# Kahana Oculoplastic & Orbital Surgery --- ## Pages - [Facelift Surgery](https://drkahana.com/facial-plastic-surgery/facelift/): Explore the benefits of upper eyelid blepharoplasty—from refreshed looks to improved vision. Learn what to expect and how to choose a top surgeon. - [Brow Lift](https://drkahana.com/facial-plastic-surgery/brow-lift/): Explore the benefits of upper eyelid blepharoplasty—from refreshed looks to improved vision. Learn what to expect and how to choose a top surgeon. - [Revision Eyelid Surgery](https://drkahana.com/blepharoplasty/eyelid-revision-surgery/): Eyelid revision surgery is a surgical option for people who are not satisfied with the outcome of a previous upper eyelid blepharoplasty. Learn more - [Double Eyelid Surgery](https://drkahana.com/blepharoplasty/double-eyelid-surgery/): Double eyelid surgery (East Asian eyelid surgery) gives the upper eyelids a well-defined and more visible crease. Learn more - [Upper Blepharoplasty](https://drkahana.com/blepharoplasty/upper-eyelid-blepharoplasty/): Explore the benefits of upper eyelid blepharoplasty—from refreshed looks to improved vision. Learn what to expect and how to choose a top surgeon. - [Lower Bleparoplasty](https://drkahana.com/blepharoplasty/lower-eyelid-blepharoplasty/): Tired eyes? Lower eyelid surgery targets under-eye bags, hollowness & sagging lids for a smoother, youthful look. Learn what to expect & why it works. - [Blepharoplasty (Eyelid Surgery)](https://drkahana.com/blepharoplasty/): Dr. Kahana specializes in functional and aesthetic upper and lower blepharoplasty, double eyelid surgery, and eyelid crease revisions surgery. - [TED FAQs](https://drkahana.com/thyroid-eye-disease/ted-faqs/): Common questions and answers about thyroid eye disease (TED) from expert practitioners. Symptoms, progression, treatment, risks, and more. - [Thyroid Eye Disease (TED)](https://drkahana.com/thyroid-eye-disease/): Understanding thyroid eye disease symptoms, diagnosis, risk factors, and treatment approaches. Everything you need to know about TED, Grave's disease, and more. - [Surgery and Surgical Management](https://drkahana.com/thyroid-eye-disease/surgery/): What is hyroid eye disease surgery? Learn more surgical considerations and treatments, timing, risks, and outcomes. - [In-Office Procedures](https://drkahana.com/cosmetic/in-office-procedures/): With advanced equipment and stringent safety protocols, our in-office procedure room offers patients a unique alternative to traditional hospital settings. - [Videos](https://drkahana.com/resources/videos/): These educational videos will help you better understand the various oculoplastic and orbital surgeries we perform. - [Diet, the Immune System & Thyroid Eye Disease](https://drkahana.com/thyroid-eye-disease/diet-the-immune-system-thyroid-eye-disease/): Diet, the immune system and thyroid eye disease: How diet affects TED, common questions, and what you can do to improve outcomes. - [Scarring Disorders of the Conjunctiva](https://drkahana.com/functional-reconstructive/scarring-disorders-conjunctiva/): Treatments for inflammatory and neoplastic conditions of the conjunctiva, including ocular cicatricial pemphigoid (OCP), Stevens Johnson Syndrome (SJS), Lichen Planus and other lichenoid conditions. - [Neurotrophic Keratitis](https://drkahana.com/functional-reconstructive/neurotrophic-keratitis/): Neurotrophic Keratitis (NK) causes, symptoms, diagnosis, and treatment options. Take control of this rare degenerative disease of the cornea. Request a consultation... - [Cosmetic (Overview)](https://drkahana.com/cosmetic/): Kahana Oculoplastic Surgery specializes in cosmetic surgeries and procedures for facial rejuvenation with a focus on the eyelids, forehead and midface. - [Facial Cosmetic Surgery](https://drkahana.com/facial-plastic-surgery/): Surgical cosmetic procedures for eyelid, forehead, and midface rejuvenation. Schedule your consultation... - [Non-Surgical Cosmetic Procedures](https://drkahana.com/cosmetic/non-surgical/): Dr. Kahana and his team specialize in expert non-surgical procedures and treatments for eye and facial rejuvenation. Schedule a consultation. - [About Our Practice](https://drkahana.com/about-our-practice/): Nationally and internationally renowned for scientific research and innovative surgical techniques, Dr. Kahana and his team are dedicated to helping patients look better, see better, and feel better. - [Droopy Eyelid and Brow](https://drkahana.com/functional-reconstructive/droopy-eyelid-and-brow/): Ptosis repair (levator muscle repair) – internal or external approach. Upper eyelid blepharoplasty. Brow lift – direct or indirect approach. Schedule a consultat - [Corneal Neurotization Surgery](https://drkahana.com/functional-reconstructive/corneal-neurotization-surgery/): Corneal neurotization surgery is a significant advancement in the treatment of corneal anesthesia, offering hope for patients who have suffered from reduced corneal sensation and its associated complications. - [Blepharophimosis Syndrome](https://drkahana.com/pediatric-oculoplastic-conditions-and-services/blepharophimosis-syndrome/): The primary goal of surgical repair of blepharophimosiis is to facilitate normal development of the visual system and to avoid the consequences of neck strain caused by a “chin-up” position (ocular torticollis). - [Dry Eye and Blepharitis](https://drkahana.com/functional-reconstructive/dry-eye-blepharitis/): Understanding the relationship between dry eyes, ocular surface inflammation, and blepharitis are crucial to treating and maintaining ocular surface health. Identify the cause of your dry eyes today... - [Dr. Jane Spadaro, MD, PharmD](https://drkahana.com/our-providers-and-staff/jane-spadaro-m-d/): Dr. Jane Spadaro, MD, PharmD, is a Board-eligible Ophthalmologist, having completed ophthalmology residency at Yale School of Medicine in Connecticut. - [Facial Palsy](https://drkahana.com/functional-reconstructive/facial-palsy/): Surgical treatments for facial nerve palsy for the correction of facial asymmetry. Our expert team can restore both aesthetics and function. Schedule a consultation... - [Tearing and Tear Duct Surgery and