Reconstructive Surgery
In Denver, Colorado
The Art of Compassion 
The Science of Beauty
Warning, some of the before and after images in this section may be graphic in nature due to the reconstructive nature of the surgeries.
Ectropion and Entropion
These are eyelid problems that cause redness and eye irritation, sometimes leading to corneal damage and loss of vision. Ectropion denotes an eyelid that hangs away from the eye, while entropion describes an eyelid that is turned toward the eye so that the lashes constantly rub the surface. They can occur from aging, trauma, Bell's palsy, and other diseases. Both conditions can be permanently repaired with outpatient surgery typically lasting less than one hour.
Eyelid Scarring and Retraction
Eyelid or facial surgery or trauma can cause the eyelids to lose normal mobility and position. In some cases, this scarring may make it impossible to properly close the eye(s) so that drying, irritation, and infection can result. When the lower eyelid is affected, there is "too much white showing" and the eye often alternates between feeling gritty and then watering excessively. Outpatient surgical repair can usually restore more normal appearance and function.
Orbital Tumors
A wide variety of benign and malignant tumors, cysts, and growths can occur in the eye socket behind or near the eye. MRI, CT scans, and other tests can often assist in diagnosis. Depending on the situation, treatment might include medications, injections, and surgery. Management of these conditions is highly specialized and sometimes requires a multidisciplinary team approach. Dr. Fante works with oncologists, ear, nose, & throat surgeons, neurosurgeons, and craniofacial surgeons when necessary to obtain the best possible outcome.
Orbital Fractures
Trauma to the upper face and eyes frequently results in broken bones. The cheekbones and sinuses are often involved, and the bones around the eye very often break as well. The bone below the eyeball is especially thin and breaks often, perhaps so that the eye itself can avoid severe injury. Because the muscles and fat around the eye commonly fall into the broken area, it is called a "blowout fracture", and often the tissue gets trapped causing double vision. Other times the hole is large and the eye starts to sink into it. In either case, surgical repair is performed with the use of plates to restore normal function and appearance. Typically, this surgery is performed under general anesthesia through a hidden incision behind the eyelid. An overnight hospital stay is occasionally necessary.
Eyelid Trauma
Car accidents, fights, dog bites, and other injuries unfortunately often damage the eyelids and tear drainage system. Repair can be simple or complex, depending on the injury. Evaluation at an emergency room is usually necessary.
Orbital Cellulitis
Infections near the eye can occur just under the skin, or sometimes deeper in the tissues around the eye. For children, it is usually associated with sinus infections. When the infection occurs deep in the eye socket area, it can be dangerous, causing blindness and even death. Prompt treatment with intravenous antibiotics is necessary, sometimes combined with surgical drainage of abscess.
Thyroid Related Eye Problems (Graves' Disease)
Autoimmune thyroid related disease can cause a wide range of symptoms and problems for the eyes, including bulging, redness, tearing, irritation, double vision, pain, pressure, and rarely, loss of vision. The eye problems can start before, after, or during the thyroid problem, and typically progress slowly over about 18-30 months. For a minority of people, the problems are minor and completely resolve, but for most people, the discomfort and change in appearance are long-lasting. Treatment for the eye disease sometimes involves oral medications, radiation, eye drops, or surgery, and is coordinated with primary care physicians or endocrinologists as needed.
Eyebrow Lift
Eyebrow lifting is most commonly performed for cosmetic reasons, but sometimes correction of sagging eyebrows can be performed to improve vision as a reconstructive operation covered by insurance. This procedure elevates the eyebrows, making it easier to open the eyes, and is especially useful for patients with facial paralysis.
Eyelid Ptosis
Ptosis is the medical term for a drooping upper eyelid. This problem affects approximately 5 percent of the population and can affect vision and appearance. The prevalence of this condition increases in the elderly.
Eyelid ptosis can occur from many causes. The most common cause is aging, when the attachments of the eyelid lifting muscle weaken with advancing age. The muscle does not have the same lifting ability and hence the eyelid droops. Some patients are born with a congenital defect in the muscle also causing ptosis. Other risk factors for the development of eyelid ptosis include trauma, contact lens wear, and some neurological conditions. In addition, with aging, excess skin and bags around the eyes can also develop, leading to the tired, sleepy look.
