Oculoplasty, surgery of the eyelids, lacrimal ducts and orbit
Oculoplastics is a sub-specialty of ophthalmology.
It covers the management of all pathologies of the adnexa of the eye, from diagnosis to treatment.
The adnexa of the eye are all the structures around the eye: eyelids, lacrimal ducts, orbit.
These diseases can be degenerative, traumatic, tumour-related, inflammatory, genetic, autoimmune or metabolic.
Dr Bela is one of the few ophthalmologists FMH in Switzerland to specialise in oculoplasty.
The eyelid is made up of different anatomical layers: the skin, the orbicularis muscle to open and close the eye, the tarsal cartilage, the eyelashes and the conjunctiva.
Diseases affecting the eyelids fall into three categories
- The upper eyelid pathologies: ptosis, dermatochalasis
- The lower eyelid pathologies: ectropion, entropion
- Eyelid tumors: benign (for example: chalazion, sty, papilloma, nevus) and malignant (for example: carcinomas).
Sometimes the treatments are medical and a simple ointment will treat these pathologies.
Most often, however, surgery will be the only option to correct, treat or prevent a worsening of the problem. This oculoplastic surgery must be performed by an ophthalmologist specialized in the field of oculoplasty like Doctor Bela.
The tear ducts allow tears secreted by the eye to drain into the nose. Obstruction of the tear ducts causes tearing.
Doctor Bela treats all tear tract pathologies.
Tearing is due to two causes:
- an increased production of tears by the lacrimal gland in reaction to local irritation (blepharitis, trichiatic eyelash, foreign body, malposition of the eyelids).
- an obstruction in the evacuation path of the lacrimal ducts (partial or complete obstruction; congenital or acquired secondary for example to a tumor in the lacrimal sac).
Sometimes the treatments are medical and will treat these pathologies.
Most often, however, a small intervention in consultation or surgery in the operating room will be necessary to treat the problem.
This oculoplastic surgery must be performed by an ophthalmologist specialized in the field of oculoplasty like Doctor Bela.
The orbit is all the tissues contained in the bone cavity that surround the eye, more precisely the eyeball.
Within this non-extensible bone content there are numerous anatomical structures.
- The intraorbital fat to protect the eyeball from direct and indirect trauma.
- Oculomotor muscles to enable eye movements and three-dimensional vision through coordination with the contralateral eye.
- The nerves responsible for all functions of the eye: tearing, dilation and contraction of the pupils, accommodation of the lens, eye movements, opening and closing of the eye through the eyelids.
- Vessels allowing irrigation and oxygen supply of all structures of the orbit, whether the eyeball or the appendages.
Each of these anatomical structures present in the orbit can be affected by diseases. These pathologies can be degenerative, neurological, neuromuscular, vascular, inflammatory, traumatic, metabolic or benign or malignant tumors.
It will be necessary to treat the disease causing this damage and perform surgery if necessary. This oculoplastic surgery must be performed by an ophthalmologist specialized in the field of oculoplasty like Doctor Bela. Our office treats all orbital diseases.
The eye itself can be irreversibly damaged by serious diseases (trauma, infection, tumor, complicated glaucoma).
These diseases can cause permanent blindness, and can be painful and aesthetically disabling in everyday life.
When there is no other alternative, the eye must be removed from the orbit. Depending on the extent, this is called evisceration, enucleation or exenteration. The eye must then be replaced by a prosthesis inside the eye socket. The eye is replaced by a ball that is covered and integrated by the tissues around the eye. An ocular prosthesis is then made by an oculoprosthetist to guarantee a very natural aesthetic result.
Over the years, certain complications can arise: loss of fat volume, ball rejection, prosthesis instability. This necessitates surgical reconstruction of the orbital cavity. Volume loss is compensated for by dermografts, buccal mucosa grafts or lipostructure with lipofilling. This oculoplastic surgery must be performed by an ophthalmologist specializing in oculoplasty, such as Dr. Bela.
How much does eyelid surgery cost?
Dr Bela works with the best clinics in Geneva for your outpatient or private surgery. All to ensure your comfort and safety.
Prices for cosmetic eyelid surgery vary according to the length of the operation and the type of anaesthetic.
The estimate includes surgery, anaesthesia, the entire stay and post-operative check-ups. Each estimate is drawn up individually and discussed in consultation. Cosmetic eyelid surgery starts at CHF 3,500.
In some cases, the upper eyelids are so heavy that they cut off part of the visual field. In such cases, a request for reimbursement by the health insurance scheme may be considered.
What are the risks of blepharoplasty?
The risks associated with blepharoplasty are essentially those related to scarring.
A normal eyelid scar heals in 7 days. After the threads have been removed, the scar will become inflamed, i.e. red, 15 days after the operation. Gradually the scar will become finer and white, so invisible.
The scar may be more inflammatory than normal and remain red or pink for up to 6 months after the operation. It may also be a little thick, in which case it may feel induration to the touch.
The expertise of an ophthalmologist specialising in oculoplasty can protect you from other risks such as retractions, incomplete closure of the eye or asymmetric results.
What is the right age for blepharoplasty?
After the age of 30, the upper eyelids become heavy with the formation of excess skin. Wrinkles are accentuated and dark circles deepen around the eyes. Pockets of fat appear in the lower eyelids. All this contributes to a tired look and a sad face. The treatment consists of reducing these signs of aging around the eyes by cosmetic surgery of the upper and lower eyelids or blepharoplasty. This will sometimes be combined with aesthetic medicine treatments. Any intervention must be combined with a healthy lifestyle to prolong the result: sunscreen and daily moisturizer, smoking cessation, restorative sleep and a balanced diet.
How to know if you need blepharoplasty
With age the look becomes heavy and sad. For what ? There are 5 anatomical levels in the face: bone, deep fat, muscle, superficial fat and skin. Around the eye, the bone called the orbit widens, the fat atrophies and the muscles freeze. Thus the eyebrow lacks support and descends gradually. The eyebrow that becomes heavier will exert additional weight on the eyelids. These also show slackening of the skin and its elasticity, which will gradually lead to visible excess skin. Finally, the levator muscle of the upper eyelid is sometimes deficient with age or linked to a disease. This is called ptosis. This leads to an eye opening that is too small with an eyelid that appears too low and an eye that is too closed. Cosmetic eyelid surgery or blepharoplasty therefore consists of lifting the eyebrow and the eyelids to restore radiance to the eyes. If necessary, an associated gesture on the levator muscle of the upper eyelid is performed to allow sufficient and natural opening of the eye and restore symmetry to your gaze.
What is oculoplasty?
Oculoplasty is a subspecialty of ophthalmology. It includes the management by your ophthalmologist of all pathologies of the appendages of the eye, from diagnosis to treatment. The appendages of the eye are all the structures around the eye: eyelids, lacrimal passages, orbit. Doctor Bela is one of the rare FMH ophthalmologist in Switzerland to be a specialist in oculoplasty. Our center is at your service to answer your questions by telephone or if you wish to make an appointment for a consultation.