By: Dr. Michael Pasquale

Blepharoplasty is a family of cosmetic eyelid surgical procedures performed to correct or mitigate the signs of aging of the upper and lower eyelids. While many of the surgeries are performed for aesthetic reasons, there are also many done for functional reasons. Some eyelid problems are caused by aging and some are not. Some of these conditions are aesthetic concerns and others may cause difficulties with vision. Below is a list of common eyelid conditions which are often treated with some variation of blepharoplasty surgery.

Experienced Eyelid Plastic Surgeon

When selecting a surgeon for cosmetic eyelid surgery it is important that you take into consideration the qualification and experience of the surgeon and not base your decision on just the cost of the surgery. Honolulu, Hawaii, is the top choice of people who want to have cosmetic eyelid surgery done. Hawaii is home to surgeons such as Dr. Michael Pasquale who has completed his entire residency in plastic surgery and also earned a 2-year training certificate in cosmetic surgery from NYU Downtown, Manhattan. At his clinic in Honolulu, Hawaii, Dr. Pasquale ensures that clients are made aware of the various aspects of cosmetic eyelid surgery including the risk of complications. He makes certain that the surgery is done in a manner to enhance the person’s natural features and not to change them drastically. Our staff is well trained in care of the cosmetic eyelid surgery patient and we treat our clients with care and respect they need.

One should consider the lovely surroundings of Hawaii to recover from cosmetic eyelid surgery and our staff can help you make arrangements. Just call today for an appointment of information. For our clients who have to travel a virtual consultation before you arrive can be arranged for your cosmetic eyelid surgery. Its easy just call or email today.

Eyelid Ptosis Surgery

Ptosis is a medical condition in which the upper or lower eyelids droop down. This drooping is usually mild and difficult to detect, however in some severe cases it can actually disturb the eyesight. Surgery to correct eyelid ptosis improves vision problems caused by drooping eyelids, but also makes a remarkable change in the appearance of the individual. Eyelid ptosis requires eyelid surgery, also known as blepharoplasty.

To understand the surgery for eyelid ptosis first it is vital to understand what causes eyelid ptosis. Eyelid ptosis may be a congenital condition or may develop with age, due to injury or certain eye surgery. The levator muscle that starts at the back of the eye and then becomes a tendon upon entering the eyelid gets thinned and causes the sagging or drooping of the eyelid known as eyelid ptosis.

The Procedure for Eyelid Ptosis Surgery

Upon arriving at Aloha Plastic Surgery LLC, patients are greeted and taken to a private spa room to prepare for surgery. The surgery is performed under local or general anesthesia. The blepharoplasty for eyelid ptosis involves an incision in the eyelid then removal of tissue to reach the levator apomeurosis. Once the desired look is achieved Dr. Pasquale proceeds to close the incision with sutures.

Recovering from Eyelid Ptosis Surgery

As with all surgeries, eyelid ptosis surgery requires good postoperative care. The patient’s eyes may feel sore and bruised. Immediately following surgery, patients are required to wear bandages over their eyes, and keep their head elevated. Patients will receive prescription medication to ease the discomfort following surgery. When the bandages are removed Dr. Pasquale recommends an ointment or eye drops to combat dryness. Sensitivity to sunlight is normal and patients are advised to use sunglasses and apply a special sun screen for the eyelid. Honolulu, Hawaii is a great place that provides the perfect location and climate to relax and recover from eyelid ptosis surgery.

Risks & Complications of Eyelid Ptosis Surgery

Like all surgeries, eyelid ptosis surgery carries risks and these risks include asymmetry between the two eyelids, irregularities in the eye shape, under or over correction. It is important that patients discuss the risks and their concerns regarding surgery with their doctor.

Dr. Pasquale is a reputable and experienced surgeon who has mastered eyelid surgery. Dr. Pasquale is not only known for his excellent skill and talent in providing outstanding cosmetic surgery results, he is also known for his remarkable ability to build meaningful and lasting rapport with all of his patients. Dr. Pasquale cares about his patients. He listens to their desires and fulfills their cosmetic surgery needs.