The condition can be either unilateral (one side) or bilateral (both sides). When the drooping is mild, it may be barely noticeable and not impair vision. When severe, the upper eyelid can encroach upon the pupil, causing loss of peripheral vision (side vision). The central visual acuity, the vision necessary for reading an eye chart, is usually not impaired. A special test called, a visual field test, can be performed to determine if vision is affected by the eyelid ptosis. In some cases, where there is vision obstruction, medical insurance may cover some or all of the costs for surgery. Some patients may also elect to have the surgery for cosmetic reasons. Children with ptosis usually need to have the eyelid(s) repaired to permit normal visual development, and for them, surgery is never cosmetic.
Surgery can be performed to repair drooping eyelids and restore them to their natural shape and contour. The procedure is performed usually under local anesthesia as an outpatient. The procedure is painless, takes less than an hour and patients can usually resume their normal activities in about a week.
Blepharospasm
Repeated uncontrollable muscle contraction around the eyes and eyebrows is the hallmark of a disease called blepharospasm. It can be disabling and was the original reason that Botox was developed. Botox is a medicine that can reduce involuntary muscle spasms around the eyelids and eyebrows. Botox is administered in the office in small amounts through tiny injections. Typically, no anesthetic is necessary, and for this purpose, Botox treatment is usually covered by health insurance. The "muscle relaxant" effect of the medicine lasts about three to four months and can be repeated as needed.
Blepharoplasty
(Blef-ah-row-plas-tee) is the common procedure surgeons recommend to remove eyelid skin and fat, to improve vision and/or appearance. Individuals with excessive skin, puffiness, and/or wrinkling are ideal candidates for this procedure.
Laser Resurfacing (Skin Rejuvenation)
State-of-the-art laser treatment can provide remarkable results even on the most environmentally damaged and discolored skin. In more mild cases, light chemical peels can tighten wrinkles, lighten age spots, and soften skin texture around the eyes.
Lid Tumors
Eyelid tumors are not uncommon and can be benign or malignant. The most common malignant eyelid tumors include basal cell carcinoma, sebaceous gland carcinoma, squamous cell carcinoma, and malignant melanoma. Treatment usually includes complete excision followed by reconstructive surgery. After healing, the repaired eyelid often looks and works so well that it is indistinguishable from before.
Loss of an Eye and Ocular Prosthetics
Traumatic accidents and treatment of ocular and orbital cancers, blind and painful eyes, and other diseases sometimes lead to the need for reconstruction of the orbit (eye socket) and removal of an eye with subsequent placement of an orbital implant. With advances in orbital implant materials and surgical techniques, the cosmetic outcome is frequently excellent after surgery, and pain is almost always permanently relieved.
Tearing Problems
Excessive tearing is often due to a blockage of the nasolacrimal duct (the main drainage duct from the eye to the nose). When the system is infected, it is called dacryocystitis. The most common symptoms of dacryocystitis are tearing and a mucous discharge in the eye. At times, the eyelids will be stuck together in the morning. A tender area is sometimes present in the area between the eye and the nose.
Treatment of dacryocystitis often involves antibiotics taken orally. Although this will alleviate some of the symptoms, it will not relieve the blockage or the excess tearing. Surgery is often necessary to bypass the blocked duct and restore normal outflow.
Other causes of excessive tearing include scarring in the tear ducts caused by chemotherapy drugs for breast cancer (especially Taxotere and 5-FU), certain prescription eyedrops, and the Herrick intracanalicular plugs used for dry eyes. Surgery can often be performed to resolve or prevent these problems so that tears flow normally into the nose.
If you’re interested in learning more about eyelid surgery, cosmetic surgery, eyelid lift, facelift, eyelid tuck, necklift, puffy eyelid, brow lift, plastic surgery, blepharoplasty, or any other cosmetic surgery, in Denver or Boulder, Colorado, contact Dr. Fante for an initial consultation.
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