RECONSTRUCTIVE SURGERY

Dr. Callahan has specialized training in surgery of the eyelids and its surrounding tissues including reconstructive eyelid surgery, surgery of the lacrimal (tearing) system and eye socket (orbital) surgery.

 

Eyelid Reconstruction

Reconstructive surgery of the eyelids is performed to correct significant aging change that impairs visual function or threatens the health of the eye. It also includes surgery to reconstruct defects left by skin cancers, to restore changes that occurred following medical conditions such as thyroid disease or bell’s palsy, and to repair wounds created in the setting of trauma. Dr. Callahan’s specialized training in surgery of the eyelids and its surrounding tissues allows her to achieve optimal results.

 

Ptosis

Drooping of the upper eyelids is a common change with aging and usually occurs as a result of the muscle that lifts the eyelid slipping from its connection to the upper eyelid. A thorough evaluation is needed to exclude other medical causes of drooping eyelids, to evaluate the degree of visual impairment, and to determine the most appropriate surgical approach. Few facial plastic surgeons perform this type of surgery due to the complexity and experience needed to achieve optimal results in this area.

 

Ectropion/Ectropion

A normal position of the eyelids is required to ensure the health of the eye and proper tear drainage. When the eyelids are malpositioned, the eyes can become dry, irritated, watery and prone to infections.

Ectropion is an outward turning of the eyelid, and while it occurs most commonly in the lower eyelid, it can also occur in the upper eyelid. Entropion is an inward turning of the eyelid and also most commonly occurs in the lower eyelid.

A thorough evaluation is needed to identify the exact cause of the eyelid malposition (frequently, but not always, aging), evaluate any damage to the eye itself, and to determine the best surgical approach to restore the eyelid to its normal position.

 

Eyelid Lesions

Many different types of benign and cancerous lesions can grow along and around the eyelids. Dermatologists and ophthalmologists often recommend that these be evaluated and removed by a subspecialist such as Dr. Callahan who is trained in surgery around the eyelids in order to maintain and protect proper eyelid positioning.

 

Skin Cancers

As with any other exposed area of skin, the eyelids and surrounding tissue are a common location for skin cancers to arise. Treatment includes complete removal of the lesion followed by reconstruction. Dr. Callahan often works in collaboration with a dermatologist who specializes in Mohs surgery for the removal of the lesion. Once the lesion is removed, Dr. Callahan reconstructs the eyelid and/or surrounding area. Particularly in the area around the eyes, reconstructions require advanced training due to the delicate nature of the eyelids and their importance in maintaining the health of the eye. Dr. Callahan’s extensive training in this area allows her to maintain proper functioning of the eyelid while providing as natural a result as possible.

 

Other Eyelid Malpositions

The eyelids can become malpositioned due to several underlying medical conditions, including thyroid disease, weakness of the seventh cranial nerve, and blepharospasm/hemifacial spasm. Dr. Callahan is trained to evaluate, treat and correct these malpositions.

 

Lacrimal (Tearing) System

Tearing can be caused by a number of disorders. Some of these are “reflexive,” meaning that they occur in response to an irritation, dryness or allergic response. These types of disorders are best treated by an ocular surface specialist. However, sometimes tearing occurs due to poor drainage which can be caused by eyelid malposition, a small opening to the tear drainage system (punctal stenosis), or a blockage of the tear duct itself. In these cases, a procedure performed by a specialist such as Dr. Callahan, may improve symptoms. A careful evaluation is needed to determine if any of these “outflow” disorders may be contributing to the tearing and whether a procedure is indicated.

 

Orbital Surgery

The orbit is the bony socket that contains the eye and its associated tissues. Numerous disorders can occur in the orbit including tumors, thyroid disease, inflammatory conditions, trauma and infection. Careful evaluation is more involved and usually requires special imaging studies of the area such as an orbital CT or orbital MRI. If you are seeing Dr. Callahan for an orbital problem and have already had imaging of your head or orbits, please obtain and bring with you a CD copy of your scan in addition to the written report for Dr. Callahan to view at your appointment.

Orbital procedures offered by Dr. Callahan include:

  • Orbital decompression

  • Surgical diagnosis or treatment of orbital tumors

  • Enucleation/Evisceration

  • Eye socket reconstruction

  • Orbital fractures