Puffy Eyelids & Eye Bags

Do you look in the mirror and think: “My eyes look puffy even though I am young…” Puffy eyes can ruin even the most attractive appearance. It is important to first determine the cause of the puffy eyes; if they are temporary and caused due to lack of sleep or fatigue or due to the loss of elasticity in the skin with age and the effect of the elements. If it is due to sleepless nights that you can try one of the listed options:

  • Splash your face with cold water.
  • Place two tea bags in water, wring them and place them in the refrigerator to chill. After a while place a tea bag on each eye for 5 to 10 minutes.
  • Puffy eyes may indicate water retention and drinking plenty of fluids can flush out excess salt in the system and reduce the water retention in the body.
  • It may be wise to check if the temporary puffiness of the eyes is related to a food or substance allergy.

For people who have puffy eyelids that are permanent and no amount of cosmetics or home remedies can remove them the only effective option is cosmetic eyelid surgery. This procedure aims at removing excess skin, fat and muscle from the eyelids and thereby ending the droopy and puffy look of the eyes. While puffy eyelids are often associated with aging and are seen in the mid 30s, this is not always so. Some people may have inherited puffy eyelids and others may develop them at a relatively young age. The fact is that the skin of the eyelids is losing its elasticity and is unable to support the fat and muscle in the area adequately.

A Bump Under the Eyelid

A bump under the eyelid may be caused by more than one reason and luckily with cosmetic surgery it can be taken care of effectively. The eyes are the focal point of a person’s face and a bump under the eyelid cannot only be awkward to feel but may make you conscious of your appearance. Honolulu, Hawaii is home to some of the world’s best plastic and cosmetic surgeons. Dr. Michael Pasquale is based in Honolulu, Hawaii and has done his entire residency in plastic surgery. He has to his credit a 2-year training certificate in cosmetic surgery from NYU Downtown, Manhattan. At our clinic at Honolulu, Hawaii, it is made certain that the patient understand exactly what the surgery is for and the end result. Clients are motivated to voice their thoughts and ideas so as to ensure that they have realistic expectations of the surgery.

What Causes a Bump Under the Eyelid?

The causes of any particular bump under someone’s eyelid obviously varies. It may be caused by fat deposits, meibomian cysts or chalazions, cysts of moll, etc. In the case of chalazions the bump under the eyelid is caused due to residue from an infection that blocks a gland on the eyelid.

Surgery to remove the bump

The surgical options change slightly based on the source or cause of the bump. If the bump is a cyst, then the bump has filled with fluid and can be easily drained and removed. Sometimes if the shell of the cyst is very tough it may be left inside. If fat needs to be removed only from the lower eyelid a transconjunctival blepharoplasty may be performed. In this surgery only an incision is made in the inside of the lower eyelid thus leaving no visible scars.

The eyes or eye, as may be the case, would feel bruised and swollen and would be bandaged. Cold compression or prescribed medication may relieve the discomfort. You would be advised to keep your head elevated when lying down and in a day or two will be able to use an ointment or eye drops to take care of the dryness. The stitches are normally taken out in about 5-7 days from the surgery for bump under eye lid and by then all the bruising and soreness has also gone. When going out you need to use sun glasses and should also use a sunscreen especially designed for the eyes. Honolulu, Hawaii is a popular destination for people looking for eyelid surgery because of the excellent surgical and medical care available here. Recovery is made more relaxed and comfortable against the beautiful background and climate of Honolulu, Hawaii.

Eye Bags

Do you find yourself looking exhausted before a big date and tried everything from used tea bags to slices of potatoes and cucumber? Do you appear older than your age simply because of the eye bags under your eyes? Do you crave to look young and attractive and wish there was something you could do to remove those eye bags? Then the answer does not lie in the tea bags or in ointments and gels. While many cosmetic products may promise you the moon and the stars the fact is that when it comes to eye bags they aren’t effective. This is because eye bags are caused due to the skin around the eyes losing its elasticity with time and age making it unable to support the fat and muscle as well as it could earlier. While eye bags are found to appear as one grows older some people may also be born with such features.

Getting rid of eye bags

There is always a risk of complications in any surgery and it is important that you discuss this clearly with your surgeon. While such cases are rare it is important to know which side effects are temporary and which need to be taken seriously. Selecting a good surgeon with skill, experience and reputation also helps reduce such risks. It is crucial that you don’t select the surgeon based on the cost involved only.

