Basu Aesthetics + Plastic Surgery: C. Bob Basu, MD
9899 Towne Lake Parkway, Suite 100
Cypress, Texas 77433
Phone: (713) 799-2278
Basu Aesthetics + Plastic Surgery: C. Bob Basu, MD
1200 Binz Street, Suite 950
Houston, Texas 77004
Phone: (713) 799-2278
Eye Reconstructive Surgery (Oculoplasty) Houston
Eye reconstructive surgery, or oculoplasty, corrects damage to the ocular region, including the eyelids and tear ducts. Ocular damage can be caused by skin cancer, trauma, or genetics, and when performed by a qualified surgeon, oculoplasty can safely and effectively improve the function and appearance of your eyes.
At Basu Aesthetics + Plastic Surgery, board-certified and fellowship-trained oculoplastic surgeon Dr. Marc Sarcia performs the following eye reconstructive surgeries in Houston:
- Eyelid reconstruction following skin cancer
- Tear duct surgery (DCR)
- Tear duct surgery with bypass tube (CDCR)
- Chalazion surgery
- Lagophthalmos surgery with gold weight implants
- Graves’ eyelid (ophthalmopathy) surgery
Eyelid reconstruction following skin cancer
There are 4 types of cancer that affect the region around our eyes, the most common of which is basal cell carcinoma (BCC). Our eyelids are very thin, and therefore easily damaged by the sun. In fact, up to 10% of all skin cancer occurs in the eyelids, most of which is caused by sun exposure. If left untreated, eyelid cancer can spread to the lymph nodes and obstruct the eyes.
Symptoms of eyelid cancer include:
- Smooth and shiny or firm and red bumps on the eyelid.
- Crusty or bloody bumps.
- Discoloration of the eyelids, including red or brown patches.
- Itchy, tender, or scaly patches on your eyelids.
- A stye that doesn’t heal properly (see chalazion surgery below).
- Loss of eyelashes.
Dr. Sarcia specializes in examining and surgically removing eyelid cancers and ensuring that your eye region looks normal and healthy by performing reconstructive eyelid surgery.
Tear duct surgery (DCR)
Dacryocystorhinostomy (DCR) is surgery that corrects blocked tear ducts. Your eyes have a system of glands and ducts called the lacrimal system that produce tears in order to keep them clean, lubricated, and protected from infection. When your tear ducts become blocked, your eyes can experience a host of problems, including:
Most people who have blocked tear ducts suffer from excessively watery eyes, a condition called epiphora. Since the ducts are blocked, the tears that your glands produce are thin and watery, and therefore unable to adequately lubricate your eyes.
Causes of blocked tear ducts
Tear duct blockage can occur due to:
- Chronic nasal infections
- Trauma to the eyes and/or nose
- Conjunctivitis (pink eye)
- Nose polyps (non-cancerous growths in the nasal passages)
- Eyelid weakness (eyelid ptosis)
- Eyelid malposition
- Allergies and sinus issues
About the DCR process
During a DCR, Dr. Sarcia will create a new opening between your eye and nose to allow for natural tear outflow. Dr. Sarcia will perform a DCR externally by making a small incision between the nose and the eye, or inside the nose with the help of an endoscope. During an external DCR, he will create a small opening in the bone through the incision to connect your lacrimal sac and your nasal cavity. Sometimes a small, silicone tube called a stent will need to be placed temporarily to help keep the new tear duct open.
What type of anesthesia is used in a DCR?
Anesthesia for your DCR may be local or general. Dr. Sarcia will also apply packing materials soaked with anesthetics to the inside of your nose to make sure you don’t feel a thing and to help mitigate blood loss during the procedure.
Recovery from DCR
You will be able to return home the same day as your DCR. Dr. Sarcia may prescribe antibiotics to help prevent infection, as well as steroids and/or nasal decongestants to help keep your sinuses open. You may experience some slight bleeding from your nose for several hours following your surgery. You can also expect your orbital region to be a little sore and bruised during the first week or 2 following your surgery, but pain and swelling should subside soon after. Dr. Sarcia will likely advise you to take over-the-counter pain medicines and will give you special instructions about caring for your nasal cavity and eye. He may schedule an appointment with you the day after your procedure to ensure you are healing properly.
If a stent is required to keep the tear duct open, Dr. Sarcia will remove it after 6 to 8 weeks. The eye may briefly appear or feel dry until it adjusts to your environment.
Tear duct surgery with bypass tube (CDCR)
A conjunctivodacryocystorhinostomy (CDCR) is DCR surgery with the placement of a bypass tube. A CDCR is performed when the upper and lower sections of the tear ducts are completely blocked, and is considered to be a last resort surgery for blocked tear ducts.
Am I a good candidate for a CDCR?
Most patients who undergo a CDCR do so because DCR surgery has failed to fully un-block their tear ducts. Other reasons a patient may undergo a CDCR include:
- Severe eyelid trauma
- Punctal agenesis
- Canalicular agenesis
- Post-DCR rehabilitation
- Tumor in the inner canthi following a DCR or canaliculotomy
- Severe narrowing of the canaliculi
- Trauma to the ocular region
- Canalicular infections
About the CDCR process
A CDCR is performed inside of the nose with an endoscope. Once the incision is made between the eye and nose, a glass Pyrex tube (called a Jones tube) is inserted between the inner canthus and the nasal cavity and sutured in place to prevent migration. Sutures are removed after 4 to 6 weeks. Unlike a stent used in DCR surgery, a Jones tube serves as a lifelong prosthesis. This tube is cleaned and replaced in Dr. Sarcia’s office during regular check-ups.