Treatments](https://drkahana.com/functional-reconstructive/tearing-and-tear-duct-surgery-treatments/): Surgical and non-surgical treatment of tearing and tear duct disorders. Michigan's most trusted surgical team. Schedule a consultation. - [Eyelid Lesions and Cancers](https://drkahana.com/functional-reconstructive/eyelid-lesions-and-cancers/): Surgical and non-surgical treatment for cancerous and non-cancerous eyelid lesions. Expert oculoplastic and orbital surgery staff. - [Pediatric](https://drkahana.com/pediatric-oculoplastic-conditions-and-services/): We have extensive experience with and passion for pediatric oculoplastic conditions and disorders. Children require a unique approach with specialized skills and tools. - [Orbital Diseases & Disorders](https://drkahana.com/functional-reconstructive/orbital-disease-disorder/): Orbital diseases and disorders can be benign or malignant and include inflammatory, vascular, structural, or neoplastic disorders. See how we can help... - [Eyelid Malpositions](https://drkahana.com/functional-reconstructive/eyelid-malpositions/): Functional and reconstructive surgery to correct eyelid malpositions caused by floppy eyelids, eyelid laxity, previous eyelid surgery, or other abnormalities. - [Functional & Reconstructive](https://drkahana.com/functional-reconstructive/): Restoring function and aesthetic appearance through oculoplastic surgery. Eyelids, orbit, tear drainage system, and surrounding facial structures. - [Preparing for Your Appointment](https://drkahana.com/resources/preparing-for-your-appointment/): First visit? Bring ID, insurance, referrals, medical history, med list, lab results & imaging—help us speed up your thyroid or orbital consult! - [Reviews](https://drkahana.com/reviews/): See why patients choose Kahana Oculoplastic & Orbital Surgery for their surgical and non-surgical management. - [Before & After Gallery](https://drkahana.com/before-after-gallery/): Before and after photos of pediatric, functional, reconstructive, cosmetic, and thyroid eye disease surgical and non-surgical treatments . - [Contact Us](https://drkahana.com/contact-us/): Learn more about how you can Contact Us and schedule a consultation or surgery with the Kahana eye and surgical team. - [Resources](https://drkahana.com/resources/): Our resources include educational videos, articles, what to expect before and after an eye or eyelid surgerical procedure and more. - [Our Providers & Staff](https://drkahana.com/our-providers-and-staff/): The providers and staff at Kahana Oculoplastic and Orbital Surgery are known for their care and concern they show toward their patients before, during, and after each procedure. - [Our Locations](https://drkahana.com/our-locations/): We proudly serve Southeast Michigan with two convenient locations in Livonia and Ann Arbor. - [Home](https://drkahana.com/): Kahana Oculoplastic Surgery, led by Dr. Alon Kahana, provides, exceptional medical and surgical care to patients with disorders of the eyelids, orbit, and lacrimal system. Contact us today. --- ## Posts - [Join Us for the 2025 TED Patient Forum](https://drkahana.com/2025/05/07/join-us-for-the-2025-ted-patient-forum/): Join us for the 2024 TED Patient Forum. Hear form experts and patients on this year's topic: Overcoming Thyroid Eye Disease. - [Choosing a Blepharoplasty Surgeon](https://drkahana.com/2025/03/30/choosing-a-blepharoplasty-surgeon/): For a blepharoplasty, choose a board-certified oculoplastic surgeon—case volume, honest results, and safety first. - [TED Quality of Life and Self-Care Webinar - September 11, 2024](https://drkahana.com/2024/08/21/ted-quality-of-life-and-self-care-webinar/): Join Dr. Alon Kahana, MD, PhD and TED EDU Layla Lohmann for an in-depth webinar on living with thyroid eye disease, managing quality of life... - [Join Us for the 2024 TED Patient Forum](https://drkahana.com/2024/05/31/join-us-for-the-2024-ted-patient-forum/): Join us for the 2024 TED Patient Forum. Hear form experts and patients on this year's topic: Overcoming Thyroid Eye Disease. - [Approach to Facial Cosmetic Surgery](https://drkahana.com/2024/01/16/approach-to-facial-cosmetic-surgery/): Our approach to facial cosmetic surgery is to customize a treatment plan to optimize results for you. Maybe you should have surgery or maybe non-surgical options are more appropriate for you. - [Uses for Botox](https://drkahana.com/2023/12/16/uses-for-botox/): Most people are familiar with the cosmetic applications of botulinum toxin (e.g. Botox, Dysport or Myobloc) – a neuromodulator that helps prevent and treat facial wrinkles. In the medical setting, however, botulinum toxin is also frequently used as a treatment for facial spasms, namely blepharospasm and hemifacial spasms. - [Rise in Styes and Chalazia Amidst the Pandemic](https://drkahana.com/2021/10/16/rise-in-styes-and-chalazia-amidst-the-pandemic/): Styes or chalazia bothering you? Discover causes, pandemic tips, Bruder-mask method & clinic treatments for clear, comfortable eyes. - [Cosmetic Surgery Around The Eyes: What Should You Know?](https://drkahana.com/2019/09/16/cosmetic-surgery-around-the-eyes-what-should-you-know/): The first step of any plastic surgery evaluation is to listen to the goals and priorities of the patient. There is so much misinformation out there so here we share some insights regarding cosmetic surgery around the eyes and what you should know. - [Vitamin D: The Story Behind Our Skin Color](https://drkahana.com/2019/08/16/vitamin-d-the-story-behind-our-skin-color/): I’d like to share information about vitamin D and its role in our health by giving the story behind our skin color. - [Why Do We Sing To Our Babies?](https://drkahana.com/2018/01/16/why-do-we-sing-to-our-babies/): Early brain development depends on critical periods—discover why singing and play unlock kids’ full potential and get easy tips inside. --- ## Videos - [Dr. Alon Kahana on Blepharoplasty](https://drkahana.com/video/dr-alon-kahana-on-blepharoplasty/): Insights on eyelid rejuvenation procedures, reasons patients seek blepharoplasty, anatomical complexities, common diagnostic challenges, and important considerations. - [TED Quality of Life