Cosmetic Botox in PTOSIS Patients

Dr. Ahmad and Daisy’s Formula

There is a reason that Cosmetic neurotoxins like botox and Jeuveau are so popular; these treatments improve wrinkles and have the bonus of opening the eye area. Oculoplastic surgeons love these medications because they improve the appearance of the entire eye area. Neurotoxins like botox are injected in three common areas in the upper face, the crows feet, glabella (between the brows) and forehead. One of the common questions Oculoplastic surgeons get asked is; can I get botox if I have an upper eyelid ptosis?

Upper eyelid ptosis is a droopy eyelid from a stretched out eyelid muscle. In these cases the patients use their forehead muscles (Frontalis muscle) to open their eyes. Most patients don’t even know they are using their forehead muscles to open their eyes. In patients with eyelid ptosis we have to be very careful about cosmetic neurotoxins as they can worsen ptosis or increase the asymmetry of the eyelids.

Patients with congenital ptosis and acquired ptosis develop eyebrow elevation which opens the upper eyelid. In older patients chronic years of lifting the forehead will cause them to have deep wrinkles. These patients will often seek cosmetic improvement of the forehead because they don’t like the wrinkles on the forehead. Unfortunately if these wrinkles are over treated the upper eyelid will become even more droopy because now the forehead muscle can not help lift the droopy eyelid. That is why Dr. Ahmad and Daisy try to educate their patients that although improved wrinkles on the forehead does freshen the look of the patient but not if it comes at the expense of worse drooping of the eyelids!

Patients with upper eyelid ptosis require an individualized plan of attack when using neurotoxins like botox or jeuveau. We usually recommend minimal neurotoxins on the forehead especially on the side of the forehead where the upper eyelid is heavier or lower. We also recommend treating the area between the eyebrows (glabella) and the crows feet as both these areas will help to keep the eyebrow from falling if too much neurotoxin has been given in the frontalis muscle(forehead muscle).

Very often Dr. Ahmad will recommend ptosis surgery to repair the droopy eyelid. In most cases the eyebrows will relax somewhat after surgical repair causing the wrinkles on the forehead to Improve. Once the eyelid has been repaired the patient can have more neurotoxin on the forehead to improve the appearance. We try to educate the patients that a forehead that is overly smooth, shiny or lacking movement is not a natural look for most patients. This type of appearance of a forehead tends to attract negative attention and takes away from the patients overall appearance. In general, less neurotoxin in the forehead leads to an overall better harmony of the upper third of the face. Please come and have us take a look at how we can better improve your appearance.


Navigating the Cutting Edge: Exploring the Latest Techniques in Oculofacial Surgery

With Dr. Amjad Ahmad


In the ever-evolving world of medical science, oculofacial surgery stands at the forefront of innovation. This specialized field focuses on rejuvenating and enhancing the appearance of the eyes and surrounding structures. As we delve into the latest techniques in oculofacial surgery, we’ll discover how this dynamic field continues to redefine beauty and restore confidence.

The Evolution of Oculofacial Surgery

Oculofacial surgery, also known as oculoplastic surgery, has come a long way since its inception. Originally, its primary purpose was to treat functional issues related to the eye and eyelids. However, as patients increasingly sought cosmetic enhancements, the field expanded to address aesthetic concerns as well.

1. Non-Surgical Options

One of the latest trends in oculofacial surgery is the integration of non-surgical procedures. Treatments like Botox, dermal fillers, and laser therapy have gained popularity due to their minimal downtime and impressive results. These procedures can smooth wrinkles, lift drooping eyelids, and rejuvenate the periorbital area without the need for invasive surgery.

2. Customized Approach

Modern oculofacial surgeons emphasize personalized treatment plans. They understand that every patient is unique and requires a tailored approach to address their specific concerns. This approach involves a comprehensive consultation to determine the most suitable techniques, whether surgical or non-surgical, to achieve the desired outcome.

