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Reconstructive Facial Surgery

Oculofacial plastic surgeons, also known as oculoplastic specialists, are experienced in facial reconstruction to restore eyelid and lacrimal (tear drainage) function. The most common reasons for reconstruction include correction of defects after removal of skin cancer of the eyelids or tear duct and restoring facial appearance after thyroid eye disease or injuries to the brow, eyelid, and orbit. Dr. Douglas Casady and Dr. Audrey Ko at Wolfe Eye Clinic look forward to assisting you through the process to making the best choice for your vision and appearance.

Reconstruction After Mohs Removal of Eyelid Tumors

Reconstructive facial surgery is necessary after removal of eyelid tumors. The most frequent skin cancers that affect the eyelids are basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and sebaceous cell carcinoma. There are many important structures around the eyelids, such as the tear drainage duct and the eye itself, so it is important that you have a qualified oculoplastic surgeon to work closely with your Mohs surgeon. The oculofacial plastic surgeons at Wolfe Eye Clinic work frequently with Mohs surgeons to ensure precise clearance of the skin cancer while preserving as much of the normal non-cancerous tissues as possible. After the cancer is removed by the Mohs surgeon, the oculofacial plastic surgeon then reconstructs the eyelid and surrounding areas to restore eyelid function and appearance.

Eyelid Reconstruction After Facial Trauma

Oculofacial plastic surgeons frequently repair injuries of the eyelid due to recent or old trauma. Dr. Douglas Casady and Dr. Audrey Ko are highly skilled and have advanced fellowship training to provide positive outcomes when treating facial trauma. Common causes of trauma that are frequently repaired by an oculofacial surgeon at Wolfe Eye Clinic include:

Eyelid lacerations – trauma to the eyelids can result in partial thickness or full thickness injuries. Careful reconstruction of the layers of the eyelid by an oculofacial surgeon are required for prevention of scarring complications that can pull the eyelids away from the eyeball. 

Canalicular (tear drainage duct) lacerations – trauma to the eyelids, especially dog bites, often result in damage to the tear drainage system located on the upper and lower eyelids. When this occurs, repair and stenting of the damaged tear drainage duct is recommended within one week of injury to prevent irreversible scarring that may result in lifelong tearing.

Scar revision – a severe trauma involving the face may result in extensive scarring. These types of scars may pull the eyelids away from the eyeball, causing abnormal eyelid positions such as cicatricial ectropion, cicatricial entropion and cicatricial retraction. The scars from these injuries can be revised with surgical scar revision or injection of anti-scarring medications by an oculofacial surgeon to allow the eyelid to return to its normal position.

Reconstruction after facial nerve palsy or Bell’s palsy – damage to the facial nerve can cause problems with eyelid closure, causing the eyeball to feel dry and painful. Oculofacial plastic surgeons frequently perform reconstructive surgeries on these patients, including lifting a drooping forehead and eyebrow, restoring blinking by implanting a gold or platinum weight in a retracted upper eyelid, and raising a drooping lower eyelid.

Eyelid Reconstruction after Thyroid Eye Disease (TED) or Graves Ophthalmopathy

Oculofacial plastic surgeons play a key role in the diagnosis and treatment of Thyroid Eye Disease (also known as Graves Ophthalmopathy). Medical management includes coordination of steroid therapy, orbital radiation therapy and TEPEZZA ® (teprotumumab). Surgical management includes upper and lower eyelid retraction repair and orbital decompression surgeries.

Medical and Surgical Treatment of Benign Essential Blepharoplasty (BEB) and Hemifacial Spasms (HFS)

Oculofacial plastic surgeons are one of the main injectors of neurotoxin (Botox®, Xeomin® or Dysport®) to control spasms around the eyes. In patients who require large doses of neurotoxin, myectomy surgery (removal of a portion of the muscles causing the eyelids and brows to spasm) can also be considered to decrease the interval between injections and the number of units needed.

Find an Eyelid or Facial Reconstructive Surgeon in Iowa

Wolfe Eye Clinic offers eyelid and facial reconstructive specialists in Iowa who are here to answer any questions you may have. Our fellowship trained oculoplastic surgeons, Dr. Douglas Casady and Dr. Audrey Ko are dedicated to maintain the functionality of the eyes and offer eyelid surgery consultations at our Ankeny and Des Moines clinics. The oculofacial surgeons at Wolfe Eye clinic can help assess the needs for your condition at a clinic consultation. To request an appointment, fill out our form here or give us a call at (833) 474-5850.