and Self-Care: TED Community Organization Webinar](https://drkahana.com/video/ted-quality-of-life-and-self-care/): Dr. Alon Kahana discusses the many daily challenges faced by thyroid eye disease patients and shares insights and recommendations for self-care. - [Clinical Trials for TED: Tempratumumab and Beyond](https://drkahana.com/video/clinical-trials-for-ted-tempratumumab-and-beyond/): DOWNLOAD PRESENTATION (PDF) This presentation was recorded at the 2024 TED Patient Forum: Overcoming Thyroid Eye Disease Presented by Kahana... - [Non-surgical Management and Risk Factor Control of Thyroid Eye Disease](https://drkahana.com/video/non-surgical-management-and-risk-factor-control-of-thyroid-eye-disease-2/): Learn more about thyroid eye disease. - [Thyroidectomy: When and How?](https://drkahana.com/video/thyroidectomy-when-and-how-dr-hunter-underwood/): Learn more about the early timing of thyroidectomy for hyperthyroidism in Grave's disease and improved biochemical recovery. - [Entropion and Ectropion Repair](https://drkahana.com/video/entropion-and-ectropion-repair/): Considering ectropion or entropion repair? Explore outpatient eyelid surgery, recovery tips, and realistic risks - [External DCR](https://drkahana.com/video/external-dcr/): Suffering excessive tearing? Learn how external dacryocystorhinostomy safely unblocks tear ducts—benefits, risks, recovery timeline. - [Endoscopic DCR](https://drkahana.com/video/endoscopic-dcr/): Endoscopic DCR unblocks tear ducts fast—learn procedure, risks & recovery so tears drain again. Stop irritation; see if surgery’s right for you! - [Eyelid Cleaning Steps for Controlling Blepharitis](https://drkahana.com/video/eyelid-cleaning-steps-for-controlling-blepharitis/): Struggling with red, crusty lids? Our blepharitis guide covers causes, symptoms & daily lid-cleaning hacks to stop itch and stinging - [Management of Dry Eyes and Eye Discomfort in Graves’ Disease](https://drkahana.com/video/management-of-dry-eyes-and-eye-discomfort-in-graves-disease/): Dry-eye discomfort relief made easy: boost natural lubrication with warm compresses, omega-3s & anti-inflammatory care—discover doctor-led steps! - [Patient Thyroid Eye Disease Testimonial: LaQuilla](https://drkahana.com/video/patient-thyroid-eye-disease-testimonial-laquilla/): Learn more about thyroid eye disease symptoms, risks, progression, and surgical and non-surgical management. Transcript: My life started changing in... - [Ptosis Repair Surgery: What you Need to Know](https://drkahana.com/video/ptosis-repair/): Ptosis (Drooping Eyelid) Your doctor has suggested surgery to repair your ptosis (pronounced “toe-sis”). A drooping eyelid, called ptosis, can... - [Oculoplastic Blepharoplasty](https://drkahana.com/video/oculoplastic-blepharoplasty/): American Academy of Ophthalmologists video on oculoplastic blepharoplasty (eyelid surgery). Risks and alternatives to surgery. - [Emotional Impact of Thyroid Eye Disease](https://drkahana.com/video/emotional-impact-of-thyroid-eye-disease/): Dr. Alon Kahaha discusses the emotional impact of thyroid eye disease, an often overlooked aspect of the condition. --- # # Detailed Content ## Pages --- ## Posts > Join us for the 2024 TED Patient Forum. Hear form experts and patients on this year's topic: Overcoming Thyroid Eye Disease. - Published: 2025-05-07 - Modified: 2025-05-07 - URL: https://drkahana.com/2025/05/07/join-us-for-the-2025-ted-patient-forum/ - Categories: Events, Thyroid Eye Disease Date Sunday, June 1, 2025 2:00-6:00pm (doors open at 1:30) Location The Baronette Renaissance Hotel 27790 Novi Rd. Novi, MI 48377 Register Today (Registration is required) Agenda 1:30 – Pre-meeting Social Time 2:00 - Opening Remarks: Alon Kahana, MD, PhD 2:05 – What is Thyroid Eye Disease: Alon Kahana, MD, PhD 2:15 – Methimazole vs. Radioactive Iodine vs. Thyroidectomy: Nadia Khoury, MD 2:25 – Choosing and dosing thyroid medications: Tae-Hwa Chun, MD, PhD 2:35 – Thyroidectomy – When and How? Sapna Nagar, MD 2:45 – Q&A – Drs. Chun, Khoury, Nagar, and Susan Pitt 3:10 – Break (appetizers, snacks, deserts, coffee, tea) 3:30 – Treating the Bulging Eye: Medical and Surgical Options: Alon Kahana, MD, PhD 3:45 – Treating the Double Vision: Amanda Ismail, MD 4:00 – Q&A 4:10 – Patient Panel: Cristy Lee, Latoya Huntington-Smith, and Katie Richer, Moderated by Dr. Kahana 4:45 – Break (appetizers, snacks, deserts, coffee, tea) 5:15 – Clinical Trials for Thyroid Eye Disease - Teprotumumab & Beyond: Jane Spadaro, MD, PharmD 5:25 – Expert Panel Q&A, Moderated by Dr. Kahana 5:55 – Closing Remarks: Alon Kahana, MD, PhD 6:00 - Adjourn Register Today (Registration is required) Faculty Tae-Hwa Chun, MD, PhD: University of Michigan Amanda Ismail, MD: Children’s Eye Care of Michigan; Children’s Hospital of Michigan; Corewell Health Alon Kahana, MD, PhD: Kahana Oculoplastic & Orbital Surgery, Beaumont Medical School Nadia Khoury, MD: Downriver Endocrinology; Corewell Health, Henry Ford Sapna Nagar, MD: Beaumont Hospital Royal Oak, Corewell Health Susan Pitt, MD: University of Michigan... --- > For a blepharoplasty, choose a board-certified oculoplastic surgeon—case volume, honest results, and safety first. - Published: 2025-03-30 - Modified: 2025-06-30 - URL: https://drkahana.com/2025/03/30/choosing-a-blepharoplasty-surgeon/ - Categories: Blepharoplasty Advancements in surgical techniques can address lower and upper eyelid patient concerns as a natural-looking improvement. An important first step in ensuring first-class care is selecting a specialist with advanced training in both ophthalmology and plastic surgery. Oculoplastic surgeons such as Dr. Kahana focus exclusively on the delicate eye area, combining aesthetic expertise with experience in eye health and function. Our surgeons are affiliated with the Oculofacial Society, an exclusive professional society dedicated to plastic surgery focused on the areas around the eye. Members are board-certified ophthalmologists who obtained additional specialized training to become true experts in surgery of the eyelids and eye socket (orbit). An invitation to join the Oculofacial Society ensures that a surgeon meets and maintains the highest standards