At Longwood Eye & LASIK Center, our oculoplastic specialists combine advanced surgical expertise with a deep understanding of ocular anatomy to deliver exceptional care. Led by Dr. Vamsee Neerukonda and Dr. Aaron Fay, our team offers comprehensive solutions for both functional and cosmetic concerns affecting the eyes and surrounding areas.
Our Oculoplastic Services
Blepharoplasty (Eyelid Surgery)
Blepharoplasty, or eyelid lift surgery, is one of the most transformative procedures we offer. This surgical procedure addresses the signs of aging that affect the eyelids, helping patients look refreshed and years younger.
During the Blepharoplasty procedure, an oculoplastic surgeon removes excess, sagging skin from the upper eyelids and targets fat pads and loose skin on the lower eyelids. Patients may choose upper eyelid surgery, lower eyelid surgery, or both, depending on their aesthetic goals and functional needs.
The blepharoplasty procedure can help improve:
- Droopy upper eyelids that may impair vision
- Loose, saggy skin on the upper eyelids
- Puffiness and bags under the eyes
- Dark circles on the lower eyelids
- Wrinkles and fine lines around the eyes
Patients who undergo blepharoplasty typically achieve a noticeably refreshed appearance and often look years younger than before surgery.
Who Is a Good Candidate for Blepharoplasty?
Ideal candidates are men and women in good general health with realistic expectations. During your consultation, our oculoplastic surgeons will evaluate your concerns and confirm whether blepharoplasty is the appropriate solution.
What Happens During Blepharoplasty?
Both upper and lower blepharoplasty surgeries are precise, outpatient procedures performed under local anesthesia with optional oral or IV sedation. The process involves:
- Marking areas of excess tissue on the eyelid
- Removing tissue through small, strategically placed incisions
- Repositioning fat when necessary to correct puffiness
- Closing incisions with minimal, nearly invisible sutures
Incisions are typically hidden in the eye’s natural crease for upper eyelids, or along the lash line for lower eyelids, ensuring scarring is virtually undetectable.
Most patients experience mild swelling, bruising, and tenderness for the first week to 10 days. While you’ll notice improvements immediately, final results become apparent once swelling subsides, typically within several weeks to months.
BOTOX: Functional and Cosmetic Treatment
BOTOX has become one of the world’s most recognized names in cosmetic treatment for reducing facial wrinkles. Now, BOTOX injections are the most popular cosmetic procedures performed worldwide.
BOTOX Cosmetic is made from botulinum toxin type A. When injected into targeted muscles, it blocks nerve signals that cause muscle contractions. Without these contractions, dynamic wrinkles on the skin surface don’t form or are significantly reduced. Results last approximately four to six months.
What Can BOTOX Treat?
BOTOX is effective for dynamic wrinkles on the upper third of the face, including:
- Crow’s feet around the eyes
- The “11s” between the brows
- Forehead wrinkles
Beyond cosmetic applications, BOTOX also treats functional conditions, such as blepharospasm (eyelid twitching).
Blepharospasm (Eyelid Twitching) Treatment
Blepharospasm is an abnormal, involuntary, and forceful closure or twitching of the eyelids. While benign, this condition can be severely disabling, causing eye pain and even functional blindness in severe cases.
Treatment with BOTOX
Botulinum toxin (BOTOX) has proven highly effective for treating blepharospasm. The treatment works by relaxing the overactive muscles causing the spasms. Due to nerve regeneration, repeat injections are typically needed every four to six months to maintain relief.
Brow Lift
As you age, the brows can sag, creating an appearance of tiredness or anger. Severe sagging can even impact vision. A brow lift restores a more youthful, alert appearance by lifting the brows and smoothing forehead wrinkles.
Our preferred method is called an endoscopic brow lift, which utilizes three to five small incisions near the hairline. An endoscope (a thin camera) allows visualization beneath the skin while specialized instruments lift and reposition tissues. This technique offers excellent results with minimal scarring.
For more severe cases, a traditional approach uses a longer incision hidden within the hairline, allowing for greater lifting and repositioning.
Most patients return to work within 10 days. Swelling and bruising typically resolve within a week to 10 days with proper care. Results last a decade or more, far exceeding the temporary effects of BOTOX.
Who Is a Good Candidate?
Most brow lift patients are between 40 and 60 years old and are concerned about sagging brows and aging forehead skin. If you place your palms above your eyebrows and gently pull upward, the refreshed appearance you see is similar to what a brow lift achieves.