  • The surgery takes 1-3 hours and would be under local or general anesthesia.
  • It involves making incisions in the natural crease of the upper eyelids and just below the eyelashes in the lower eyelids. Thereafter the excess skin, fat and muscle are removed and the incisions closed with fine sutures. Once healed the scars from the surgery are barely visible.
  • The recovery time is about two weeks and the stitches come off within 2-5 days after the surgery. The eyes would feel bruised and swollen for a while and this is taken care of by cold compressions and medication. Sensitivity to light is expected and adequate care must be taken.
  • The person can go back to his or her normal routine in a week to ten days but must refrain from strenuous exercise or activity until recommended by the surgeon.

Eyelid Twitching

The eyes are not just a vital sensory organ but also the focus of an individual’s face. The attractiveness of a face is largely determined by the eyes and the eyelids that frame it. Any problems or conditions related to the eyelids can be quite distracting. All of us have experienced eyelid twitching at some time or the other. This action of the eyelid can be mildly irritating at times and at other times quite troublesome and a cause of distress. An eyelid twitch in simple terms is an involuntary spasm of the eyelids. There are various degrees of eyelid twitching that one may experience due to various reasons.

Mild Eyelid Twitching

While temporary eyelid twitching is common in most individuals and it stops as abruptly as it started and doesn’t really require any medical attention. The cause of minor eyelid twitching is uncertain and may effect either or both the upper and lower eyelids of either eyes or just one eye. Taking a break and relaxing the eyes and warm compressions may help in mild eyelid twitching. Some ophthalmologists also suggest reducing your daily dose of caffeine.

This condition involves the involuntary closing of eyelids of both eyes. In severe cases the muscles of the mouth and neck may also be affected. Blepharospasm is due to abnormal nerve behavior in the eyelid region that results in involuntary muscle spasms. These spasms though rare result in temporary inability to see during the spasm. Medication and biofeedback are suggested for this condition but are not found to be very effective. On the other hand surgery and injection of botulinum is found to be a more useful course of action for blepharospasm. Injections of botulinium are effective for several months after which the effect wears off. There are virtually no side effects of this treatment.

Hemifacial Spasm

Hemifacial spasm is when the eyelid muscles and often the muscles around the mouth of one side of the face spasm. This condition is due to the pressure applied on a nerve to the facial muscles by an artery. This leads to eyelid twitching and also twitching of the face. Both botulinum injections and surgery are effective for this condition. A neurosurgical surgery would remove the pressure applied by the artery on the nerve. However this surgery carries associated risks due to its very nature. The botulinum injections on the other hand carry almost no side effects.

Cosmetic Surgery for Droopy Eyelids

The procedure can be performed under local or general anesthesia and can take between 1-3 hours. Basically what is done is removal of excess skin, fat and muscle that lead to the droopy look of the eyelids. The incisions in the upper eyelids are placed on the natural crease of the eyelids and for the lower eyelids they are made under the eyelashes. Once the excess skin, fat and muscle are removed sutures are placed. In case fat needs to be removed only from the lower eyelids the incision is made inside the eyelid and this is called a transconjunctival blepharoplasty. This can be done with a LASER with virtually no bruising, minimal eyelid swelling and a quick return to work.

After the Cosmetic Surgery for Droopy Eyelids

The eyes may be bandaged and they will feel swollen and bruised. Discomfort can be eased by the use of cold compressions and prescription drugs. The head needs to be kept elevated even while lying down. Once the bandages are off Dr. Pasquale and his staff will show you how to take care of your eyes. This may include the use of eye drops or an ointment to keep the area lubricated. The stitches would be removed in 3 days after droopy eyelid surgery.

Recovery from Cosmetic Surgery for Droopy Eyelids

Sensitivity to light is common and the eyes need to be protected, especially when you are going out. Sun glasses are recommended as is the use of a special sun screen for the eyes. In about 7 days you can go back to your normal routine but strenuous activities and exercise should be avoided until you consult with Dr. Pasquale regarding it. Alcohol should be avoided as it causes fluid retention in the body. In about 3 months the scars from the cosmetic surgery for droopy eyelids will be barely visible especially when the procedure is performed by a talented and experienced cosmetic surgeon like Dr. Pasquale at his Honolulu Hawaii clinic. Droopy eyelids are commonly treated here by Dr. Pasquale.

