Looking for Eyelid Surgery in Ann Arbor?
Dr. Kahana offers a customized approach to various eyelid surgeries. Please continue reading below to learn more about the eyelid surgery options available to you in Ann Arbor, Michigan.
Droopy eyelids can make it difficult to keep your eyes open, giving you a sleepy appearance and potentially interfering with vision. For good vision, the margin of the upper eyelid – the location of the lashes – should easily clear the pupil (dark circle in the middle of the iris). Peripheral vision is most affected by droopy eyelids, making it harder, even dangerous, to drive. When working on a computer, droopy heavy eyelids can make staring at the screen very challenging. And when reading, droopy eyelids may drop further to cover part of the pupil, making reading difficult.
There are three causes of droopy eyelids: (1) weakness of the muscle that opens the eyelid (levator palpebrae superioris), (2) excess eyelid skin, and (3) mechanical brow drooping. When the drooping is caused by weakness of the levator muscle, it is referred to as “true ptosis” (the first ‘p’ of ‘ptosis’ is silent). When the brows are very droopy causing mechanical brow ptosis, they press on the upper eyelid skin and cause it to bunch up, giving the appearance of even more excess eyelid skin (dermatochalasis).
A customized approach to droopy upper eyelids requires a complete eye exam, including assessment of eyelid muscle function as well as skin height and brow position. The goals of treatment depend on whether your primary concern is functional (i.e. vision is affected) or cosmetic. Of course, ALL eyelid surgery must be performed aesthetically, and Dr. Kahana is an expert in optimizing the appearance as well as the function of upper eyelids, with a focus on brow-eyelid crowding, eyelid crease, eyelid platform, and lash position.
The lower eyelids are not nearly as mobile as the upper eyelid, but they are more susceptible to the effects of gravity. There are many conditions that affect the lower eyelids:
- Ectropion: the eyelid is turned outward. This is usually caused by laxity of the ligaments and tendons that keep the lid in good position.
- Entropion: the eyelid is turned inward, causing the lashes to rub against the cornea and conjunctiva, causing pain, irritation, redness and discharge.
- Baggy lower eyelids: with age and certain genetic predispositions, orbital fat can herniate, giving the lower eyelids a “baggy” appearance. This often also involves descent of the cheeks, hollowing of the junction between the cheek and lower eyelid, and lateral laxity of the eyelid.
- Lower eyelid retraction: Retraction of the lower lids can be cause by many factors, including laxity, mechanical/gravitational pull, loss of tissue (from prior surgery or trauma), and medical conditions such as thyroid eye disease.
Repair of lower eyelid malposition is among the more complex of oculoplastic procedures. The goals are (1) to restore eyelid position in order to protect the eye, and (2) improve the appearance of the eyelid. Cosmetic lower eyelid surgery frequently involves removing or repositioning herniated orbital fat and tightening the muscles and ligaments of the lower eyelid. In addition, elevation of the cheeks can improve appearance by smoothing the transition between the eyelid and cheek. Excision of excess skin is usually not needed, and any excision must be performed carefully and conservatively in order to avoid complications such as lower eyelid retraction. As the ‘go-to’ surgeon for correcting eyelid surgery complications in patients from throughout the Midwest, Dr. Kahana is particularly experienced with avoiding complications.