Dermal Fillers: Restylane & Radiesse
Dermal fillers restore volume and smooth wrinkles by filling depressed areas beneath the skin. At Longwood Eye & LASIK Center, we offer both Restylane and Radiesse to address different aesthetic concerns.
Restylane
Restylane was the first FDA-approved dermal filler in 2006. Made primarily from hyaluronic acid, a naturally occurring substance in the body, Restylane hydrates and plumps the skin by binding with water molecules.
Treatment areas include:
- Marionette lines (corners of mouth downward)
- Nasolabial folds (nose to mouth)
- Parentheses lines around the mouth
Results typically last 6 to 18 months, depending on the treatment area and formula used.
Radiesse
Radiesse offers a unique two-pronged approach using calcium hydroxylapatite microspheres suspended in a water-based gel. It provides immediate volume while stimulating the body’s natural collagen production for longer-lasting results.
Treatment areas include:
- Smile lines
- Marionette lines
- Pre-jowl folds
- Chin wrinkles
- Hand rejuvenation (the only FDA-approved filler for this use)
Results typically last up to one year or longer due to continued collagen production.
Entropion and Ectropion Repair (Eyelid Tightening)
Sometimes eyelids become incorrectly positioned due to muscle weakness, aging, injury, or other factors. Both entropion (inward-turning eyelid) and ectropion (outward-turning eyelid) can cause significant discomfort and risk corneal damage if left untreated.
Entropion (Inward-Turning Eyelid)
When the eyelid turns inward, skin and eyelashes painfully rub against the cornea. Symptoms include eye pain, redness, excessive tearing, and a gritty sensation. Without treatment, entropion can lead to corneal abrasions, ulcers, and infections.
Ectropion (Outward-Turning Eyelid)
When the eyelid turns outward, proper tear drainage is inhibited. This causes eye irritation, redness, excessive tearing, and sensitivity to light. Like entropion, untreated ectropion can result in corneal damage.
Surgery is the only definitive treatment for these conditions. For entropion, a small section of eyelid is removed to tighten the area. For ectropion, surgery may involve stretching scar tissue or similar tightening techniques.
Recovery typically involves an eye patch for 24 hours, with healing occurring over about two weeks. Most patients experience successful correction with minimal complications.
Graves’ Disease (Thyroid Eye Disease)
Thyroid Eye Disease, the most common cause of hyperthyroidism, is an autoimmune disorder where the immune system mistakenly attacks healthy tissues. In its ophthalmopathy form, tissues and muscles behind the eyes become swollen, causing the eyeballs to protrude beyond their normal range.
Symptoms include:
- Bulging eyes or staring appearance
- Dry, itchy, irritated eyes
- Gritty sensation in the eyes
- Sensitivity to light and excessive tearing
- Pain or pressure around the eyes
- Difficulty fully closing the eyelids
- Double vision, especially when looking to the side
Who Is at Risk?
Thyroid Eye Disease typically develops in people under 40, with women being significantly more susceptible than men. Stress, pregnancy, and smoking increase risk factors.
Treatment Phases
Active Phase: During this inflammatory stage lasting several months to a few years, symptoms are managed with lubricating eye drops, gels, and sometimes prisms for double vision. Severe cases threatening vision may require steroid treatment or urgent orbital surgery.
Stable Phase: Once inflammation resolves, additional surgical intervention may be considered if needed.
Management Strategies
You can help manage symptoms by:
- Sleeping with your head elevated to reduce swelling
- Wearing protective sunglasses or clear glasses
- Taking frequent breaks from screens to close your eyes
- Avoiding smoking
- Discussing beneficial supplements with your doctor
Orbital Surgery
For severe cases where increasing pressure threatens the optic nerve, we may perform orbital surgery to remove bone between the eye socket and sinuses. This creates space for the eyes to return to a more normal position. Studies show success rates up to 90 percent with appropriate surgical techniques.
Schedule Your Consultation Today
The oculoplastic specialists at Longwood Eye & LASIK Center bring unparalleled expertise in facial anatomy and advanced surgical techniques to every procedure. Whether you’re seeking cosmetic enhancement or treatment for a functional condition, we’re committed to providing personalized care with exceptional results.
Schedule an appointment at Longwood Eye & LASIK Center in Greenfield, MA, today to learn more about how we can help you achieve your aesthetic and functional goals.