of oculofacial plastic surgery. We strongly believe in the mantra that "you never have a second chance to do it right the first time. " We are versed in a variety of surgical techniques in order to customize the surgical plan to the patient's particular priorities, to achieve the best cosmetic outcomes and do it right the first time. The true value of this ability is evidenced by the fact that a major part of our practice is devoted to the revision and correction of complications from plastic surgery of the eyelids and face performed elsewhere. We have become "the oculoplastic surgeons of last resort" for patients across the region and country suffering from complex oculofacial conditions and adverse outcomes from cosmetic surgery. Over more than 20 years... --- > Join Dr. Alon Kahana, MD, PhD and TED EDU Layla Lohmann for an in-depth webinar on living with thyroid eye disease, managing quality of life... - Published: 2024-08-21 - Modified: 2025-01-30 - URL: https://drkahana.com/2024/08/21/ted-quality-of-life-and-self-care-webinar/ - Categories: Events, Thyroid Eye Disease Join Dr. Alon Kahana, MD, PhD and TED EDU Layla Lohmann for an in-depth webinar on living with thyroid eye disease, managing quality of life, and the best self-care strategies for managing this devastating disease. Dr Kahana will be addressing these questions and more: Of the physical symptoms associated with TED, which ones do you see as the most disruptive of one’s quality of life and why? Do your patients confide in you about feelings of isolation, depression, and anxiety? If so, how do you counsel them? How would you define self-care and how can we best practice this as TED patients? This is a very innovative time for research into TED. When looking toward the future, what is your hope for TED patients in terms of solutions for this often-devastating autoimmune disease? FREE webinar: Wednesday, September 11, 2024 2:30 PT/3:30 MT/4:30 CT/5:30 Join by Zoom: https://us06web. zoom. us/j/81520618462? pwd=w0f9VUkwRa5K74doyXeaPDH19zgF1x. 1 Meeting ID: 815 2061 8462 Passcode: 2024 For more information on thyroid eye disease surgical and non-surgical management, please click here. Meet Dr. Kahana: https://drkahana. com/our-providers-and-staff/dr-alon-kahana/ The TED Community Organization is comprised of patients, caregivers, medical professionals, and individuals who advocate for those dealing with Thyroid Eye Disease (TED). In essence, a community of individuals who have the shared living experience of TED. Learn more about the TED Community Organization: https://tedcommunity. org/ --- > Join us for the 2024 TED Patient Forum. Hear form experts and patients on this year's topic: Overcoming Thyroid Eye Disease. - Published: 2024-05-31 - Modified: 2025-01-03 - URL: https://drkahana.com/2024/05/31/join-us-for-the-2024-ted-patient-forum/ - Categories: Events, Thyroid Eye Disease Date Sunday, June 30, 2024 2:00-5:30pm (doors open at 1:30) Location The Baronette Renaissance Hotel 27790 Novi Rd. Novi, MI 48377 Register Today (Registration is required) Agenda 1:30 – Pre-Meeting Social Time 2:00 - Opening Remarks: Alon Kahana, MD, PhD 2:05 – What is Thyroid Eye Disease: Alon Kahana, MD, PhD 2:15 – Methimazole vs. Radioactive Iodine vs. Thyroidectomy: Nadia Khoury, MD 2:25 – Thyroidectomy – When and How? Hunter Underwood, MD 2:35 – Q&A 2:45 – Patient Story: Cristy Lee, Host of HGTV Steal This House 3:00 – Break (appetizers, snacks, deserts, coffee, tea) 3:30 – Treating the Orbitopathy - Medicine or Surgery? Brittany Simmons, MD 3:40 – Treating the Double Vision: Rajesh Rao, MD 3:50 – Choosing and Dosing Thyroid Medications: Tae-Hwa Chun, MD, PhD 4:00 – Q&A 4:10 – Patient Story: Latoya Huntington-Smith, Senior Planning Manager, General Motors 4:25 – Break and Small Group Discussions 5:00 – Clinical Trials for Thyroid Eye Disease - Teprotumumab & Beyond: Jane Spadaro, MD, PharmD 5:10 – Expert Panel and Q&A, Moderator: Alon Kahana, MD, PhD 5:25 – Closing Remarks: Alon Kahana, MD, PhD 5:30 - Adjourn Register Today (Registration is required) Faculty Tae-Hwa Chun, MD, PhD: Associate Professor, Endocrinology, University of Michigan Alon Kahana, MD, PhD: Professor & Vice Chair, Beaumont Ophthalmology, Kahana Oculoplastic & Orbital Surgery Nadia Khoury, MD: Downriver Endocrinology, Beaumont, Henry Ford Shravani Mikkilineni, MD: Consultants in Ophthalmic and Facial Plastic Surgery, Beaumont Medical School Rajesh Rao, MD: Children’s Eye Care of Michigan, Beaumont Medical School Brittany... --- > Our approach to facial cosmetic surgery is to customize a treatment plan to optimize results for you. Maybe you should have surgery or maybe non-surgical options are more appropriate for you. - Published: 2024-01-16 - Modified: 2024-01-16 - URL: https://drkahana.com/2024/01/16/approach-to-facial-cosmetic-surgery/ - Categories: Cosmetic As we age, our face changes in predictable ways. The upper eyelids may droop, with fullness and heaviness. The lower eyelids develop “bags” and dark circles. And since the eyes are a window to our soul, it is natural to want your eyes to reflect your youthful soul. Fortunately, we can help restore that more youthful appearance. But it’s important to understand a few things in advance. First, surgical and non-surgical procedures can help you look younger, but if you’re 50, you will not suddenly look 20. In an effort to achieve the unachievable, some people undergo procedures that make them look unnatural. I do not condone that. I will do my best to make you look the best that you can and will work to maximize your natural features. But I make it a priority to achieve a natural-looking result – something that will not look surgical. I want your friends and family to know that you look good, not that you had surgery (unless you tell them). Second, facial appearance follows aesthetic units that relate to one another. For example, the upper eyelids are strongly affected by brow position, and lower eyelid appearance is strongly affected by cheek position. To achieve the best possible result for the upper eyelids, you may need to do something to address brow position. And to achieve the best possible result for the