Blepharoplasty(Eyelid Surgery) – BEAUTY BY DESIGN, Las Vegas

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Dear Prospective Patient,

Thank you very much for your inquiry regarding cosmetic eyelid surgery of the upper and/or lower eyes,
formally known as a blepharoplasty.

I have 16 years of experience performing blepharoplasty surgery. In my career, I have performed over 600
cosmetic eyelid procedures over the past five years, which is significantly higher than the national average.

I completed a residency and fellowship at Stanford University Medical Center and remained as a clinical
professor for seven years. I have a practice in Las Vegas, Nevada and in Laguna Beach, California, known as the
Center of Excellence in Facial Plastic & Reconstructive Surgery. I am quadruple board certified including the
American Board of Facial Plastic & Reconstructive Surgery, the American Board of Cosmetic Surgery, Facial
Plastic Surgery and the American Board of Otolaryngology-Head & Neck Surgery.

Sometimes forehead or brow lift surgery is indicated at the same time as upper eyelid surgery to optimize the
result. I have authored a published peer-reviewed manuscript on choosing the optimal forehead lift procedure
given one’s anatomical issues (Koch RJ, Troell RJ, Goode RL: Contemporary management of the aging brow and
forehead. Laryngoscope. 107(6): 710-715, 1997).

With regard to the lower eyelid, sometimes a mid-facelift or volume replacement to the indentation underneath
the eyelid, known as the tear trough, may be indicated. A dermal filler (Restylane, Juvaderm, Radiesse) or
placing your own fat (fat grafting) are available treatment options to fill areas of facial volume deficiency,
especially in the tear trough.

The lower eyelid is addressed either through an incision inside the eye to hide the incision, usually when there is
fat herniation with no to minimal excess skin, known as a tranconjunctival approach. The other option is an
incision immediately below the lower eyelid lashes, usually for excess skin or to strengthen a weak lower eyelid,
known as a subciliary approach. There are No non-surgical eyelid surgical procedures to date.

Surgery on the outer corner of the eye, lateral canthus, is indicated to strengthen a weak or redundant lower
eyelid, known as a canthopexy. The lateral canthopexy may need to be performed simultaneously with the
cosmetic lower eyelid procedure (blepharoplasty).

I have before and after blepharoplasty patient photographs at www.drtroell.com for you to review. I look
forward to meeting you in my office. Thank you again.

Sincerely & Respectfully,

Robert J. Troell,MD, FACS