Comprehensive Care in Oculofacial Plastic Surgery
Specialty Care
When your symptoms are more than what they seem, you need specialists who look deeper. Oculofacial plastic surgeons are experts in uncovering the root causes of complex conditions affecting the eyes, orbit and face. We're here to diagnose and treat a wide range of issues with a focus on effective, personalized care. Count on our team to guide you through each step towards better health.
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Excessive tearing may stem from allergies, infections, eyelid malpositions, or blocked tear ducts. Our approach includes a thorough evaluation to accurately diagnose the cause and effectively address your symptoms for lasting relief. Should surgery be indicated we can perform this endoscopically to eliminate the need for skin incisions, leaving no scars.
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Dry eyes can arise from a complex interplay of environmental, systemic, and anatomical factors, and may even indicate underlying rheumatologic disease. At our clinic, your journey to relief begins with a comprehensive review of your symptoms and potential triggers. This is followed by a detailed physical examination and a series of targeted tests designed to pinpoint the exact cause of your dry eye condition. Our approach is meticulous and patient-focused, ensuring that the treatment plan we devise is perfectly tailored to your unique needs.
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Ptosis results from the inability of the eyelid muscles (Mueller's muscle and the levator) to fully lift the eyelids. This condition can make eyes look uneven, half-closed, or sleepy, and may obstruct peripheral vision, affecting daily activities like driving. Some forms of ptosis are treatable with medication. For cases requiring surgery, Dr. Nathan specializes in internal (scarless) and external techniques, as well as sling procedures.
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Age, injury, prior surgery and inflammatory conditions can all cause the eyelid to roll inward (entropion) or outward (ectropion). The discomfort can be unbearable. Symptoms like redness, blurry vision, pain with blink, tearing and discharge are common. A procedure to bring the eyelid back to its natural position is often all it takes to bring substantial relief.
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Skin cancer removal can have a profound impact on both the function and aesthetics of your face, significantly affecting your self-perception and daily life. Our clinic specializes in the sensitive areas around the eyes, excelling in reconstructive surgery following Mohs procedures. We work in tandem with your Mohs surgeon to provide cohesive care. By shifting surrounding tissues and using skin grafts from discreet areas we can restore both your appearance and function.
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Thyroid eye disease presents a spectrum of symptoms, from mild discomfort and dry eyes to debilitating double vision and eye bulging. Accurate diagnosis requires a specialist's insight and may include a comprehensive physical exam, blood tests, and specific imaging. Treatment options range from medication to surgical interventions. Dr. Nathan brings extensive experience in both the medical management of thyroid eye disease and surgical decompression of proptosis, offering personalized care tailored to each patient's unique needs.
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The orbit is the anatomical space that surrounds and supports the eyes. Tumors, both benign and malignant, that develop in this region can affect vision, eye movement, and subtly change the appearance of the face. Accurate diagnosis involves physical exam, neuroimaging, and in some instances, biopsy. Dr. Nathan's specialized training in orbital surgery is crucial for managing these complex conditions, ensuring precise diagnosis and effective treatment. He collaborates with a multidisciplinary team, integrating care across specialties to provide the best possible outcomes.
Facial Rejuvenation
Form follows function. Trained in both ophthalmology and plastic surgery, Dr. Nathan brings a unique depth of understanding to the intricate balance between the functional and aesthetic aspects of the periocular and facial regions. Our approach ensures that each treatment enhances your appearance while also honoring the natural functionality of your face. We offer a comprehensive range of procedures that include surgical, minimally invasive, and non-surgical options.
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Eyelid surgery, or blepharoplasty, rejuvenates upper and lower eyelids to enhance both appearance and vision. An upper blepharoplasty eliminates sagging skin that may impair vision. The placement of the incisions and the amount of skin, muscle and fat to be removed are meticulously considered. For patients from Asian and Hispanic backgrounds, who often present distinct anatomical features such as a less defined or absent eyelid crease and a fuller upper eyelid, Dr. Nathan customizes the surgery to achieve the desired look while ensuring a natural appearance. This tailored approach is frequently referred to as an Asian blepharoplasty.
A lower blepharoplasty reduces under-eye bags that contribute to a tired look. The approach may involve a reduction or repositioning of fat, often complemented by a skincare regimen to reduce dark circles. This customized approach is designed to honor each patient's distinct facial characteristics, ensuring enhancements that are both aesthetically pleasing and true to their natural beauty.
