons can cause the edge of the eyelid to dip. Many people do not like this because it makes them look old and tired. At Beach Eye Medical Group we offer cosmetic eyelid surgery (Blepharoplasty) for patients hoping to look and see better. By rejuvenating the eyelids patients, look less tired and more alert and refreshed. In some cases drooping eyelids become a medical issue and can obstruct vision or cause other problems. In these cases insurance may cover some or all of the cost of eyelid surgery.
Ptosis Repair- Eyelid Muscle Repair/ Lift
Ptosis occurs when specialized muscles that open the eyelid slip or stretch. It often occurs in combination with sagging eyelid skin and bags, but may happen by itself. Patients with ptosis commonly complain that their eyelids always look “tired” or “bored” and may notice that they are blocking their field of vision. Sometimes the amount of weakness can differ between the lids giving an uneven appearance. Occasionally, people are born with ptosis. Ptosis surgery can be performed as an outpatient, and can sometimes can be done in the office. As with blepharoplasty, insurance may cover the cost of ptosis repair.
Medical Eyelid, Tear Duct, Brow, Eye Socket, and Eyelid Cancer Surgery
BOTOX® is one of the most popular cosmetic treatments in the world. Originally approved for the treatment of eye muscle spasms, it was quickly recognized for its cosmetic value. Our Orange County eye doctors have been using BOTOX® for years to correct the visible signs of stress and aging as well as relieving facial muscle spasms. The medication relaxes the muscles in the face that cause wrinkles that may make you look tired or angry. Commonly treated areas include wrinkles between the brows or “anger lines” and laugh lines around the eyes or “crows feet,” but other areas such as the forehead can be treated as well. BOTOX® treatments are quick and often painless. There is no “downtime” after treatment.
Juvederm® and Restylane®
Resalyne® and Juvederm® are dermal fillers. These are water based gels that are used to fill creases or wrinkles of the face. They are commonly used to fill the creases near the nose and mouth (smile lines and frown lines) and to plump the lips, but can be used in many other places such as the hollow appearing grooves under the eyes. Treatment is performed in the office and takes only a few minutes. There is usually very little if any pain and minimal to no downtime. Both products are made of a hyaluronic acid – a substance that occurs naturally in the body. Together with BOTOX®, dermal fillers have revolutionized facial rejuvenation and eliminated the need for invasive surgery in many cases
LATISSE® is a breakthough medication that lengthens eyelashes. Since it is a medication that works on a cellular level, it is far more effective than any over the counter eyelash product. Bitamaprost, the active ingredient in LATISSE® is believed to affect the growth (anagen) phase of the eyelash hair cycle in two ways: first, it increases the length of this phase, and second, it increases the number of hairs in this growth phase. For more information regarding LATISSE® please see this website page.
- Eyelid Diseases and Disorders
- Ptosis Repair
- Ectropion Repair
- Entropion Repair
- Lid Retraction Repair
- Eyebrow Disorders
- Brow Lift
- Tearing Disorders
- Tear Duct surgery (dacryocystorhinostomy)
- Thyroid Eye Disease
- Orbital Decompression
- Lid Retraction Repair
- Eyelid and Socket Cancer
- Tumor Removal
- Eyelid Reconstruction
- Socket/ Orbital Reconstruction
- Orbital Fracture
- Orbital Fracture Repair
- Enucleation/ Evisceration
Eyelid Diseases and Disorders
The eyelids provide a critical role in maintaining good vision and the health of the eye. The eyes are also the focal point of the face and droopy upper eyelids and excess skin can interfere with vision and caused a tired appearance. The upper eyelid itself may be sit too low (ptosis) or there may be too much skin (dermatochalasis) or both. Both conditions are usually due to age, but rarely can be caused by a medical disease of the nerves and muscles or trauma.
Droopy lower lids and can turn in (entropion) or out (ectropion) and cause tearing, burning, and red eye as well as give an aged appearance. They can also cause the eyelashes to rub the eye (trichiasis) resulting in an abrasion. Overly tight eyelids (lid retraction) may also cause watering, pain, and irritation. Like the upper lids, age usually causes these problems, but trauma, tumors, thyroid disease, Bell’s palsy (or seventh nerve palsy), and sun damage can also cause the lower lids to be in the incorrect position.