3. Advanced Surgical Techniques

For those seeking more comprehensive transformations, advanced surgical techniques are continually emerging. These include:

  • a. Blepharoplasty: This procedure involves reshaping the eyelids to create a more youthful appearance. Newer techniques focus on minimizing scarring and achieving natural-looking results.
  • b. Canthopexy: Canthopexy is a surgical procedure used to lift and support the outer corners of the eyes. It can provide a subtle yet effective enhancement to the eyes’ shape.
  • c. Midface Lift: This technique rejuvenates the midface area, reducing sagging and restoring a youthful contour. It can complement eyelid surgery for a harmonious result.
  • d. Endoscopic Brow Lift: This minimally invasive procedure lifts the eyebrows and smooths forehead wrinkles through tiny incisions. It offers a shorter recovery time compared to traditional brow lifts.

4. Focus on Safety

Patient safety remains paramount in oculofacial surgery. Surgeons are adopting the latest safety protocols and technologies to minimize risks and complications. These include meticulous surgical planning, infection control measures, and the use of advanced anesthesia techniques.


Oculofacial surgery has evolved dramatically, offering a wide range of options for both functional and aesthetic improvements. The latest techniques in this field prioritize natural-looking results, minimal downtime, and patient-centric care. Whether it’s a non-surgical touch-up or a comprehensive surgical transformation, oculofacial surgery continues to redefine beauty and boost confidence, one procedure at a time.


Understanding the Procedures: A Comprehensive Guide to Oculofacial Surgery

With Dr. Amjad Ahmad


Our eyes are not only the windows to our souls, but they also play a vital role in our day-to-day lives. However, various eye conditions can affect our vision and overall eye health. In some cases, oculofacial surgery can provide effective treatment options to alleviate these conditions, improving both our vision and quality of life. In this blog post, we will explore some of the most common eye conditions and how oculofacial surgery can help in their management.

1. Ptosis (Droopy Eyelid)

Ptosis, or a droopy eyelid, is a condition characterized by the sagging of the upper eyelid. It can obstruct the visual field, causing a diminished range of vision. Oculofacial surgeons can perform a procedure called blepharoplasty to correct ptosis. During this surgery, excess eyelid skin and fat are removed, allowing the lid to open fully and restoring a clear field of vision.

2. Entropion and Ectropion

Entropion involves the inward turning of the eyelid, causing the eyelashes to rub against the cornea. This can result in discomfort, excessive tearing, and potential corneal damage. Conversely, ectropion is the outward turning of the eyelid, leading to exposure and drying of the cornea. Both conditions can be corrected through surgical procedures that restore the eyelid’s normal position, preventing further damage to the cornea and improving overall eye health.

3.Eyelid Tumors

Eyelid tumors can arise from both benign and malignant sources. Oculofacial surgeons specializing in orbital oncology can remove these growths using highly precise surgical techniques. Early intervention is crucial in the case of malignant tumors, as timely removal can prevent further spread and improve prognosis.

4. Tear Drainage System Disorders

Disorders of the tear drainage system, such as blocked tear ducts, can cause excessive tearing and discomfort. In such cases, oculofacial surgeons can perform dacryocystorhinostomy (DCR), a procedure that creates a new drainage passage by bypassing the blocked tear duct. This surgery allows tears to drain properly, alleviating symptoms and reducing the risk of infection.

5. Thyroid Eye Disease (TED)

Thyroid eye disease, commonly associated with Graves’ disease, causes eye-related symptoms such as bulging eyes, double vision, and eye pain. Oculofacial surgeons skilled in TED management can perform orbital decompression surgery, which involves removing bone from the eye socket to alleviate pressure on the optic nerve. This procedure not only improves the eye’s appearance but also reduces the risk of vision loss associated with severe TED.

6. Eyelid Malpositions

Eyelid malpositions, such as eyelid drooping (eyelid ptosis) or elevation (eyelid retraction), can occur due to various factors, including age-related changes, trauma, or congenital conditions. Oculofacial surgeons employ techniques like eyelid repositioning or tightening to correct these malpositions, resulting in improved eye function, comfort, and aesthetics.

7. Facial Aging

As we age, our facial tissues lose elasticity, leading to the development of wrinkles, sagging eyelids, and hollowed-out areas around the eyes. Oculofacial surgeons employ facelift techniques, such as blepharoplasty and brow lift, to address these concerns. These procedures tighten and rejuvenate the skin and underlying tissues, revitalizing the overall appearance and giving patients a more youthful, alert look.


