Blepharoplasty – Upper and/or Lower Eyelids
Are you tired of always looking tired? The loose skin over your eyes and the fat bags under your eyes can make you look more tired and older than you really feel. As you age, your eyelid skin can stretch, your muscles weaken and the fat accumulates around your eyes. Blepharoplasty (eyelid surgery) helps eliminate droopy eyelid skin, making you look younger and more alert.

Blepharoplasty can be performed using a local anesthetic. We place fine incisions in the crease of the upper eyelids and remove the excess skin and fat. A laser is often used to speed the recovery. To eliminate the lower lid bags, the surgery is performed through the inside of the lower eyelid to hide the incisions. The procedure, depending on the complexity, usually takes about 15-30 minutes.

Your medical insurance may cover an upper eyelid blepharoplasty. We would need to perform a special test to determine if you meet your insurance criteria.

Endoscopic Browlift
Lines in your forehead can be caused by aging, laughing, crying or even sleeping. This can be corrected with a forehead and brow lift. People with sagging eyebrows may choose this surgery to eliminate their sad or angry look. By elevating the brow, the tired and unhappy look may disappear completely.

Dr. David Pratt performs an Endoscopic Brow Lift using a small fiber optic camera inserted through tiny incisions placed in the hairline. This allows visualization of the surgery on a television monitor and reduces the incision size, minimizing scarring and allowing for a quicker recovery. He is the only surgeon in Thurston County routinely performing this state-of-the-art surgery.

Tear Duct Surgery
If you are experiencing excessive tearing you may have a tear duct obstruction. Tears normally drain into the puncta (small holes located on the inside corners of the upper and lower eyelids). Tears collect in the tear sac that lies under the skin between the corner of the eye and the nose. The tears then flow through a small tube, called the nasolacrimal duct, into the nose. The tears are pumped through this drainage system by the blinking of the eye.

A blockage anywhere in the drainage system can prevent proper drainage of tears and lead to excess tearing. If it is determined there is a blockage in your tear system, it may be necessary to perform a Dacryocystorhinostomy (DCR). A small incision is placed on the side of the nose. A small hole is then created in the paper-thin bone where a small, temporary tube is placed from the inside corner of the eye into the nose. The tube is used as a stent in the tear drainage system to prevent scarring. The tube is easily removed in the office approximately 3 months post-operatively.

Thyroid Eye Disease / Proptosis
Grave’s Disease is an autoimmune condition where the immune system mistakenly attacks the thyroid gland, causing the patients to develop proptosis or bulging eyes. The space between the lids may widen producing a staring appearance. Because the eye muscles are involved, some patients may develop double vision. In the worst cases, vision may be threatened due to compression of the optic nerve. In those cases, a procedure called an orbital decompression may be required.

Oribital Repair
Following an ocular trauma, the orbital structure (the boney structure that surrounds the eye) may be fractured or compromised. Dr. Pratt performs facial and/or orbital reconstructive surgery to repair the affected structure.

Botox
Botox® is a treatment used to reduce blepharospasms, eyelid twitching, and/or hemi-facial spasms. Botox is delivered by strategically placed injections in the affected muscles. Botox is a toxin produced by the same bacteria responsible for botulism. However, when very small amounts of the toxin are injected into the eyelid muscles it is proven to be safe and effective. The effectiveness is temporary; therefore periodic injections may be necessary.