Dr. Moloney is a fellowship trained eyelid surgeon, proficient in many types of eyelid procedures. These may range from reconstruction of the lids after removal of tumours to elective procedures to restore or rejuvenate the ageing lid.
Perhaps the most common eyelid procedure is called a blepharoplasty. It is done to correct the puffiness, sagging and drooping of upper eyelids. It is also used to remove excess skin and bags under the lower eyelids. Blepharoplasty improves the appearance of your eyelids and the area around it to give you a younger and more relaxed look.
You are a surgical candidate if you are healthy and not suffering from any chronic or life threatening disease conditions and are a non-smoker. Risks increase for people with diabetes, dry eyes, glaucoma, high blood pressure, thyroid problems, heart and vascular diseases. If you are on blood thinning medication this may need to be ceased prior to surgery. If it is required for an abnormal heart rhythm, prior history of stroke or blood clot or to keep cardiac stents open it should not be ceased. Your GP will be involved in this decision.
During the procedure you will be administered either local anaesthesia and sedation or general anaesthesia as felt appropriate by your surgeon. The incision on the upper eyelid is made such that after the procedure the scars are hidden in the natural creases of the upper eyelid. The fat or the extra skin is removed. For lower eyelids the incision is either made just below the lower lash line or inside the lower eyelid. The excess skin is removed and/or the fat may be removed or redistributed as required. The incisions are closed with sutures, surgical tape or skin adhesives. Medications and ointment are prescribed to help with faster healing and to prevent infection after the procedure. You may prefer to wear sun glasses until healing is complete.
Risks occur rarely but may include infection, scarring, temporary blurred vision or double vision and dry eyes. Loss of vision may occur in very rare cases.
The swelling and bruising seen after the procedure goes away in a few weeks. The scars of the incisions fade away in a few months to reveal well-defined smooth eyelids. The aim of the surgery is to relieve upper lid heaviness, open up your peripheral visual field and give you a rejuvenated eyelid appearance.
Drooping of the upper lid is referred to as ptosis. It can occur for many reasons including malformation during birth, problems with nerve supply to the eyelid or diseases of the eyelid muscle itself. By far the most common cause is simply stretching of the tendon that lifts the eyelid over time.
Most forms of ptosis can be corrected by advancing the tendon that lifts the eyelid back into its natural position. This can be achieved with a day surgery procedure. The surgery results in bruising and swelling that can take some weeks to subside. 1 in 10 cases may require a later adjustment to the same or the fellow eyelid to achieve the best possible symmetry.
Eyelid tumour removal and reconstruction
Skin cancers may occur anywhere on the body including the eyelids. Depending on the type of skin cancer a large or small amount of tissue may need to be excised from the lid to clear the tumour. This leaves a defect in the lid that requires reconstruction. Reconstruction is achieved through rotation or sliding of adjacent tissue (flap) or excision of tissue from another site and placement in the defect (graft).
Ectropion is the term for an eyelid that is rolled outwards. This occurs because of a pulling force on the cheek, typically from a scar (cicatricial ectropion), laxity of the supporting tendons (involutional), damage to the nerves that close the eyelid (paralytic) or from a dragging force created by a lump on the eyelid (mechanical).
Each cause of ectropion is treated differently. The most common procedure will involve tightening the eyelid at its outside corner. A cicatricial ectroion will require addition of skin to the lower lid with a flap or graft.
Entropion is the term for an eyelid that is rolled inwards. This most commonly occurs due to laxity of the tendons that hold the lid in place. This can create a scratchy feeling as the lids are closed due to rubbing of the lashes against the eyeball. It is preferable to correct an entropion promptly, as continued scratching of the lashes can lead to ulceration and infection.
Dr Moloney is licensed to administer Botox (TM) for medical and cosmetic purposes.