Oculofacial surgery encompasses a wide range of procedures that can effectively address various eye conditions and related issues. From correcting eyelid malpositions to treating conditions like thyroid eye disease or eyelid tumors, specialized oculofacial surgeons offer the expertise to restore and improve vision as well as enhance aesthetic appeal. If you are experiencing any of these eye conditions, consultation with an oculofacial surgeon is a valuable step toward receiving the personalized care and treatment plan that can significantly improve your eye health and quality of life


Understanding the Procedures: A Comprehensive Guide to Oculofacial Surgery

With Dr. Amjad Ahmad


Oculofacial surgery, a specialized branch of ophthalmology, focuses on providing surgical solutions for various conditions affecting the eyelids, orbit (eye socket), tear ducts, and surrounding facial structures. These procedures aim to improve both the functional and aesthetic aspects of the eyes and their surrounding areas. This comprehensive guide will delve into the various oculofacial surgeries and provide an in-depth understanding of their procedures and potential benefits.

I. Blepharoplasty: Enhancing the Eyelids’ Appearance

Blepharoplasty, the most common oculofacial surgery, addresses aesthetic concerns and functional problems related to the eyelids. This procedure targets excess skin, fat deposits, and muscle laxity that cause drooping upper or lower eyelids, obstructing vision and giving a tired appearance. By surgically removing or redistributing excess tissues, blepharoplasty can rejuvenate the eyes, making them appear more alert and youthful.

II. Ptosis Repair: Correcting Eyelid Droop

Ptosis refers to the drooping of the upper eyelid, often resulting from weakened or detached muscles responsible for lifting the lid. Ptosis repair involves tightening or reattaching these muscles to improve eyelid function and field of vision. This surgery not only restores clear vision but also enhances the aesthetic symmetry of the eyes, contributing to a more balanced and youthful appearance.

III. Entropion and Ectropion Repair: Restoring Eyelid Position

Entropion and ectropion are eyelid malpositions that can affect the eyelid’s position, leading to discomfort, excessive tearing, or drying out of the eye. Entropion occurs when the lid turns inward, causing eyelashes to rub against the cornea, while ectropion occurs when the lid turns outward, leaving the eye exposed to the elements. Surgical repair of these conditions involves restoring the eyelid’s proper position, improving comfort, and preventing potential complications such as corneal damage.

IV. Orbital Decompression: Relieving Pressure on the Eye

Orbital decompression is a surgical procedure performed to alleviate pressure on the eyes caused by conditions like Graves’ disease or orbital tumors. By removing bony tissue or fat in the eye socket, this procedure creates extra space for the eyes, reducing bulging of the eyeballs and improving overall eye function. Orbital decompression can restore a more natural eye appearance while relieving pain, discomfort, and potential vision complications.

V. Tear Duct Surgery: Navigating Obstructions

Tear duct surgery, also known as dacryocystorhinostomy (DCR), aims to address tear duct obstructions that result in watery eyes, recurrent infections, and tearing. This procedure involves creating a new pathway between the tear sac and the nasal cavity to bypass the blocked portion, allowing proper tear drainage. By eliminating tear duct obstruction, this surgery can alleviate symptoms, improve tear flow, and enhance overall eye comfort.

VI. Eyelid Reconstruction: Restoring Form and Function

In cases of eyelid trauma, cancer excision, or congenital malformation, eyelid reconstruction becomes necessary to restore both functionality and aesthetics. This surgery involves intricate techniques to rebuild the structures of the eyelid, ensuring proper alignment, protection of the eye, and maintaining a natural appearance. Eyelid reconstruction often employs advancements such as skin grafting, local flaps, and even tissue engineering to achieve optimal results.


