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Eyelid Cosmetic Surgery


Dear Prospective Patient,

Thank you very much for your inquiry regarding eye cosmetic surgery of the upper and/or lower eyes, formally known
as a blepharoplasty. I have 20 years of experience performing blepharoplasty surgery. In my career, I have performed
over 800 cosmetic eyelid procedures, 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 am medical director of Estrella Aesthetics & Surgical Arts in Corona, California and the Center of
Excellence in Facial Plastic & Reconstructive Surgery. I am multiple board certified including the American Board of
Facial Plastic & Reconstructive Surgery, the American Board of Cosmetic Surgery in 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). Also, Dysport or Botox can alleviate wrinkles of the forehead, lateral
eye area (crows feet) and between the eyes (glabellar area).

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 (Perlane, Juvaderm, Artefill) or placing one’s
own fat (facial fat transfer) are available 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. Laser skin resurfacing can also rejuvenate the skin in this area.

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

Sincerely & Respectfully,
Robert J Troell, MD, FACS
firma dr troell

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