lower eyelids, you may need to address cheek position. Brows and upper eyelids, cheeks and lower eyelids – think of... --- > Most people are familiar with the cosmetic applications of botulinum toxin (e.g. Botox, Dysport or Myobloc) – a neuromodulator that helps prevent and treat facial wrinkles. In the medical setting, however, botulinum toxin is also frequently used as a treatment for facial spasms, namely blepharospasm and hemifacial spasms. - Published: 2023-12-16 - Modified: 2024-01-16 - URL: https://drkahana.com/2023/12/16/uses-for-botox/ - Categories: Cosmetic Most people are familiar with the cosmetic applications of botulinum toxin (e. g. Botox, Dysport or Myobloc) – a neuromodulator that helps prevent and treat facial wrinkles. In the medical setting, however, botulinum toxin is also frequently used as a treatment for facial spasms, namely blepharospasm and hemifacial spasms. In fact, botulinum toxin was first used by ophthalmologists to treat strabismus and facial spasms, far before it was being used for cosmetic applications! Blepharospasm (full name is “benign essential blepharospasm” or BEB), is a disorder that causes uncontrollable eyelid twitching (spasms) or blinking, sometimes making it difficult to open the eyes and therefore perform daily functions such as driving. This is not to be confused with eyelid myokymia, which is the involuntary continuous twitching of an eyelid that is self limited and benign, and often caused by stress or caffeine. Eyelid myokymia often presents unilaterally, or just affecting one side, and BEB is bilateral, affecting both eyes. The true cause of blepharospasm is unknown, but it is most frequently associated with dry eye disease. It can also be associated with weakness of the eyelid-opening muscle (levator muscle), certain medications, or a neurologic disorder called “apraxia of eyelid opening. ” A complete evaluation by a specialist is important to determine whether you have an underlying condition. If you are diagnosed with benign essential blepharospasm, the most common and effective treatment is chemodenervation – weakening of the eyelid closing muscle using botulinum toxin. Botulinum toxin is injected directly into the spasming muscles... --- > Styes or chalazia bothering you? Discover causes, pandemic tips, Bruder-mask method & clinic treatments for clear, comfortable eyes. - Published: 2021-10-16 - Modified: 2025-06-30 - URL: https://drkahana.com/2021/10/16/rise-in-styes-and-chalazia-amidst-the-pandemic/ - Categories: Functional & Reconstructive Have you ever gotten a painful little pimple on your eyelid margin? What about a big red lump on your eyelid? These are called styes (acute infectious process) and chalazia (inflammatory process), which result from blocked up oil glands within the eyelids. In normal healthy eyelids, oil is produced within these glands and contributes to your tear film. When the oil glands get blocked, this leads to decreased oil production and increased likelihood that you will develop an infection or inflammation (stye or chalazia) within the blocked off gland. It also leads to the nuisance of dry eyes! During the pandemic, ophthalmologists saw a rise in the number of patients presenting for styes and chalazia. This has been attributed to mask wear, which creates a humid environment with increased bacteria near the eyes, and increased touching near the eyelids to rub your eyes due to dryness or adjust your mask. Additionally, stress is a component in inflammatory processes, and stress levels have been higher due to the pandemic. Ways that you can prevent styes and chalazia from forming: wash your cloth masks frequently, wear a small piece of tape over the bridge of your nose to prevent air from flowing upward, and use hot compresses on the eyelids for 1-2 minutes at least a few times per week. I recommend the Bruder mask, which is about $20 on Amazon. Remember to apply upward pressure to the lower eyelids immediately after removing the mask to effectively squeegee the liquified oil from... --- > The first step of any plastic surgery evaluation is to listen to the goals and priorities of the patient. There is so much misinformation out there so here we share some insights regarding cosmetic surgery around the eyes and what you should know. - Published: 2019-09-16 - Modified: 2024-01-16 - URL: https://drkahana.com/2019/09/16/cosmetic-surgery-around-the-eyes-what-should-you-know/ - Categories: Cosmetic This month’s theme is “Listen. ” Indeed, we would all do well to be better listeners. In medical practice, much of the diagnostic process relies on good listening skills. In my estimation, 75-90% of a diagnosis is made by listening to the patient, and the final 10-25% comes from a physical exam and various tests to assess and confirm the clinical suspicion. In a cosmetic plastic surgery practice, the first step of any evaluation is to listen to what the patient is aiming to accomplish, and what their priorities are. There is so much misinformation and so many false narratives in the field of cosmetic medicine that I often find myself needing to inform and reeducate patients. In today’s column, I will share some insights regarding cosmetic procedures around the eyes. Chemodenervation (pharmacologically paralyzing a muscle) of facial muscles with botulinum toxin to reduce dynamic wrinkles is among the most common of cosmetic procedures. Botulinum toxin comes in various formulations and brands, including Botox, Dysport and Xeomin. Chemodenervation is minimally invasive and highly effective. Unfortunately, it is also plagued by misinformation. One of the most common is the notion that one should use botulinum toxin “early and often” to “prevent” facial wrinkles. As a result, many young women with nary a wrinkle on their face initiate treatment to chemodenervate their facial muscles. The problem is that if a muscle gets denervated for a length of time, it atrophies. Atrophic facial muscles are a hallmark of facial aging, with crinkly, saggy... --- > I’d like to share information about vitamin D and its role in our health by giving the story behind our skin color. - Published: 2019-08-16 - Modified: 2024-09-11 - URL: https://drkahana.com/2019/08/16/vitamin-d-the-story-behind-our-skin-color/ - Categories: Educational, Cosmetic These are summer days in Michigan, and everyone is out and about, enjoying the sunshine. Michigan is a double peninsula, “upper” and “lower,” surrounded by water. As a result, our skies are often overcast, even in summer. And given our northern latitude, winters are long and sunny days are few. The result is that much of the year, we get little to no sun exposure. Unfortunately, this is associated with chronic vitamin D deficiency in much of Michigan’s population. In this month’s column, I’d like to share information about vitamin D and its role in our health. Vitamin D is a hormone produced by the skin in response to exposure to UV light. It circulates in the blood stream, and when it enters cells, it binds to and activates vitamin D receptor, which is a transcription factor that binds to DNA and regulates gene expression. Vitamin D is widely recognized to be important for bone health and calcium metabolism. A less well-known role is that it is a master regulator of the immune system. It is also involved in metabolism, brain health, cancer surveillance, and many other biological roles – all critical for a healthy body. Vitamin D is so important that over the course of human evolution, it gave rise to the skin color difference among people from different parts of the world. Yes! The skin color difference that gets all that media attention these days – “black,” “white,” and “brown,” – is actually an evolutionary solution to the... --- > Early brain development depends on critical periods—discover why singing and play unlock kids’ full potential and get easy tips inside. - Published: 2018-01-16 - Modified: 2025-06-30 - URL: https://drkahana.com/2018/01/16/why-do-we-sing-to-our-babies/ - Categories: Educational In 1981, Professors David Hubel and Torsten Wiesel won the Nobel Prize for Physiology or Medicine for their pioneering work on the neuroscience of visual processing. This Nobel Prize was the culmination of decades of work that began in the 1950s, when Dr. Hubel first used a tungsten wire (an electrode) to record electrical activity from a single neuron. Next, in the 1960s Hubel and Wiesel collaborated to show that specific neurons were activated by vision from one or the other eye. In these experiments, neuron activities of a kitten’s brain were measured while the kitten was shown various visual stimuli. So what does that have anything to do with why we sing, play with and stimulate babies? Here is where it gets really interesting. In a series of published scientific manuscripts, Hubel and Wiesel revealed that blocking vision in an eye prevented development of the neurons that were supposed to register vision from that eye. Furthermore, if vision was blocked for just a short period, the brain still developed the ability to see out of that eye. But the longer that vision was blocked, the poorer the visual outcome in that eye even after the cover was removed. Until eventually vision would not develop at all – even though the eyelids were reopened and the eyeball itself was completely normal. This is called “neurologic blindness” or amblyopia. These experiments revealed three very important things: (1) the brain is born with the potential to do things such as vision, (2)... --- --- ## Videos > Insights on eyelid rejuvenation procedures, reasons patients seek blepharoplasty, anatomical complexities, common diagnostic challenges, and important considerations. - Published: 2025-03-30 - Modified: 2025-03-30 - URL: https://drkahana.com/video/dr-alon-kahana-on-blepharoplasty/ - Categories: Blepharoplasty Dr. Alon Kahana offers his expert perspective on blepharoplasty (eyelid surgery, eyelid lifts) drawing from years of specialized experience in oculoplastic surgery. He shares his insights on why patients seek upper eyelid rejuvenation and the emotional disconnect many feel between their internal self-image and what they see in the mirror. Dr. Kahana explains the intricate anatomy of the eye area with compelling examples, noting how a drooping brow can be mistaken for excess eyelid skin, and how the "Roman blind effect" plays a crucial role in proper eye function. He candidly discusses revision surgeries, sharing common mistakes other surgeons make when addressing the eyelid crease. Dr. Kahana weaves in thoughtful observations about facial asymmetry, explaining why perfect symmetry isn't the goal and how our dynamic, expressive faces in real life differ dramatically from the "frozen" images we scrutinize in mirrors or photographs. His perspective offers both technical expertise and a refreshing philosophy on natural beauty and aging. Transcript "Dr. Alon Kahana on Blepharoplasty" Patients frequently come to seek our help looking for an "eyelid lift. " And when they say eyelid lift, what they really mean is that they want their upper eyelids to look better. As we get older, our upper lids sag. They sag in a variety of ways. Sometimes the eyelids are just low, and you look kind of sleepy. Sometimes the eyelid skin hoods over the lashes or wrinkles or becomes kind of prominent and fatty. You see, the fat pads, herniating, sometimes the brow drops,... --- > Dr. Alon Kahana discusses the many daily challenges faced by thyroid eye disease patients and shares insights and recommendations for self-care. - Published: 2025-01-30 - Modified: 2025-01-30 - URL: https://drkahana.com/video/ted-quality-of-life-and-self-care/ - Categories: Educational, Thyroid Eye Disease This webinar was recorded on September 11, 2024 as a part of the TED Community Organization's EDU series hosted by Dr. Layla Lohmann. The TED Community Organization is a 501(c)(3) nonprofit dedicated to education and support of patients, caregivers, medical professionals and individuals who advocate for those who affected by Thyroid Eye Disease. Host: Dr. Layla Lohmann, TED Community Foundation Featured Speaker: Dr. Alon Kahana, Kahana Oculoplastic Surgery Living with Thyroid Eye Disease Living with thyroid eye disease (TED) can be very challenging in many aspects that go far beyond just eye health. In this TED Community