Will I have a scar from an upper lid blepharoplasty procedure?
A skin incision is made when performing an upper lid blepharoplasty so there will be a scar. However, the incision is hidden in the eyelid crease. Also, the eyelid skin is thin and tends to heal very nicely.
What can I do to heal scars from an upper lid blepharoplasty procedure?
Dr. Parbhu recommends using Biocorneum on the wounds to help improve the appearance of the scar. Using sunscreen and wearing hats and glasses to minimize sun exposure will also help the scar heal well.
How will eyelid scars look after surgery?
For upper lid ptosis and blepharoplasty, the scar is usually not noticeable because it is hidden in the eyelid crease.
How do I hide eyelid scars?
For upper eyelid ptosis repair and blepharoplasty it is hidden in the eyelid crease. For lower lid blepharoplasty, if a skin incision is needed, it is hidden underneath the eyelash line.
Why should I seek consultation for my eyelids with Dr. Parbhu?
Who do you trust more with your eyelids — an ophthalmologist, or a plastic surgeon? They both have their strengths — an ophthalmologist is trained specifically in the delicate details of the eye and has completed years of study devoted to that area. A plastic surgeon is trained in the aesthetic arts and is blessed with creativity and imagination, in addition to their surgical prowess. It is a difficult decision, and yet, there is a simple solution.
Oculoplastic surgery is a relatively new field that has been around since the late 1960s and combines the best elements of ophthalmology and plastic surgery. After completing an ophthalmology residency and gaining proficiency in microsurgical skills and ocular anatomy, an oculoplastic surgeon then completes a plastic surgery fellowship in order to hone their surgical skills of the eyelid, nasolacrimal system and orbit. This gives them a unique vantage point, since they have the advantages of both groups and the limitations of neither.
When looking for a plastic surgeon, board certification is always recommended. This requires passing a host of academic rigors, validation of surgical ability, and a promise of acting ethically. Keshini Parbhu, MD is board certified with the American Board of Ophthalmology and is a member of the prestigious American Society of Ophthalmic Plastic & Reconstructive Surgery. She has written numerous articles and helped teach other ophthalmologists oculoplastic techniques. Additionally, as a female, she brings a woman’s delicate touch and an unparalleled eye for creating beauty.
Does Dr. Parbhu also perform non-surgical cosmetic procedures?
Dr. Parbhu performs injectables to the face including dermal fillers and sculptra. She also injects neurotoxin – Botox and Dysport. Furthermore, she does Kybella. Other cosmetic services including IPL, nonablative laser resurfacing (Resurfx), microneedling, and eyeliner tattoo.
Is Dr. Parbhu considered a cosmetic surgeon?
Dr. Parbhu performs cosmetic surgery and performs non- surgical cosmetic procedures.
What should I expect on the day of my surgery?
Patients are expected to arrive 60-90 minutes prior to the planned surgery time. You will be assessed by a nurse and the anesthesia team in preparation for surgery. You may be asked to change into a gown and an IV will be started. Dr. Parbhu will also greet you and at that time you may ask any questions prior to surgery.
What should I expect after undergoing surgery in terms of recovery and pain control?
Dr. Parbhu encourages patients to take it easy the first two weeks following surgery – no heavy lifting, aerobic exercise, or bending over. She prefers patients to sleep on the back and slightly elevated for the first several nights to help prevent dependent edema and unequal healing. Dr. Parbhu prescribes narcotic pain medications depending on the surgery performed. A detailed postoperative instruction sheet is given on the day of surgery in the post anesthesia care unit.
What are blunt-tipped microcannulas and when are they used?
Blunt tipped microcannulas are a hollow bore tool through which filler can be injected. It is used to place filler in some areas of the face to decrease discomfort and decrease the risk of bleeding and bruising.
How to best prepare for my upcoming botox and fillers
Prior to injectables such as botox and fillers, it is best to discontinue any blood thinners such as aspirin, alleve, ibuprofen, vitamin E, and fish oil. Any anti-inflammatory supplements carry the risk of thinning the blood and increasing the chance of bruising. If it can be discontinued 7-10 days prior to the injectable procedure, this can minimize the degree of bruising. Arnica and bromelain supplements can decrease swelling and bruising. Dr. Parbhu recommends starting this two days prior to surgeries as well as injectable procedures and then continuing for five days. In our office, we carry Arnika Forte which combines both arnica and bromelain.
For non-surgical cosmetic procedures (fillers, botox, etc): Is the procedure painful and should I expect bruising?
We try to make the experience as comfortable as possible for the patient. Dr. Parbhu uses a very small needle for Botox and Dysport injections. The pain is transient and minimal. Patients always have the option of having numbing cream placed or using ice packs prior to the procedure. We also have a distractor that can be placed while injecting to decrease the sensation of pain. There may be more discomfort with filler injection. Numbing cream prior to injection the filler helps and all fillers Dr. Parbhu uses have lidocaine in it so it numbs as it is introduced to help relieve discomfort. Bruising is always a possibility. Dr. Parbhu utilizes Acuvein technology to identify blood vessels while injecting to decrease the chance of bruising.
For non-surgical cosmetic procedures: If I’m not happy with the results, is the procedure reversible?
Fillers are reversible with hyaluronidase. Botox and Dysport are not reversible but the effect of the neurotoxin is only 3-4 months.
What are the risks associated with non-surgical cosmetic procedures?
