Quick Summary
- Oculofacial plastic surgeons offer the most specialized training available for eyelid, orbital, and tear-system procedures.
- Blepharoplasty and related procedures can be performed by oculofacial plastic surgeons, facial plastic surgeons, or general plastic surgeons — each with a different training path.
- Oculofacial plastic surgeons are the rarest of the three specialties, with about 1,000 practicing in the U.S., compared to roughly 3,000 facial plastic surgeons and 8,000 general plastic surgeons.
- Oculofacial training combines a 4-year ophthalmology residency with a two-year ASOPRS-accredited fellowship focused on the eyelids, orbit, tear system, and surrounding facial structures.
- Fante Eye & Face Center’s Denver-based surgeons are exclusively ASOPRS-trained oculofacial plastic surgeons.
- Fante Eye & Face Center’s surgeons typically each perform 500+ blepharoplasty surgeries annually.
Surgeons who perform facial plastic surgery come from several different training backgrounds. There are multiple training pathways that all lead to expertise in facial cosmetic and reconstructive procedures. What’s the difference between these specialties, and what matters most when choosing a surgeon in Denver or the surrounding area? Here’s how to know who’s best for you.
Who Performs Blepharoplasty and Eyelid Surgery?
Blepharoplasty is commonly performed by oculofacial plastic surgeons (oculoplastic surgeons), facial plastic surgeons, general plastic surgeons, and sometimes dermatologists or general ophthalmologists. Oculofacial plastic surgery has very few training slots each year, making it the rarest of the three specialties — about 1,000 practice in the U.S., compared to roughly 3,000 facial plastic surgeons and 8,000 general plastic surgeons nationwide. Although there are fewer oculofacial plastic surgeons, their specialty focus on the eyelid means that each one typically performs 500+ blepharoplasty surgeries annually, at least in our practice.
What Is an Oculofacial Plastic Surgeon?
An oculofacial plastic surgeon is a board-certified ophthalmologist (MD or DO who completed a 4-year surgical residency) who studies eye and facial plastic surgery for an additional two-year fellowship accredited by the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS). During those two years, they:
- are on call continually and must perform research in their field
- see thousands of patients
- perform thousands of procedures while training under masters in the field at U.S. and Canadian medical centers
- write a thesis, and take written and oral examinations
An oculofacial plastic surgery fellow performs virtually every type of cosmetic, reconstructive, and functional eyelid surgery along with a wide range of orbital, lacrimal (tear drainage), and facial surgeries — from droopy eyelid lifting to complex cancer reconstruction to thyroid eye disease to deep plane face and neck lifts. Fellowship training typically includes:
- every type of eyelid surgery, including many variations of upper and lower blepharoplasty
- facial cosmetic plastic surgery, including face and neck lift, brow lift, midface lift, lip lift, and fat transfer/grafting
- orbital surgery
- thyroid eye disease medical and surgical management
- lacrimal surgery
- cosmetic and reconstructive filler and botulinum toxin injections and other non-surgical rejuvenation procedures
Oculofacial plastic surgeons generally do not perform surgery on the rest of the body except for harvesting fat, skin, cartilage, and bone grafts as needed for facial cosmetics or reconstruction.
What Makes Oculofacial Plastic Surgeons Unique?
Oculofacial plastic surgeons receive the greatest concentration of education and surgical experience devoted specifically to the eyelids and surrounding structures. Ophthalmology residency provides 4 years of microsurgical training and extensive experience managing the eye itself. Fellowship then builds on that foundation with advanced training in eyelid, orbital, tear-duct, and facial plastic surgery. This combination gives a detailed understanding of eyelid anatomy and its relationship to the eye — knowledge that helps protect eye health and prevent complications.
What Is the Difference Between Oculofacial Plastics, General Plastics, and Facial Plastic Surgery?
Traditional facial plastic surgeons start out as otorhinolaryngologists who have mastered ear, nose, and throat diseases, then study facial plastic surgery in a one-year (AAFPRS) fellowship. General plastic surgeons train in procedures that may involve the entire body, particularly the breast and abdomen; most start as general surgeons before some later focus on facial cosmetic surgery through additional experience or fellowship training.