Surgery for Eyelid Skin Tag

The skin is the largest organ in the human body. It serves many purposes from creating a protective layer, in circulation, perspiration, etc. The way your skin looks has a lot to do with how attractive one appears. Some skin imperfections that may make a person feel conscious include skin tags, acne, pimples, dark circles under the eyes, etc. Skin tags look odd anywhere in the body but eyelid skin tags are especially noticeable and mar the way your face looks. Your eyes are the highlight of your face and perhaps are given the most attention when you interact with someone and eyelid skin tags can make you feel shy and awkward. Fortunately the techniques used for removing eyelid skin tags have improved dramatically over the years.

Electrocautery or Liquid Nitrogen

Amongst the several methods of eyelid skin tag removal is the use of electrocautery or liquid nitrogen, this method requires anesthesia as the process may be painful and also there is a risk to damage to skin. Another method of eyelid skin tag removal is by dipping a hemostat or a non-toothed forceps in liquid nitrogen and then holding the skin tag at its base for a while. The frozen tag shed in 7-10 days. This procedure produces a sting but does not effect the skin surrounding the eyelid skin tag. This method is particularly effective with eyelid skin tag as the patient can lie down as there is no dripping as compared to cotton-tipped application of liquid nitrogen.

Laser skin resurfacing is an advanced cosmetic surgery technique that provides the patient with a fresh and revitalized look. Laser surgery for removal of eyelid skin tags uses a high energy laser beam that it is focused on the area to be effected. The depth of the laser is controlled and ensures no damage is done to the skin. Laser skin resurfacing can remove eyelid skin tags and is available in Honolulu, Hawaii. It is performed by a cosmetic surgeon and it is crucial that you go to a reputed and experienced plastic or cosmetic surgeon who is proficient in this procedure. The skin recovers in virtually no time leaving you with eyelids that have clear and clean skin. After the surgery you would be advised to apply prescribed creams for a few days after which you can begin to wear make up.

The eyelids perform various protective functions for the eye. The eyelid is a highly complicated part of the body with as many as eight layers together in the few millimeters of its thickness. Any problem in even one layer can cause the eyelid to feel and appear abnormally. Any irritation in the eyelids may affect vision but is definitely difficult to leave unattended. A swollen eyelid may be caused due to a variety of reasons. It may be a natural condition due to excess fat in the region that the skin is unable to support or could be a symptom of an underlying infection.

Swollen eyelid may be experienced in many conditions such as the following:

  • When the swelling is localized and more of a bump it may be a symptom of chalazion.
  • With age prolapsed orbital fat may also result in swollen eyelid.
  • Blepharitis is a condition found mainly in people over the age of 50 and causes chronic swelling of the eyelids. While the exact cause of blepharitis is not certain it is related to the unbalanced oil secretion in the eyelids.
  • A sty is basically an abscess in the eyelid oil gland and also results in swollen eyelids. Usually a sty last between 1-3 days and persistent swollen eyelids would indicate a more serious infection.

The eyelid surgery is performed under anesthesia and takes about 1-3 hours. The surgeon makes incisions in the natural crease of the upper eyelid and just below the eyelashes in the lower eyelid. Once the excess fat, skin and muscle are removed fine stitches are placed to close the incisions. After healing the scars from the surgery are barely visible; especially when the surgery is done by an experienced and talented cosmetic or plastic surgeon. Recovery from eyelid surgery is easier and more comfortable in the scenic and comfortable environs of Honolulu, Hawaii. In about 10 days one can go back to one’s normal routine but strenuous exercise and activity need to be avoided until advised by the surgeon. It is important that you select an experienced and competent surgeon for the eyelid surgery as the complications related to it are like any other medical surgery.

Swollen Upper Eyelid

Appearances affect the way people feels about themselves. They can make you feel confident or want to shy away from the public eye. The eyes can convey more than words can and the eyelids also add to the way the eyes appear. A swollen upper eyelid can be painful and irritating and also make one conscious of the way one’s eyes look. It may also interfere with the person’s vision. There are different reasons because of which a person may have a swollen upper eyelid. While some people may have excess fat and skin in the area that the skin is unable to support, often the swollen upper eyelid is a symptom of an infection in the region.