Organization EDU series webinar, host Layla Lohmann sits down with our own Dr. Alon Kahana, an internationally renowned orbital surgeon, to explore the complex day-to-day aspects of living of TED patients. Dr. Kahana brings a refreshing whole-person approach to treating this debilitating autoimmune condition, addressing not just the physical symptoms but also the emotional, interrelation, social and workplace impacts on patients' lives. From cutting-edge treatments to practical lifestyle guidance, this discussion provides valuable insights for anyone affected by TED, whether they're patients, caregivers, family, friends, or healthcare providers. Dr Kahana Addresses These Questions and More Of the physical symptoms associated with TED, which ones do you see as the most disruptive of one’s quality of life and why? Do your patients confide in you about feelings of isolation, depression, and anxiety? If so, how do you counsel them? How would you define self-care and how can we best practice this as TED patients?... --- - Published: 2024-09-09 - Modified: 2025-01-03 - URL: https://drkahana.com/video/clinical-trials-for-ted-tempratumumab-and-beyond/ - Categories: Thyroid Eye Disease DOWNLOAD PRESENTATION (PDF) This presentation was recorded at the 2024 TED Patient Forum: Overcoming Thyroid Eye Disease Presented by Kahana Oculoplastic & Orbital Surgery June 30, 2024 | Novi, Michigan Jane Spadaro, MD, PharmD Kahana Oculoplastic and Orbital Surgery Dr. Jane Spadaro is a Board-eligible Ophthalmologist. She completed her residency at Yale School of Medicine. Originally from Pennsylvania, Dr. Spadaro earned a dual MD and PharmD degree from Rutgers Robert Wood Johnson Medical School, graduating at the top of her class and inducted into the Alpha Omega Alpha medical honor society. Dr. Spadaro has contributed significantly to her field, authoring numerous papers in peer-reviewed journals like Ophthalmic Plastic & Reconstructive Surgery and Orbit. She also wrote a book chapter on Thyroid Eye Disease for the International Ophthalmology Clinics and has presented at various professional meetings and events, including the ASOPRS annual meeting. SUMMARY: Clinical Trials for TED: Teprotumumab (Tepezza) and Beyond What are Clinical Trials? Clinical trials are studies where patients voluntarily participate in trials of new medical, surgical, or behavioral interventions, to ensure these new interventions are safe and efficacious. In the United States, federal law requires that new medications must be proven safe and effective before becoming commercially available. The NIH (National Institute of Health) and the FDA have strict guidelines for conducting clinical trials. Clinical research and trials can be sponsored by various organizations: Biotech companies Pharmaceutical companies Hospitals Federal agencies Investigative physician initiatives Clinical trials can be conducted in various settings: Universities Hospitals Clinics (e. g.... --- - Published: 2024-08-01 - Modified: 2025-01-03 - URL: https://drkahana.com/video/non-surgical-management-and-risk-factor-control-of-thyroid-eye-disease-2/ - Categories: Thyroid Eye Disease Learn more about thyroid eye disease. --- > Learn more about the early timing of thyroidectomy for hyperthyroidism in Grave's disease and improved biochemical recovery. - Published: 2024-07-24 - Modified: 2025-01-03 - URL: https://drkahana.com/video/thyroidectomy-when-and-how-dr-hunter-underwood/ - Categories: Thyroid Eye Disease DOWNLOAD PRESENTATION (PDF) This presentation was recorded at the 2024 TED Patient Forum: Overcoming Thyroid Eye Disease Presented by Kahana Oculoplastic & Orbital Surgery June 30, 2024 | Novi, Michigan Dr. Hunter Underwood, MD Assistant Professor, Division of Endocrine Surgery, University of Michigan Dr. Hunter Underwood is an assistant professor in the Division of Endocrine Surgery at Michigan Medicine. He completed his general surgery residency at NYU Langone Health and an AAES Endocrine Surgery Fellowship at Michigan Medicine. Dr. Underwood specializes in endocrine surgery, including thyroid, parathyroid, and adrenal procedures, with a particular interest in improving endocrine surgery education to enhance patient outcomes. Summary Early Surgery Benefits: Early thyroidectomy is recommended to prevent thyroid eye disease from worsening and to stabilize thyroid function more rapidly. It also tends to result in fewer complications compared to delayed surgery. Risks and Complications: Risks include bleeding, infection, voice changes due to nerve damage, and calcium regulation issues due to parathyroid gland damage. These risks are higher in patients with Graves' disease. Thyroid Function Prior to Surgery: Previously, perfectly controlled thyroid levels were deemed necessary before surgery to avoid complications. Recent studies indicate that even patients with uncontrolled thyroid levels can safely undergo surgery if performed by an experienced surgeon. Surgical Procedure: The surgery typically results in a visible scar and requires a one-night hospital stay. Recovery is straightforward, with a recommendation to avoid strenuous activity for two weeks and most patients returning to work in one week. Surgeon Experience: It is crucial to... --- - Published: 2024-04-30 - Modified: 2025-01-04 - URL: https://drkahana.com/video/patient-thyroid-eye-disease-testimonial-laquilla/ - Categories: Thyroid Eye Disease Learn more about thyroid eye disease symptoms, risks, progression, and surgical and non-surgical management. Transcript: My life started changing in the 90s because we noticed that my eyes were always swollen. We didn't know what it was. In 2000, I started losing an enormous amount of weight - 100 pounds in less than a month. That's when they discovered that I had what's called hyperthyroidism. I was losing my hair, my nerves were out of whack, my skin complexion had changed - it was like the color of cigarette ashes. Thyroid eye disease - it's like your eyes are full of sand, sand from the beach. That's how dry they are. They get dry, they get teary, and they begin to protrude. They bulge out like you've been shocked by a ghost. Because everything was going