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Blepharoplasty (eyelid lift) & Brow Lift


 

Your eyes are often the first things that people notice about you, and are an important aspect of your overall appearance. Young eyelid skin is smooth, but over time, the eyelid skin stretches, the fat bulges, and the muscles weaken. The eyebrows may also droop and sag (a condition called brow ptosis). Age, heredity and sun exposure all contribute to this process. Loose or baggy lids detract [Tom your overall appearance and make you look tired or older. When the brow droops, it crowds more skin down over the upper lids and exaggerates the hooding and crow's feet at the outer corners of the eyes, making you look sad, tired, or angry. When severe enough, the upper eyelid skin may bang over the lashes and obstruct peripheral vision.


Blepharoplasty

Surgery to improve the appearance of the eyelids is called blepharoplasty. The goal of blepharoplasty is to give the eyes a more youthful look by removing excess skin, bulging fat, and lax muscle from the upper or lower lids. If the sagging skin obstructs peripheral vision, blepharoplasty can eliminate the obstruction and expand the visual field.

Excess skin and fat are removed from the upper lid through an incision hidden in the natural eyelid crease. If the upper lid is droopy, the muscle that raises the lid can be tightened. The incision is then closed with fine sutures.

Fat in the lower lid can be removed or repositioned through an incision hidden on the inner surface of the lid (transconjunctival blepharoplasty). Laser resurfacing or a chemical peel can be performed at the same time if desired, to smooth and tighten the lower lid skin. If there is excessive skin in the lower lid, the incision is made just below the lashes. Fat can be removed or repositioned through this incision,and the excess skin is removed. The incision is then closed with fine sutures.


Brow Lift

Blepharoplasty will not elevate a drooping brow or remove wrinkles in the crow's feet area. A procedure to elevate the brows may be appropriate, instead of, or in addition to upper lid blepharoplasty. Correction of mild to moderate brow ptosis can be accomplished through incisions directly above the brows, in the forehead creases, or at the hairline. These techniques are most effective if the brow ptosis involves predominantly the central area of the forehead.

For more significant amounts of brow ptosis, or to address deep frown lines or lateral hooding of the upper lids, it may be necessary to raise the brows and forehead through incisions behind the hairline, The endoscopic brow lift is performed through small incisions hidden behind the hairline, using all endoscope and special instruments. The muscles that pull the brow down and crease the forehead skin are relaxed, allowing the brow to be raised into a more youthful position. A coronal brow lift can achieve the same results through a larger incision well behind the hairline.


After Surgery

Cold compresses are applied to reduce swelling and bruising. Antibiotic ointment or drops may be prescribed. Strenuous activity should be minimized for several days. Warm compresses may be recommended after several days to increase blood flow to the area and promote healing. Discomfort is generally mild. Non-aspirin pain relievers are usually all that is necessary postoperatively. Aspirin products, non-steroidal anti-inflammatory medications like ibuprofen, and other blood thinners should be avoided before and after surgery as they may increase the risk of bruising and bleeding. Most patients are able to return to regular activities within several days.


What are the risks and complications?

Excessive pain, bleeding, infection, or visual loss is extremely rare. As with any medical procedure, there may be other inherent risks that should be discussed with your surgeon.


Is surgery effective?

Blepharoplasty and brow lift surgery can provide both a more youthful appearance and functional improvement with minimal risk.



Copyright: ASOPRS

For questions, contact Swaraj Bose, MD

Meet Dr. Swaraj Bose, MD


Click here for Dr. Bose's CV

Dr. Swaraj Bose is a leading neuro-ophthalmologist, orbital surgeon and strabismus specialist serving patients in Beverly Hills and Culver City area, providing the best care for a broad array of conditions, including complex and specialty issues such as optic neuropathies, lacrimal disorders, eyelid disorders, cranial nerve palsies and ocular diseases. As an accomplished surgeon and research scientist, Dr. Bose works closely with patients to determine the best course of care for optimal outcomes, even in the most complex cases. His advanced skills and expertise combined with a personal, compassionate approach help patients feel confident in the medical and surgical care they receive, and he is committed to taking time with each patient to ensure every question and concern is completely addressed.

After receiving his bachelor of science degree in zoology at Delhi University, Dr. Bose completed his medical degree at All India Institute of Medical Sciences in New Delhi and an internship and residency in general medicine and ophthalmology in India. Upon his arrival in the U.S., he completed an additional internship in internal medicine at the Veterans Administration Hospital and New York University Medical Center, and a residency in ophthalmology at New York University Medical Center. In addition, Dr. Bose has completed fellowships in neuro-ophthalmology, neuroplastics and orbital surgery (Doheny Eye Institute University of Southern California – Los Angeles), neurovascular neuro-ophthalmology (New York University Medical Center and New York Eye & Ear Infirmary), and glaucoma research and visual psychophysics (Scheie Eye Institute, University of Pennsylvania).

In addition to his private practice, Dr. Bose is an associate professor of ophthalmology and neurology at the University of California, Irvine, and an attending physician at Cedars Sinai Medical Center. He has received several awards and accolades, including Best Doctors in America, America’s Top Ophthalmologists, Castle-Connolly’s Best Doctor in Southern California and Physician of Excellence Award (OCMA). In addition, Dr. Bose has held several university research and teaching positions, has served as principal and co-investigator on numerous NIH-funded clinical studies, and has been widely published.