Surgical correction (blepharoplasty, ptosis repair, ectropion/ entropion/ lid retraction repair) can often improve these symptoms as well as provide a rejuvenated appearance. Surgery is usually performed on an outpatient basis with most patients returning to normal activity in about a week.
Like the upper lids, the eyebrow can sag as well. This can also interfere with vision and cause an aged appearance. This may be due to the brow hanging low, loss of eyebrow volume or deflation, or both. Surgical correction (brow lift) can help improve the visual field and appearance. A nonsurgical “brow lift” can sometimes be achieved by adding more volume to the area.
Tearing and Tear Duct Diseases
The tear ducts run from the corner of the eyelid down through a bony duct and empty into the nose. They may become blocked (nasolacrimal duct obstruction) or infected (dacryocystitis) and cause excessive tearing. A detailed tear duct examination can if and where a blockage is present.
If the tear duct is blocked in an adult, surgery is often necessary to prevent tearing and infection. Children with a blocked tear duct usually do not require surgery, but may need a “stent” placed in the tear duct. Tear duct surgery redirects the flow of tears around the blockage so they drain properly (dacryocystorhinostomy). Tear duct surgery is usually performed as an outpatient procedure and takes about an hour. Most patients can return to work in about a week.
Thyroid Eye Disease
Thyroid disorders may cause eye problems. This condition is often referred to as thyroid eye disease, Graves disease, thyroid ophthalmolopathy, or thyroid orbitopathy. Typically, the eyes, lids, and socket are affected when thyroid levels are too high, as in Graves disease, but can occur when thyroid levels are too low, or even normal. Bulging eyes (proptosis or exophthalmos), wide eyes (lid retraction), double vision (diplopia), swelling of the eyes and lids, tearing, and irritation are common eye problems that can be related to thyroid disease. Rarely the disease can be severe enough to cause vision loss.
Thyroid eye disease can be treated with medicine and/or surgery. Corticosteroids can help to calm the disease down. Surgery can be performed to decrease eye bulging (orbital decompression), correct double vision (strabismus surgery), and fix the wide eyed “thyroid stare” (lid retraction repair).
Eyelid and Socket Cancer
Skin cancer can develop anywhere on the body and the eyelids are no exception. Most eyelid cancer is caused by the sun. A biopsy should be performed for any suspicious growth to determine if it is cancerous. Basal cell carcinoma is the most common eyelid cancer, but other types such as squamous cell carcinoma, melanoma, and sebaceous cell carcinoma can occur. Cancers should be completely removed and eyelid reconstruction performed immediately after.
The eyelids are an extremely delicate and intricate area and reconstruction should be performed by an eyelid expert.
Signs that a lump or bump may be cancerous include:
Cancer of the socket is rare but does occur. The type of treatment is dependent on the type of cancer. Biopsy or surgery may be necessary. Reconstruction of the eyelids and area around the eye should be performed by a specialist who has formal training in orbital surgery.
An orbital fracture (sometimes called a “blow out fracture”) occurs when the bones of the eye socket are broken. They are typically caused by trauma. Orbital fractures can cause swelling around the eye, double vision, pain, facial numbness, and can cause the eye to appear to “sink into” the socket. A detailed facial and eye examination should be performed by a specialist to determine the extent of injuries. A CT scan is an important test used to evaluate orbital fractures, and if already performed, should be brought with you to your consultation.
If an orbital fracture is large or causing double vision then surgery is usually recommended. It is often advisable to wait a week or two for the swelling to improve prior to surgery, unless an eye muscle is caught in the fracture. The broken bones can be bridged by a synthetic plate and held together with micro plates. Most of the time, the surgical incision can be placed on the inside of the lid to prevent a scar from forming on the eyelid skin.
In special circumstances it may be necessary or beneficial for a patient to have an eye removed. The procedure performed is either an enucleation or an evisceration. There are two main reasons a patient may need this; a malignant tumor in the eye, or a blind eye that has intractable pain.
The procedure involves removing either the whole eye (enucleation) or the inside contents of the eye (evisceration), and placing an implant in the socket. The procedure takes about an hour and is done under general anesthesia. Many patients with a blind painful eye get pain relief within a few days. After a few weeks, a prosthesis is made that matches the other eye. The prosthetic eye looks natural and moves well in most patients.