What kind of anesthesia is used for a CDCR?
Dr. Sarcia typically performs a CDCR under general anesthesia.
What complications are associated with CDCR?
CDCR has a 90% success rate; however, certain complications can occur, including migration and clogging of the Jones tube. Both of these issues present themselves immediately and are easily fixed. Dr. Sarcia will discuss blowing your nose after surgery with you, as there are a few specific considerations, such as closing your eyes and/or holding your Jones tube while doing so.
Recovery from CDCR
Like a DCR, postoperative bleeding can occur, especially within the nose. Bleeding can be remedied by postoperative nasal packing or with nasal decongestants. Dr. Sarcia will schedule follow-up appointments with you at regular intervals that eventually taper off to just once a year, or as needed.
A chalazion is an uncomfortable bump on the upper or lower eyelid. Chalazia are aesthetically unpleasing, can lead to further eye issues if left untreated, and may be cancerous. Some chalazia can be treated with a simple warm compress, but if they persist, surgery should be considered.
A chalazion vs an eye stye
A chalazion is not an eye stye, although the two are often confused. Eye styes are caused by bacterial infections and are painful, while a chalazion is the product of a healed eye stye and is not painful. Dr. Sarcia will examine your chalazion to determine whether or not it is cancerous.
Removing a chalazion
Removing a chalazion is a simple procedure. Dr. Sarcia will either make an incision from underneath the eyelid without leaving any visible scarring, or inject the chalazion with corticosteroid to kill it. Because a side effect of corticosteroid injection can be skin lightening, Dr. Sarcia likely will not use this option for darker-skinned patients.
What kind of anesthesia is used for chalazion surgery?
Dr. Sarcia typically performs chalazion surgery using local anesthesia.
Lagophthalmos surgery with gold weight implants
Lagophthalmos is a condition where a patient is unable to fully close their eyelids. Lagophthalmos can be caused by:
- Paralysis of the eyelid muscle
- A thyroid disease
- Bulging of the eyes (exophthalmos) caused by an orbital tumor
- A traumatic eyelid injury
If left untreated, the cornea will be continuously exposed to environmental conditions, which can result in conjunctivitis (pink eye), severe damage to the cornea, or even blindness. If non-surgical methods such as artificial tears, ointments, and therapeutic contact lenses have not been effective, surgery should be considered.
About the lagophthalmos process
Dr. Sarcia treats lagophthalmos with the placement of weighted implants in the upper eyelids. These implants are made of either gold or platinum, and allow you to close your eyelids completely without obscuring your vision. Dr. Sarcia may also inject hyaluronic acid gel or BOTOX to weaken your upper eyelid muscles and further help them close.
What kind of anesthesia is used for lagophthalmos surgery?
Dr. Sarcia usually performs lagophthalmos surgery with weighted implants under local anesthesia.
What are the risks of lagophthalmos surgery with gold weight implants?
Lagophthalmos surgery with gold weight implants is a popular procedure for patients suffering from droopy eyelids (eyelid ptosis) and has a very low chance of vision loss, infection, or the development of astigmatism. Removing the implants can remedy most complications that arise.
Recovery from lagophthalmos surgery
If Dr. Sarcia used sutures to hold your implants in place, he will remove them after 5 days, at which point he will conduct a follow-up exam with you. Dr. Sarcia will provide specific instructions for cleaning your eyelid, and may prescribe topical ointments.
Graves’ eyelid (ophthalmopathy) surgery
Graves’ eyelid disease, also called thyroid eye disease (TED), is an autoimmune disease that targets the thyroid gland and orbital region of the eye. Graves’ disease can also result in:
- Droopy eyelids (eyelid ptosis)
- Shallow eye sockets
- Crossed eyes (strabismus)
- Damage to the optic nerve (optic neuropathy)
Patients with Graves’ eyelid disease often have eyes that appear to bulge out of their sockets. This bulging is caused by inflammation of the tissue and muscle around the eyes, coupled with eyelid retraction (the eyelids being pulled away from the front of the eyes). In severe cases of Graves’ disease, patients may struggle to close their eyelids and/or have dry spots on their corneas, which can lead to corneal damage or blindness if left untreated.
About the ophthalmopathy surgical process
Dr. Sarcia treats patients of Graves’ eyelid disease with an intensive form of blepharoplasty (eyelid surgery), which reduces the swelling of the upper and/or lower eyelids and allows the eyelids to adequately protect the eyes.
Stiffness caused by scar tissue may persist after surgery. Most patients with thyroid-related eye disease have upper and/or lower eyelid asymmetry prior to reconstructive surgery, and a mild amount of eyelid asymmetry should still be expected after surgery.
What kind of anesthesia is used for ophthalmopathy surgery?
To treat Grave’s eyelid disease, Dr. Sarcia uses local anesthesia for upper eyelid surgery and general anesthesia for lower eyelid surgery.
Recovery from ophthalmopathy surgery
You can go home the day of your ophthalmopathy surgery. Dr. Sarcia will recommend you use ice packs and a topical antibiotic ointment, and elevate your head and get plenty of rest. He may also prescribe prednisone for the first week following your surgery. You will need to take 5 to 10 days off of work and can expect to fully heal 3 to 6 months after your surgery.
Schedule your Houston consultation today
To learn more about eye reconstructive surgery with board-certified oculoplastic surgeon Dr. Marc Sarcia, schedule a consultation online or at our Houston or Cypress offices by calling (713) 799-2278.