The eyelid is made up of seven layers compacted into a few millimeters. Any problem in even one of layers can cause a swollen upper eyelid. A specialist should be contacted at the earliest to clarify the reason for the swollen upper eyelid.

possible causes of a swollen upper eyelid

  • A swollen eyelid may be caused with age prolapsed orbital fat.
  • A localized swelling that is more of a bump may be a symptom of chalazion.
  • Blepharitis is a condition found mainly in people over the age of 50 and causes chronic swelling of the eyelids. While the exact cause of blepharitis is not certain it is related to the unbalanced oil secretion in the eyelids.
  • A sty also results in swollen eyelids and is basically an abscess in the eyelid oil gland. It generally lasts for 1-3 days and persistent swollen eyelids would indicate a more serious infection.

For cases where the swollen eyelid is due to excess fat, skin and muscle eyelid surgery may be suggested. Blepharoplasty is eyelid surgery where the required fat, skin and muscle are taken out. At our clinic at Honolulu, Hawaii clients are made aware of any risks involved in the procedure. The surgery for eyelid surgery takes about 1-3 hours and incisions are made in the natural crease of the upper eyelids and just below the eyelashes of the lower eyelids. Once the fat, skin and muscle are removed the incisions are closed with fine sutures. After healing the scars from the surgery are barely visible. Honolulu, Hawaii is a good place to have eyelid surgery done as it provides a great location to relax and recover from the surgery.

Surgery to Eliminate Dark Eyelids

Despite the saying, “Don’t judge a book by its cover”; much emphasis is still placed on appearance in the world we live. The way you see your self has a lot to do with the way you feel about yourself. Dark eyelids can make a person feel uncomfortable and conscious about his or her appearance. If you’ve been wondering about a way to take care of your dark eyelids then there is good news! Surgery for dark eyelids can change the way your eyelids look.

The dark and sometimes purplish eyelid skin is basically because of the color of the muscle underneath the skin. This condition can be improved by blepharoplasty or eyelid surgery. It is particularly effective with a dark lower eyelid which causes the skin around the eye to also look darker. The surgery for dark eyelid is performed under anesthesia and may take between 1-3 hours. It requires incisions to be made on the natural lines of the upper eyelids and below the eyelashes for the lower eyelids. Dr. Pasquale eliminates the appearance of darker or tired looking eyes by removing excess tissue. Once the desired look is achieved the incisions are closed with sutures.

In cases where tissue is to be taken out of the lower eyelid only, a transconjunctival blepharoplasty may be performed. In this case the incision is made in the inside of the lower eyelid.

After the Surgery for Dark Eyelids

The patient’s eyes will be bandaged and may feel sore after dark eyelid surgery. Dr. Pasquale prescribes medication to ease the discomfort following all procedures. After having surgery it is important for the patient to keep their head elevated. Cold compressions may also be used to reduce the swelling. Dr. Pasquale will prescribe eye drops or ointment to help with any dryness that may occur. Temporary changes in eyesight such as blurring, sensitivity to light is normal. Wearing sunscreen and sunglasses is advised to protect the sensitive skin around the eye following surgery. Sutures may be removed in 5-7 days after surgery. Usually after ten days patients may resume their normal routine. Driving must be avoided until eyesight is back to normal. Beautiful weather and peaceful surroundings make Honolulu, Hawaii a perfect place for dark eyelid surgery and recovery.

Possible Risks from Dark Eyelid Surgery

At Aloha Plastic Surgery LLC in Honolulu, Hawaii, clients are made aware of the risks that may be associated with this procedure. In rare cases patients have experienced partial or total loss of eyesight, damage to the eyeball surface or muscle around it, hematoma in the eye, difference in eyelids size etc. It is vital that you select a reputable and experienced doctor when you consider surgery for dark eyelid. Dr. Michael Pasquale has mastered the skill and artistry involved in performing the dark eyelid surgery.

Surgery for Eyelid Cyst

If an eyelash going into one’s eye for a few seconds can create discomfort and irritation; it is well imaginable how uncomfortable an eyelid cyst can be. The eyes are perhaps one of the most sensitive areas of the human body and even the most minor irritation to it can be distracting. An eyelid cyst may be both painful and awkward. It is important to understand the cause of the eyelid cyst before understanding the course of action that may be required to be followed.