Oculofacial surgery encompasses a wide range of procedures that aim to enhance vision, improve eye comfort, and restore the aesthetic appearance of the eyes and surrounding facial areas. From blepharoplasty and ptosis repair to tear duct surgery and eyelid reconstruction, each procedure plays a vital role in addressing specific oculofacial conditions. By understanding the procedures available, individuals can make informed decisions and embark on their journey towards improved eye health and appearance. Remember, consulting with a qualified oculofacial surgeon is key to determining whether these surgeries are suitable for each patient’s unique needs and goals.


Understanding the Role and Expertise of an Oculofacial Surgeon

With Dr. Amjad Ahmad


Medical advancements have allowed for the emergence of specialized fields within the broader realm of healthcare. Oculofacial surgery is one such unique field that focuses on the delicate procedures involving the eyes, eyelids, and surrounding structures. In this blog post, we will explore the fascinating world of oculofacial surgery, understanding the role of an oculofacial surgeon, their qualifications, expertise, and the diverse range of conditions they treat.

Defining Oculofacial Surgery:

Oculofacial surgery is a specialty that combines the disciplines of ophthalmology and plastic surgery. An oculofacial surgeon possesses detailed knowledge of both medical and surgical aspects related to the eyes and its surrounding facial structures. By integrating these two fields, oculofacial surgeons deliver comprehensive care with a focus on functional and aesthetic improvements.

Qualifications and Training:

To become an oculofacial surgeon, one must first complete a rigorous educational journey. After obtaining a medical degree, aspiring oculofacial surgeons complete a residency in ophthalmology, usually lasting three years. This residency provides a strong foundation in understanding eye-related diseases, diagnosis, and medical management. Following this, surgeons pursue a fellowship specifically focused on oculofacial surgery, which typically lasts one to two years. During this fellowship, surgeons acquire specialized training in both surgical and non-surgical techniques to treat various eye and facial conditions. This training encompasses eyelid surgery, orbital surgery, lacrimal (tear drainage) system surgery, dermal fillers and injectables, laser treatments, and much more.

Expertise and Conditions Treated::

Oculofacial surgeons possess a wealth of expertise in treating a diverse array of conditions. Let us delve into some of the key conditions and procedures they specialize in:

  1. Eyelid Surgery: Oculofacial surgeons can perform both functional and cosmetic eyelid surgeries. These procedures address droopy eyelids (ptosis), eyelid malpositions (entropion and ectropion), excess skin and fat pockets (blepharoplasty), and eyelid reconstruction following trauma or cancer treatment.
  2. Orbital Surgery: Surgeons skilled in oculofacial surgery possess the necessary knowledge to diagnose and treat various orbital diseases and conditions. These may include orbital fractures, disorders affecting the optic nerve, benign or malignant tumors, and congenital anomalies.
  3. Tear Drainage System Disorders: Oculofacial surgeons diagnose and treat conditions affecting the tear drainage system, such as blocked tear ducts or excessive tearing. Surgical procedures, such as dacryocystorhinostomy (DCR), are performed to restore normal tear drainage.
  4. Facial Rejuvenation: Oculofacial surgeons are often sought after for their expertise in non-surgical facial rejuvenation techniques. They carefully and skillfully administer treatments, such as dermal fillers, injectables, and laser therapies to enhance facial aesthetics, reduce wrinkles, and restore a youthful appearance.
  5. Thyroid Eye Disease: Oculofacial surgeons play a vital role in managing the complexities associated with thyroid eye disease (TED). Their valuable expertise helps alleviate symptoms like bulging eyes, double vision, and eye discomfort, while also providing cosmetic interventions if required.


Oculofacial surgery offers a unique blend of ophthalmology and plastic surgery, bringing specialized care to patients seeking treatments for conditions related to the eyes and surrounding facial structures. The extensive training and expertise of oculofacial surgeons allow them to perform intricate procedures while addressing both functional and aesthetic concerns. From treating eyelid malpositions and orbital diseases to managing tear drainage disorders and implementing facial rejuvenation techniques, these professionals play a significant role in improving patients’ quality of life.

With their comprehensive knowledge, technical skills, and dedication to patient care, oculofacial surgeons continue to be the key players in managing and treating a broad spectrum of eye-related conditions, employing cutting-edge surgical techniques and innovative non-surgical interventions.

Copyright © 2024 Dr. Amjad Z. Ahmad.