Appropriate eyelid position and relationship to the eyeball (or globe) surface is critical in maintaining normal vision. There are, however, certain eyelid conditions which may disrupt this relationship. One such condition is known as ‘blepharoptosis’ (ie. unnatural drooping of the upper eyelid) which may affect either or both upper eyelids. This may arise in childhood due to a congenital lack of upper eyelid muscle development (ie. ‘congenital blepharoptosis’), as a progressive muscle weakening typically seen later in life (ie. ‘acquired or senile bleparoptosis’), or as a result of decreased nerve function as with Bell’s Palsy (ie. ‘neurogenic blepharoptosis’). Another condition which may disrupt the lower eyelid position is known as an ‘ectropion’ or turning outward of the lower eyelid. This may, likewise, result from a variety of causes, including injury (such as traumatic tears, burn or bites), prior surgery or progressive laxity associated with the aging process. Irrespective of the type of eyelid malposition encountered, plastic surgeons are uniquely qualified to address these conditions.
The management of eyelid malposition invariably begins with a detailed patient history and physical examination, including general patient characteristics (such as age, coexisting medical illnesses and medication usage) as well as specific characteristics related to the malposition, including timing of onset, extent or degree of malposition and basis for its occurrence. Based upon this comprehensive assessment, your plastic surgeon will then formulate a rational treatment plan for reconstruction of your eyelid. Although there is no single treatment which is universally applied in eyelid reconstruction, surgical techniques include local or distant tissue transfer (or ‘flap’) procedures, muscle advancement or ‘gathering’ procedures or the use of simple or composite (ie. ‘multi-layer’) grafts. Typically requiring between 30 and 90 minutes of operative time, these procedures are preformed on an outpatient basis in a State Licensed, Nationally Accredited Ambulatory Surgery Center ( see about Keystone Surgery Center) as a brief outpatient surgery utilizing a combination or intravenous sedation and local anesthesia.
When considering eyelid reconstruction, be sure to select a qualified, experienced plastic surgeon, certified by the American Board of Plastic Surgery (ABPS). As a board certified plastic surgeon with over 15 years of clinical practice experience and member of the American Society of Plastic Surgeons (ASPS) and American Society of Aesthetic Plastic Surgery (The Mark of Distinction in Cosmetic Plastic Surgery® ASAPS), Dr. Robert Kimmel welcomes the opportunity to perform eyelid reconstruction in order to optimize both function and cosmetic appearance.