Bleeding, bruising, allergic reactions, and infection are always possible with even non-surgical procedures. There is also the possibility of introducing product into vessels with resulting loss of blood flow to the affected area. It is important to see specialists that are knowledgeable of the anatomy of the face to minimize these risks. Dr. Parbhu utilizes Acuvein technology to identify blood vessels while injecting fillers to minimize this occurrence.
When can I resume my activities and what are general post care instructions for my non-surgical cosmetic procedures?
For most non-surgical cosmetic procedures, activity may be resumed the following day. Bruising may be covered with concealer on the following day. Using oral or topical arnica may help with any bruising. Cold compresses may be applied gently to the procedural sites to help decrease swelling and bruising but must be done with care to minimize shifting the filler.
What is an Oculoplastic Surgeon?
An oculoplastic surgeon is a physician whose clinical practice consists of aesthetic, plastic and reconstructive surgery specializing in the face, orbits, eyelids and lacrimal system. Dr. Parbhu is a board certified ophthalmologist who spent two years doing a rigorous fellowship under the American Society of Ophthalmic Plastic and Reconstructive Surgery. There are only approximately 500 members in the United States. She is the only female in the Central Florida area with this distinction.
Why an Oculoplastic Surgeon?
Who do you trust more with your eyelids — an ophthalmologist, or a plastic surgeon? They both have their strengths — an ophthalmologist is trained specifically in the delicate details of the eye and has completed years of study devoted to that area. A plastic surgeon is trained in the aesthetic arts and is blessed with creativity and imagination, in addition to their surgical prowess. It is a difficult decision, and yet, there is a simple solution.
What happens during a consultation?
At the initial consultation you will meet with Dr. Parbhu and discuss your concerns. If there is any testing to be performed it may be done at this visit or may require a subsequent visit. Dr. Parbhu will customize a surgical plan for you and discuss the details of the recommended surgical procedures. You will also meet with the surgery scheduler and receive written material to go home with.
Do I need to schedule/make a decision right away?
Surgery can be scheduled at a later date by contacting the surgery scheduler. If the surgery is scheduled several months after consultation it may be necessary for the patient to return to ensure there have been no changes and for insurance cases, to get authorization again.
Will I need to have photos taken?
Yes. Photos are important for documentation as well as monitoring your results and progress following your procedure or surgery. For insurance cases, it is necessary for documentation of the condition and can help with claims of necessity of the procedure.
What if I have additional questions?
We welcome questions and want you to feel comfortable going into your procedure and surgery! Our staff and Dr. Parbhu are available to answer questions through our patient portal or be email.
What testing will I need before surgery?
The testing required prior to surgery will depend on the surgical procedure recommended. Photos for documentation are performed. If eyelid surgery will be covered by insurance then a visual field will be necessary. For lacrimal surgeries, an irrigation of the tear duct system is performed in the office. For orbital disease visual fields and imaging may be necessary.
What type of anesthesia will be used?
Monitored anesthesia care or a conscious sedation is the typical anesthesia used for most of Dr. Parbhu’s surgeries in the surgery center setting. Some lacrimal and orbital surgeries require general anesthesia. In office surgeries can be done without anesthesia or with valium.
Will I need to schedule pre and post-operative appointments?
Yes! It is important to have a preoperative consultation with Dr. Parbhu so that a surgical plan can be developed. At this visit, the recommended surgical procedure(s) will be discussed. If there is any testing to be performed it may be done at this visit or may require a subsequent visit. Postoperative appointments are necessary for suture removal and monitoring the progress of healing.
How much will my procedure cost?
The cost of surgery varies. Dr. Parbhu will determine what your needs are during your consultation. Once a surgical plan is developed, a quote will be given by her scheduler.
Will it be covered by insurance?
If the lids are drooping or there is heaviness of the brow and skin to the degree that it affects the superior field of vision then it may be covered by insurance. We perform visual field testing and take photographs demonstrating the extent of the droop. Dr. Parbhu will determine if you have ptosis, visually significant dermatochalasis (extra skin), and/or brow ptosis that is resulting in functional impairment. If it is, then we send the records and testing to receive authorization. Other reconstructive procedures such as eyelid malpositions, eyelid reconstructions, lacrimal repair and orbital surgery are general covered by insurance plans as well.
Can I finance my procedure/products?
We offer CareCredit to help finance our fees.
Will I have pain after my procedure?
There may be pain following surgery. Dr. Parbhu always prescribed pain medications if it is appropriate for the procedure performed.
What is the typical recovery time?
Generally, patients should expect to have bruising that may last up to two weeks. The majority of the swelling is resolved in the first two weeks as well but it may take 4-6 weeks for residual swelling to resolve. Some medications and medical conditions may cause patients to have swelling that takes longer to resolve.
What if I’m scared or anxious?
On the day of surgery, the anesthesia team can give medications to help relieve anxiety. For in office procedures, valium may be prescribed or nitrous oxide can be administered to help relieve anxiety and discomfort.
What are the risks of surgery?
The risks of surgery depend on the procedure performed. For any procedure bleeding, infection, and risks of anesthesia are possible. For procedures around the eye there is always the risk of change in vision or vision loss. It is important to follow all preoperative and postoperative instructions to minimize this risk! The need for further surgery is also always a possibility. Everyone is asymmetric and Dr. Parbhu aims to achieve better symmetry and this may require a revision.