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Oculoplastic Surgery

The Difference Between Cosmetic & Plastic Surgery

Too often plastic surgery and cosmetic surgery are misinterpreted.  Though the difference between the two can be easily confused, it’s important to understand what makes plastic surgery plastic, and what makes cosmetic surgery cosmetic. Dr. Taban, board certified oculoplastic surgeon in Beverly Hills and Santa Barbara, sheds light on the common misconceptions relating to the … Read more

Eyebrow Asymmetry: Causes and Treatment

Asymmetric eyebrow height is common patient complaint. It can range from being subtle to obvious. There are various causes, with nonsurgical and surgical treatment options. Causes of eyebrow asymmetry The eyebrow asymmetry could be due to congenital facial bony asymmetry, with side of the face being smaller than the other. The brow on the smaller … Read more

TabanMD Eyelid Surgeon: Cosmetic Procedures up 5 percent in 2011

Article originally published by NewBeauty Magazine. For the second year in a row, the number of cosmetic procedures performed in America increased, illustrating that an uncertain economy isn’t deterring patients. A total of 13.8 million cosmetic procedures, both invasive and minimally invasive, were performed in 2011, a 5 percent increase over 2010. Reconstructive surgeries were … Read more

What is a Chalazion?

An eyelid chalazion is simply a sty that does not go away. It is due to a blocked tear gland in the eyelid. It occurs due to a common condition called blepharitis, which cause the many tiny tear glands in the eyelids to produce thick oily secretions. Symptoms of blepharitis include ocular irritation, itching, foreign … Read more

Prosthetic Eye – Socket Surgery

What is Anophthalmia? Anophthalmia or anophthalmic socket results when an eye is removed (enucleation or evisceration). Losing an eye is an emotional event to any patient and can cause insecurities about his/her appearance. An oculoplastic surgeon is responsible for restoring proper function of the remaining and surrounding structures (eye socket, eyelids) to provide the best … Read more

Causes of Tearing

The tear film on the surface of the eye is a critical component of maintaining vision. Tears nourish and lubricate the surface of the eye as well as wash away debris. If there is a disturbance of the tear film, patients will often experience tearing, burning, irritation and most importantly blurred vision. Patients who experience tearing, or epiphora, either have a problem with tear production or tear drainage, including dry eyes, blepharitis, eyelid malposition (ectropion, entropion, eyelid retraction), nasolacrimal duct(tear duct) obstruction (congenital and acquired).

Increased Tear Production and Dry Eyes

As odd as it sounds, the most common cause of tearing is dry eyes. If your eye doesn’t make enough tears, the lacrimal gland responds by secreting watery tears that don’t stick to the eye. So despite the tears spilling from your lids, the eye continues to be dry. The eye has two sets of structures that produce tears. Smaller tear glands help maintain a baseline level of moisture on the surface of the eye. Unfortunately, inflammatory conditions like rheumatoid arthritis, Sjogrens disease as well as aging and menopause lead to decreased tear production. As tear production diminishes, the surface of the eye starts to dry out.

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Types of Anesthesia For Oculoplastic or Eyelid Surgery

Here are three basic types of anesthesia that can be used during oculoplastic or eyelid surgery. From least invasive to most invasive are: local anesthesia, MAC anesthesia, and general anesthesia.

Local anesthesia involves injecting local numbing injection to numb the eyelid and surrounding structures and the surgery is performed is performed while the patient is fully awake, much like a dental work. MAC anesthesia combines local anesthesia with intravenous sedation, whereby the patient is relaxed and in “twilight sleep” during the surgery, much like how it is done during colonoscopy. Most oculoplastic surgeries can safely be performed using either local anesthesia or MAC anesthesia. The advantages are patient cooperation during the surgery which produces better results along with quicker postoperative recovery.

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Functional Versus Cosmetic Oculoplastic Surgery

Functional vs Cosmetic Eyelid Surgeries

The question of functional versus cosmetic surgery arises often. Here is the difference between the two:

More than 170,000 people in the US each year get some form of eyelid surgery. Most of those people average around 57 years of age. Sometimes , the need is more cosmetic and others, it’s more so for medical purposes like cancer and uncomfortable situations.

What Does “Functional” Surgery Mean?

Functional (or reconstructive) oculoplastic surgery is considered medically necessary and is usually covered by health insurances. It is designed to help with the function of the eyelid or periorbital areas. Examples include ptosis (droopy eyelid), eyelid malpositions (ectropion, entropion), eyelid retraction, eyelid tumors or skin cancer reconstruction, lacrimal tear duct (DCR) surgery, orbital tumors, bulgy eyes, thyroid eye disease, trauma (eyelid laceration, orbital fractures), orbital tumors, eye socket surgery, facial or eyelid paralysis, and facial or eyelid spasms.

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Are Your Tears As Healthy As You Think?

The tear film on the surface of the eye is a critical component of maintaining vision. Tears nourish and lubricate the surface of the eye as well as wash away debris. A smooth, balanced tear film (consisting of water, oil and mucus) also allows light to enter the eye in an optimal fashion. If there is a disturbance of the tear film, patients will often experience tearing, burning, irritation and most importantly blurred vision. Patients who experience tearing, or epiphora, either have a problem with tear production or tear drainage, including dry eyes, blepharitis, eyelid malposition (ectropion, entropion, eyelid retraction), nasolacrimal duct(tear duct) obstruction (congenital and acquired).

 

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Combined DCR and Rhinoplasty with Septoplasty

Dr. Mehryar (Ray) Taban is the ONLY surgeon in the world who performs combined tear duct surgery (DCR) and cosmetic rhinoplasty (plus functional nose surgery, septoplasty, etc) at the same time (“Rhino-DCR” or R-DCR operation).

Patients with tearing secondary to blocked tear ducts often have concurrent difficulty with breathing secondary to deviated septum or other nasal problem. They often require concurrent nose surgery (septal deviation surgery, turbinate surgery, nasal collapse surgery) along with tear duct surgery (DCR). This is usually done by two different surgeons (oculoplastic surgeon and nose surgeon) at different times, requiring two separate surgeries with two postoperative recoveries. Moreover, many patients are unhappy about the appearance of their nose and for many years, they have thought about undergoing cosmetic rhinoplasty but haven’t done it due to cost, recovery period, or stigmata of having had a “nose job”.

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