Different types of eyelid cysts:

  • A sty or abscess at the oil gland is one of the most common types of eyelid cysts. The infection causes the eyelid cyst to become red, swollen and tender. A sty usually lasts between 24-72 hours and drain away naturally. An eyelid cyst that persists longer than this period is probably not a sty and needs to be attended to immediately. The treatment for a sty would depend on the severity of infection. While a mild case can be treated with hot compressions and cleansing. A severe case would require a course of antibiotics to take care of the infection.
  • Chalazions: A meibomian cyst or chalazion is a lump on the eyelid that is caused due to debris left after an infection. It may or may not be painful and may disappear in 8-16 weeks. Surgery is suggested to remove the eyelid cyst if it persists beyond this period. Proper cleansing of the eyes and eyelids is suggested to avoid chalazions.
  • Sweat gland cysts are common and appear as round, shiny and transparent lumps near the tear ducts. Removal of this eyelid cyst is simple.
  • Keratosis is a combination of keratin and tissue that may be found in various forms. Removal of these eyelid cysts is straight forward and would rule out any chance of malignancy.
  • A white painless swelling on the eyelid may be an inclusion cyst; and while it may be harmless an examination nonetheless needs to be carried out.
  • Nevus is a flesh colored growth in the eyelid.
  • Other eyelid cysts may include skin tags, warts, etc. An eyelid cyst needs to be examined well and removed if necessary not only for the pain and infection it may cause but also to ensure that it doesn’t mar the individual’s appearance.

The options that cosmetic and plastic surgery provide are many and are available in our clinic at Honolulu, Hawaii. Eyelid surgery and laser skin resurfacing are amongst the options that one may want to consider. Laser skin resurfacing is found to be particularly effective with skin tags leaving the eyelid skin looking rejuvenated. It is important that you choose a good and experienced surgeon when you are considering having eyelid surgery done as this would bring down the risk of complications tremendously. Eyelid surgery can also be combined with other procedures such as a brow lift and a face lift.

Eyelid Edema

Your face is your fortune they say. It is also one of the most sensitive and delicate parts of the human body. The area around the eyes in particular requires special care and attention. Any infection or reaction in this part of the face needs to be given due and appropriate attention. A skin or medical condition that involves the eyes or the eyelids causes discomfort, irritation and of course affects the way one looks. Eyelid edema is when the eyelids contain excessive fluids. Usually eyelid edema is caused due to an allergic reaction that the individual has. The reaction may be to food, drugs, plant allergens, etc. Also trichinosis, a disease caused by consumption of uncooked or undercooked meat, leads to eyelid enema. It is vital that you contact a qualified medical professional at the earliest. Eyelid edema may also be caused by infection and can lead to complications such as orbital cellulites which may harm the vision.

Some of the characteristics of eyelid edema include swelling, itching, redness in the area and pain. It is crucial to first identify the cause of the eyelid enema before treatment is begin. It is vital to rule out any chance of infection which would require immediate medical attention. The eyelid edema is most often caused by and allergic reaction so to start with the allergen needs to be identified. It could be as simple a case of touching your eyes after you have finished removing nail paint from your nails and reapplied it. Once the allergen is identified it is important to avoid it.

Treating eyelid edema

If the eyelid edema is not due to an infection then cold compressions and immunosuppressive drug that your medical specialist recommends should be utilized. It is vital to remember that use of steroids can cause cataracts and increase intraocular pressure. For trichinosis related eyelid edema it is advised that the disease be first treated, nonetheless cold compressions and prescription medication would provide relief from the discomfort. Eyelid surgery is not recommended in cases of eyelid edema.

Preventing eyelid edema

Eyelid edema can be prevented to a large extent by reducing contact with allergens. Thus if you are using anything around the eyes you need to be cautious. Also avoiding plants when the pollen count is high is advisable. Eyelid and personal hygiene is also crucial in avoiding eyelid enema. Do not touch your eyes or the eyelids unless your hands are absolutely clean.

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Honolulu Hawaii Plastic Surgeon

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