Facial plastic surgeons and plastic surgeons also learn blepharoplasty, but they may not master the nuances of anatomy and pathology that permit consistently excellent results; in fact, how much eyelid-specific training they get varies by individual practice and fellowship. Some develop real expertise in cosmetic eyelid surgery, while most focus primarily on rhinoplasty, facelift surgery, breast surgery, body contouring, hand surgery, or reconstructive procedures.
Comparison at a Glance
| Oculofacial Plastic Surgeon | Facial Plastic Surgeon | Plastic Surgeon | |
| Initial residency | Ophthalmology | Otolaryngology (ENT) | General surgery (or integrated plastic surgery) |
| Primary focus | Eyelids, orbit, tear-drainage system, face and neck | Face and neck | Face and body |
| Blepharoplasty | Major focus | Common procedure | Common procedure |
| Eye disease training | Extensive | Limited | Limited |
What Conditions Do Oculofacial Plastic Surgeons Commonly Treat?
Oculofacial plastic surgeons treat both cosmetic and functional conditions affecting the eyelids, eyes, and surrounding facial structures, including:
- Drooping or heavy eyelids
- Under-eye bags and hollows
- Brow descent
- Eyelid malposition
- Orbital conditions
- Tear drainage problems
- Reconstruction after skin cancer
- Cosmetic changes around the eyes and face
At our practice, we spend about half our time working with the eyes, and the other half working with cheeks, jowls, loose necks, scars, sun damage, and other facial cosmetic concerns.
How Should I Choose My Surgeon?
Patients who want the deepest possible training in a narrower range of procedures often choose an oculofacial plastic surgeon for that reason. Training pathway is an important piece of the puzzle, but there are other pieces too — even within a specialty, every surgeon gravitates toward a specific area. Other factors worth weighing:
- Experience with the specific procedure
- Surgical volume
- Aesthetic judgment
- Before-and-after results
- Comfort and rapport with the surgeon
At Fante Eye & Face Center in Denver, our surgeons are exclusively ASOPRS-trained oculoplastic surgeons specializing in cosmetic and reconstructive surgery of the eyelids, orbit, and face. Our focused training allows us to evaluate not only appearance but also eyelid function, ocular health, and the subtle anatomy that contributes to natural, lasting results. Whether your goals are cosmetic, functional, or reconstructive, we believe this specialized expertise helps us provide the highest level of care for patients throughout Denver, Greenwood Village, Castle Pines, Highlands Ranch and the surrounding area.
Dr. Robert Fante, Dr. Alexandra Levitt, and Dr. Amy Huang each completed ASOPRS-accredited oculofacial plastic surgery fellowship training:
- Dr. Robert Fante, MD, FACS — board-certified ophthalmologist, board-certified facial cosmetic plastic surgeon, ASOPRS member, and clinical associate professor at the University of Colorado School of Medicine
- Dr. Alexandra Levitt, MD, MPH — board-certified ophthalmologist and ASOPRS candidate member, who completed ophthalmology residency at Bascom Palmer Eye Institute and fellowship training at the University of Colorado
- Dr. Amy Huang, MD — ASOPRS fellowship-trained oculofacial plastic and reconstructive surgeon with expertise in eyelid, orbital, and Mohs reconstruction procedures
Frequently Asked Questions
There are approximately 1,000 practicing oculofacial plastic surgeons in the U.S., compared to about 3,000 facial plastic surgeons and 8,000 general plastic surgeons.
After a 4-year ophthalmology residency, oculofacial plastic surgeons complete an additional two-year ASOPRS-accredited fellowship focused on the eyelids, orbit, tear system, and surrounding facial structures.
Yes. Training also covers functional and reconstructive conditions such as thyroid eye disease, tear drainage problems, eyelid malposition, and reconstruction after skin cancer.
Generally no, except for harvesting fat, skin, cartilage, or bone grafts needed for facial cosmetic or reconstructive procedures.
Consult an Oculofacial Plastic Surgeon in Denver, CO
If you’re considering eyelid, brow, orbital, or facial surgery, Fante Eye & Face Center can help you understand whether an oculofacial plastic surgeon is the right choice for your goals. To book a consultation with Fante Eye & Face Center in Denver, CO, serving patients throughout Greenwood Village, Castle Pines, Highlands Ranch and the surrounding communities, call (303) 839-1616 today.
External reference links included in Dr. Fante’s submitted draft: https://www.asoprs.org/ (opens in new tab)and https://www.aafprs.org/ (opens in new tab)