 

"Providing Professional & Compassionate Eye Care"

What we offer

Services

Awards & Associations
  • Best Doctors in Orange County, Orange Coast Magazine
  • Best Doctors in America
  • Fellow, North American Neuro-Ophthalmological Society
  • Achievement Award 2015, American Academy of Opthalmology
  • America's Top Opthalmalogist

For a full list of Dr. Bose's awards and affiliations, view his CV here.

What is a Neuro-Opthalmologist?

Neuro-ophthalmologists take care of visual problems that are related to the nervous system; that is, visual problems that do not come from the eyes themselves. We use almost half of the brain for vision-related activities, including sight and moving the eyes. Neuro-ophthalmology, a subspecialty of both neurology and ophthalmology, requires specialized training and expertise in problems of the eye, brain, nerves and muscles. Neuro-ophthalmologists complete at least 5 years of clinical training after medical school and are usually board certified in neurology, ophthalmology or both.

Although some problems seen by neuro-ophthalmologist are not worrisome, other conditions can worsen and cause permanent visual loss, or become life threatening. Sometimes the problem is confined to the optic nerve or the nervous system and other times it is related to a general medical condition. Neuro-ophthalmologists have unique abilities to evaluate patients from the neurologic, ophthalmologic, and medical standpoints to diagnose and treat a wide variety of problems. Costly medical testing is often avoided by seeing a neuro-ophthalmologist.

Some of the common problems evaluated by neuro-ophthalmologists like Dr. Bose include:

What Does an Orbital Surgeon Do?

In addition to neuro-opthamology, Dr. Bose is also trained in orbital surgery. Orbital surgeons are specially trained to diagnose, treat and perform surgery on the supporting tissues surrounding the eye including eyelids, contents and the bony structure of the eye socket or orbit.

Some common adnexal and orbital diseases treated are:

Dr. Bose also specializes in the assessment and management of eye movement disorders resulting in double vision resulting from paralysis of eye muscles, and scarring of eye muscles from thyroid eye disease by giving prisms and performing surgery if necessary.

 

Modern tests offered at NEOi

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We are pleased to offer the most advanced technological options for our patients at NeuroEyeOrbit Institute!

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What to Expect on Your First Visit

Before your neuro-ophthalmology exam, we ask that you please read the following instructions so you know what to bring and what will happen during the visit. We also recommend that you arrange for transportation home after the exam as your eyesight will be blurry. 

If you have any questions or concerns, please call the office and we'll be happy to assist you. 

Preparing for the Neuro-Ophthalmology Examination:

  1. Request that your treating physicians send all relevant information to us prior to your appointment, including office notes, results of laboratory tests, visual fields, OCTs, retina pictures, and reports of CT and MRI scans.
  2. If you have had a CT or MRI scan performed, arrange to pick up the actual films or a copy in a CD/DVD and bring them with you at your appointment.
  3. You will probably have your pupils dilated during the visit. The eye drops last about 4 hours and will make things look bright and blurry up close. Have someone else drive you to the appointment and bring your sunglasses.
  4. Ladies, in order for the physician to get a good look at your eyelids and to avoid ruining your appearance when the eye drops are administered, do not wear eye makeup.
  5. Bring a complete list of medications with you, including the name and dosage of prescription and over-the-counter medications. 

What happens during the evaluation?

  1. The neuro-ophthalmologic evaluation is one of the most comprehensive examinations you will experience. It may take a few hours to complete. You will be asked to give an account of your current problem and relate your entire medical history, including previous hospitalizations, operations, serious illnesses, medical problems in your family members, and medication allergies.
  2. You will have a complete eye examination. This may include testing of your peripheral vision (visual field test), taking pictures of your eyes and your optic nerves (HRT/OCT), and Ultrasound of your eyes.
  3. You may have a partial or complete neurologic exam to test your strength, sensation, and coordination.
  4. The neuro-ophthalmologist will review the records and scans from previous evaluations, if applicable.
  5. After the examination, the neuro-ophthalmologist will discuss the diagnosis (or possible diagnoses), the need for any additional testing and possible treatment. 
Patient Forms for NeuroEyeOrbit Institute (NEOi)

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Please download the Registration Forms to complete and bring with you to your appointment. 

Click here to access the patient portal.

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Patient Portal

We are pleased to provide patients with secure, 24/7 access to their health records through Dr. Swaraj Bose's Patient Portal. Patients can safely and easily:

  • Request prescription refills
  • Update insurance/demographic information
  • Review financial statements/make secure payments
  • View lab and test results
  • Access relevant health education materials

Patient Portal Login

Major Insurance Providers Accepted

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For questions regarding your specific insurance plan, please contact the office.

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Aetna
Anthem Blue Cross Blue Shield
Anthem Blue Cross of California
Assurant Health
Cedar Sinai Medical Group
Cigna
Health Net
Healthcare Partners
Medicare
Motion Picture Industry Health Plan
Railroad Medicare
Screen Actors Guild
Tricare
UnitedHealthcare
Universal Healthcare
Worker's Compensation

Welcome to NeuroEyeOrbit Institute (NEOi)!

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We are pleased to announce our new location at Cedars Sinai Medical Towers!

We are now seeing patients at Cedars Sinai Medical Towers, East Tower, 8631 West 3rd Street, Suite 200E, Los Angeles, CA 90048.

I am very pleased that you have visited my website and very excited to see you!

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Location

NeuroEyeOrbit Institute
8631 West 3rd Street, Suite 200E
Cedars Sinai Medical Towers

Los Angeles, CA 90048
Phone: 310-469-9080
Fax: 310-469-9085

Office Hours

Get in touch

310-469-9080