on for so long undetected, I had lost the sight in my left eye. I began to rapidly lose sight in my right eye. I never went out. I wouldn't let nobody see me. I covered all the mirrors in the house because I didn't want to see myself. When I walked to the mailbox, the kids used to tease and say "Oh my god, look at the monster. " It was a mental experience that I'll never forget because all I could do was cry. I was told I was never going to see again. I was gainfully employed - I was in property management - but there was no way I could... --- - Published: 2024-04-30 - Modified: 2025-01-06 - URL: https://drkahana.com/video/ptosis-repair/ - Categories: Functional & Reconstructive Ptosis (Drooping Eyelid) Your doctor has suggested surgery to repair your ptosis (pronounced "toe-sis"). A drooping eyelid, called ptosis, can partially or fully cover your eye and block your vision. This usually happens when the muscles that lift your eyelid become weak, stretched, or separated. Sometimes ptosis develops because of nerve damage that affects these same muscles. Impact on Daily Life Ptosis affects both vision and appearance. Droopy eyelids may make you look tired and older than you are. A common sign of ptosis is raising your eyebrows or titling your head back in order to see better. Ptosis repair can provide a better field of vision as well as improve the eye's appearance. The Surgical Procedure Ptosis repair surgery is typically an outpatient procedure done under local antithetic. This numbs the eyelids and relaxes you for the surgery. During surgery to repair ptosis, the eye surgeon will make an incision in the crease of the upper eyelid skin or on the inside of the eyelid where it won't be visible. During surgery, the muscles responsible for raising your eyelid will be addressed. The surgeon will either tighten one of the muscles or reattach it to the upper lid using stitches or surgical adhesive. The technique used will depend on the specific cause and severity of your ptosis. Recovery Period The healing process determines where your eyelid will ultimately rest. Your eyelid may still droop after surgery. It can take a few weeks for your eyelid to reach its final... --- > American Academy of Ophthalmologists video on oculoplastic blepharoplasty (eyelid surgery). Risks and alternatives to surgery. - Published: 2024-04-30 - Modified: 2025-03-30 - URL: https://drkahana.com/video/oculoplastic-blepharoplasty/ - Categories: Blepharoplasty, Cosmetic, Functional & Reconstructive Oculoplastic Blepharoplasty Video Credit: American Academy of Opthamologists Blepharoplasty addresses both functional (upper eyelid) and aesthetic patient concerns. Common reasons for eyelid surgery include sagging upper eyelid skin blocking vision, puffy eyelids, under-eye bags, and impaired field of vision. The surgery is typically an outpatient procedure using local anesthetic, sometimes with possible sedation. Surgical approach varies by location: Upper eyelid: an incision is made within the natural eyelid crease, excess skin is removed, fat is removed or repositioned, and muscles may be modified. Lower eyelid: the incision is made below lower lash line or inside lower eyelid, excess skin is removed, fat is redistributed or removed, and the incision is closed with stitches or surgical adhesive. After surgery it is important to protect your eyes from sun exposure and follow your opthomogists specific recover instructions Potential Risks - Bruising and swelling - Severe dry eye - Incision bleeding - Infection - Pain - Sun sensitivity - Difficulty closing your eyes - Eyelid positioning issues - Scarring - Possible need for revision surgery - Vision changes (temporary or permanent) - Potential blindness - Anesthesia complications Alternative Options - Upper eyelids: Consider eyebrow lift surgery - Lower eyelids: Non-surgical skin treatments available Important Notes - Discuss all options with your ophthalmologist - Ask questions about risks and benefits - Review any concerns about your eyes or vision - Follow all preoperative and postoperative instructions carefully Video Transcript: Your ophthalmologist has suggested an eyelid surgery called blepharoplasty. With this procedure, a surgeon removes... --- > Dr. Alon Kahaha discusses the emotional impact of thyroid eye disease, an often overlooked aspect of the condition. - Published: 2024-03-30 - Modified: 2025-01-04 - URL: https://drkahana.com/video/emotional-impact-of-thyroid-eye-disease/ - Categories: Thyroid Eye Disease Patients aren't alone in their struggles, and the emotional impact of TED is normal and valid. While the condition can be devastating, proper treatment can help patients return to normal life, though some emotional effects may linger. This presentation from Dr. Alon Kahana focuses on the emotional impact of thyroid eye disease (TED), an often overlooked aspect of the condition. While medical and surgical treatments have advanced significantly, the emotional aspects remain understudied and undertreated. Key Points: 1. Thyroid hormone affects nearly every system in the body, including emotional centers in the brain 2. The effects of thyroid dysfunction can persist long after treatment begins, like "a train that doesn't just stop" 3. Physical symptoms have significant emotional impact: - Constant eye discomfort/pain - Changes in appearance leading to social stigma - Vision problems affecting daily activities and employment Case Studies: 1. 38-year-old man: - Personality changes led to job loss - Developed severe eye disease after radioactive iodine treatment - Eventually recovered but remained traumatized 2. 17-year-old girl: - Misdiagnosed with bipolar disorder - Behavioral issues and substance abuse - Successfully treated and recovered, now pursuing nursing Treatment Insights: - Not all patients need surgery - Treatment plans are highly individualized - Standard psychiatric treatments can help with emotional aspects - Group therapy can be beneficial but is often not covered by insurance - The active disease phase typically lasts 1. 5-2. 5 years - Regular monitoring is essential to track disease progression Transcript: I'm going to talk about... --- ---