Reconstructive Procedures

Dr. Tiffany Kent, MD, PhD, is specialized in several different types of treatments. From cosmetic surgeries that will revitalize your face and eyes, to functional and reconstructive surgeries, Dr. Kent is skilled with expert knowledge and experience. 

Drooping Upper Eyelids (Dermatochalasis and Ptosis)

 

Drooping upper eyelids can be the result of either excess skin and fatty tissue obstructing the edge of the eyelid (dermatochalasis) or from the edge of the eyelid itself blocking vision (ptosis).  While the surgical procedure to repair the upper eyelid differs, the goal is to improve the eyelid height, and improving peripheral vision.

Brow Ptosis (drooping)

 

Over time, the brows may descend, creating heaviness on the eyelids.  Often patients will compensate for this and engage their forehead muscles to elevate the brows.  These can lead to fatigue.  There are a variety of approaches to repair drooping brows.  Dr. Kent can discuss them with you during your consultation and together, we will decide what the best approach is for you.

Lower Eyelid Malposition (Ectropion and Entropion)

 

Lower eyelid malpositions generally result from loosening of the lower eyelid tissues.  This can lead to ocular irritation, dryness, watering eyes or mattering of the lashes with mucous discharge.

Skin Cancer

 

The eyelids and periorbital region are common locations for skin cancer to grow.  Our office can provide the initial biopsy of any suspicious lesion, as well as reconstruction of the tissue following complete excision of the skin cancer.

Eyelid Tumors

 

Any new or changing growths near the eyelid should be examined for malignant features.  Many times, these require removal to ensure that they are not a skin cancer.

Orbital Tumors

 

A variety of tumors can grow within the eye socket.  Many are slow growing, and the presenting feature is bulging (proptosis) of the eye.  Congestion of the eye socket and double vision may also be present.  If you are suspected of having an orbital tumor, a complete exam is warranted, followed by imaging (MRI or CT scan).  Depending on the nature of the tumor, surgery may be indicated for complete removal or diagnosis (biopsy).

Orbital Fractures

 

Following trauma, the bones of the eye socket may fracture.  Many patients will not require surgical repair, however a thorough eye exam is warranted to ensure that the eye has not been damaged.  Indications for surgical repair include persistent double vision, trapped orbital tissues, continued pain with eye movement and large-sized fractures.  A complete exam with review of CT scans will determine the management of your fracture.

Tear Duct Surgery

 

Blockage of the tear duct drainage system often presents with a watering eye or with a more severe infection.  During your exam, the location of the blockage will be determined, which helps to dictate the treatment plan.

Eyelid and Facial Laceration Repair

 

Following trauma to the periocular region, a thorough eye exam will be performed to ensure no damage to the eye or eye socket.  Eyelid and facial lacerations are repaired with the goal being to realign the tissues to their original location. This helps to ensure better functioning once healed.  If tissue is missing as a result of trauma, more extensive reconstruction will need to be performed to restore the eyelid tissue.

Enucleation

 

Enucleation is a surgery to remove the eye.  This can be performed when there is a tumor within the eye, such as a melanoma, of when a blind eye becomes painful and debilitating.  The surgery involves removal of the eye, with sparing of the eye muscles.  An orbital implant is placed in the eye socket, and the muscles attached.  A large plastic contact lens (conformer) is placed in the socket for 6-8 weeks until the tissue is healed. Once healed, an evaluation by an ocularist is scheduled for construction of a prosthetic eye.

Movement Disorders (blepharospasm & Hemifacial spasm)

 

Twitching or spasming of the eyelids can be very debilitating. This can be bilateral, if blepharospasm, or unilateral, if Hemifacial spasm, aberrant regeneration of the 7th nerve (following Bell’s palsy), or benign myokymia.  Depending on the nature of your spams, and the degree of debility, there are treatment options.  Generally, treatment begins with weakening the muscles using injectable medications such as Botox®, Dysport® or Xeomin®.  In most cases, spasms are adequately controlled with injectable medications.  However, if not, myectomy surgery may be indicated.

What to expect from surgery

Eyelid surgery is performed as an outpatient procedure in the operating room with IV sedation.  Severe post-operative pain is generally not expected with these procedures.  Swelling and bruising are expected, however, and generally worsened 1-2 days following your surgical procedure.  During the first 48 hours following surgery, plan to use plenty of ice to reduce swelling.  For the first 1-2 weeks after surgery, we ask that you refrain from any strenuous activity or exercise. Sutures are removed 1-2 weeks following surgery. At this point, bruising should be improved.  Swelling is variable, and can persist for 1-2 months.