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As makeup artists often emphasize, the eyebrows frame the face; altering them can significantly change the shape of the face. While makeup, plucking, and shaving are the primary methods to keep brows in line with current trends, aging inevitably leads to the descent of the underlying brow volume, or sub-brow fat pad, casting a tired or melancholic expression. This can be addressed through various approaches: small internal sutures during blepharoplasty or incisions camouflaged within the brow hairs or along the hairline. For certain patients, an endoscopic brow lift, involving small incisions behind the hairline to lift the forehead-brow complex, might be the best approach. This technique not only repositions the brows but also smooths forehead wrinkles and "11 lines" that appear between the brows. By tailoring the treatment to each individual's specific needs, Dr. Nathan ensures a revitalized appearance that reflects every patient's unique beauty.
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Botulinum toxin, widely recognized by trade names such as Botox, Dysport, Jeuveau and Xeomin, serves as a versatile treatment that relaxes facial muscles to reduce dynamic wrinkles associated with facial expressions, and can also enhance facial symmetry by shaping and lifting the brow. Recent studies even suggest its potential to improve mood by altering how facial expressions influence emotions. The effectiveness of botulinum toxin injections lies in the precise location, dosage, and technique used, which are critical to avoiding complications like eyelid or brow drooping. Choosing an oculofacial plastic surgeon like Dr. Nathan for your treatment ensures a safe procedure with natural-looking results.
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Facial augmentation with dermal fillers offers an effective solution to address age-related volume loss and structural changes in the mid-face, chin, jaws, temples, and tear troughs. As an oculofacial plastic surgeon, Dr. Nathan employs safe techniques to restore youthful contours, improve facial symmetry, and replenish volume, ensuring results that look natural and blend harmoniously with each patient's features. Among the various fillers available, hyaluronic acid is frequently chosen for its compatibility with the body and safety profile, providing enhancements that can last for up to a year or more. For patients seeking longer-lasting effects, Dr. Nathan may recommend alternatives such as fat transfer or collagen stimulators like Radiesse (calcium hydroxyapatite) or Sculptra (poly-L-lactic acid).
Urgent Concerns
We understand that unexpected health issues can arise at the most inconvenient times. Whether you're dealing with a stye, a cut, a fracture, or an infection, our team is ready to provide prompt and effective care. Trust us to take care of your immediate needs with the attention and expertise they deserve while you focus on the rest of your life.
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Styes and chalazia are both lumps that form in and along the edge of an eyelid, causing discomfort. They arise when a tiny oil gland near the eyelash becomes blocked. Treatment options vary based on the severity and persistence of the condition. For smaller, less severe cases, an injection of medication can help reduce inflammation and promote healing. For more persistent or larger chalazia, a minor procedure may be recommended to remove them. This involves a small incision on the inner side of the eyelid, allowing for the precise removal of the blockage without visible scarring.
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Eyelid lacerations not only affect the appearance but can also impair the functionality of the eyelid. Injuries severe enough to affect the tear duct require meticulous repair to ensure proper tear drainage and prevent chronic eye irritation or watering. Moreover, precise repair of the eyelid is crucial to maintaining its essential functions, such as full closure and proper positioning against the eye. Inadequate repair may lead to complications like eyelid drooping (ptosis), incomplete closure (lagophthalmos), or the eyelid rolling inward (entropion) or outward (ectropion), each of which can significantly impact eye health and vision. As an oculofacial plastic surgeon, Dr. Nathan specializes in the delicate repair of eyelid lacerations, employing techniques that prioritize both aesthetic and functional outcomes.
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Facial fractures, particularly those around the eye, vary significantly in severity—many may not require surgical intervention. While many fractures may heal without the need for repair, delaying or incorrectly addressing those that do require intervention can lead to complications such as double vision, a sunken appearance, or incomplete eyelid closure. Repairing fractures near the eye is often performed through an incision on the inside of the eyelid. This approach minimizes the risk of visible scars on the face, providing an effective solution for restoring function and appearance without external skin incisions.
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Infections and inflammation within the orbit can arise from a variety of sources, such as the sinuses, lacrimal duct, and lacrimal gland. While some cases respond well to medication, others may require the skilled intervention of an oculofacial plastic surgeon to avert vision loss. Additionally, because certain orbital inflammatory conditions can mimic the appearance of tumors, biopsies are often necessary for an accurate diagnosis and appropriate treatment plan. As an oculofacial plastic surgeon, Dr. Nathan specializes in identifying and treating these complex conditions, ensuring both the preservation of vision and the health of the orbit.