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Frequently asked questions

Find answers to common questions about oculoplastic surgery and our practice.

General questions

Oculoplastics is the subspecialty of ophthalmology dedicated to the diagnosis and treatment of the eyelids, orbit, and tear ducts. It combines reconstructive and cosmetic surgery to address problems affecting both visual function and the appearance of the eyes.

Every oculoplastic surgeon is first an ophthalmologist. After completing the ophthalmology specialty, they undergo additional training (advanced specialization or fellowship) focused on the eyelids, orbit, and tear ducts, allowing them to operate with a deeper understanding of periocular anatomy and minimize risks to vision.

When the problem involves the eyelids, orbit, or tear duct system, it's best to see an oculoplastic surgeon, since they are specifically trained to operate near the eyeball without compromising vision, and can also treat underlying medical causes (thyroid, tumor-related, traumatic) rather than just the cosmetic aspect.

Orbit and thyroid orbitopathy

This can be due to eyelid retraction or thyroid orbitopathy, among other causes. An ophthalmologic evaluation is important to identify the cause, since in some cases it reflects an active medical condition that needs to be treated promptly.

This is an autoimmune disease associated with thyroid problems that causes inflammation of the tissues around the eye, bulging eyes (exophthalmos), eyelid retraction, and, in advanced cases, double vision. It requires joint management with endocrinology and, in many cases, specialized oculoplastic treatment.

This is a fracture of the bones surrounding the eye, common after facial trauma. If it traps the eye muscles, it can cause double vision. Treatment may be surgical, reconstructing the orbital wall with the patient's own bone or a special material.

Drooping eyelids and blepharoplasty

This is when the upper eyelid droops below its normal position, which can result from aging, prolonged contact lens use, trauma, or congenital causes. When significant, it can obstruct the visual field and give a permanently tired appearance. It is corrected through specialized surgery to reposition the eyelid.

This is the surgery that removes excess skin, muscle, or fat from the upper and lower eyelids. It is performed both for cosmetic reasons (to rejuvenate the eyes) and functional ones, when excess skin limits peripheral vision.

It is generally performed with local anesthesia and sedation, so the procedure is painless. Incisions are hidden within the eyelid's natural folds, so scars are usually practically imperceptible once healing is complete.

Initial swelling and bruising usually improve noticeably within 7 to 14 days. The final result continues to refine over several weeks. The specialist provides personalized instructions based on the procedure performed.

These are lower eyelid malpositions: in entropion, the eyelid rolls inward and the lashes rub against the eye; in ectropion, it turns outward, leaving the eye exposed. Both cause irritation and constant tearing and require definitive surgical correction.

Botulinum Toxin

Botulinum toxin is a purified protein that temporarily relaxes the muscle where it is applied. It blocks the signal the nerve sends to the muscle, so the muscle stops contracting for several months. In ophthalmology it has been used for more than forty years to treat conditions such as blepharospasm and hemifacial spasm, and also to soften expression lines around the eyes.

Yes. Hemifacial spasm consists of involuntary contractions of one side of the face, usually caused by compression of the facial nerve. Toxin applied to the affected muscles significantly reduces the frequency and intensity of the contractions, and it is today the most widely used management option because of its effectiveness and low risk profile.

The most common ones are mild and temporary: redness, slight swelling or a small bruise at the injection site, and occasionally a headache on the first day. Less common — and almost always the result of poor technique — are drooping of the eyelid, asymmetry of the eyebrows, or double vision. All of these are temporary and resolve as the effect of the medication wears off.

The most common ones are mild and temporary: redness, slight swelling or a small bruise at the injection site, and occasionally a headache on the first day. Less common — and almost always the result of poor technique — are drooping of the eyelid, asymmetry of the eyebrows, or double vision. All of these are temporary and resolve as the effect of the medication wears off.

There is no single age. For cosmetic use it is generally considered from around twenty-five to thirty years of age, when expression lines begin to show even with the face at rest. What matters is not age but each person's pattern of facial expression and whether the lines are already visible without gesturing. For medical indications such as blepharospasm, age is not a criterion: treatment is given when the patient needs it.

Yes, it is the treatment of choice. Blepharospasm is the involuntary, repeated closing of the eyelids, which in advanced cases prevents the person from keeping their eyes open and makes reading, driving, or working impossible. The toxin relaxes the muscles responsible for the spasm and restores function. It is applied periodically, since it is a treatment for control rather than a cure.

Yes. Hemifacial spasm consists of involuntary contractions of one side of the face, usually caused by compression of the facial nerve. Toxin applied to the affected muscles significantly reduces the frequency and intensity of the contractions, and it is today the most widely used management option because of its effectiveness and low risk profile.

Yes, and this is a lesser-known use. When facial palsy prevents the eyelid from closing completely, the cornea is left exposed and at risk of ulceration. Toxin applied to the levator muscle induces a controlled, temporary drooping of the upper eyelid, which protects the surface of the eye while the nerve recovers. It works as a reversible alternative to suturing the eyelid.

Yes, and this is a lesser-known use. When facial palsy prevents the eyelid from closing completely, the cornea is left exposed and at risk of ulceration. Toxin applied to the levator muscle induces a controlled, temporary drooping of the upper eyelid, which protects the surface of the eye while the nerve recovers. It works as a reversible alternative to suturing the eyelid.

Yes, and this is a lesser-known use. When facial palsy prevents the eyelid from closing completely, the cornea is left exposed and at risk of ulceration. Toxin applied to the levator muscle induces a controlled, temporary drooping of the upper eyelid, which protects the surface of the eye while the nerve recovers. It works as a reversible alternative to suturing the eyelid.

Yes, and this is a lesser-known use. When facial palsy prevents the eyelid from closing completely, the cornea is left exposed and at risk of ulceration. Toxin applied to the levator muscle induces a controlled, temporary drooping of the upper eyelid, which protects the surface of the eye while the nerve recovers. It works as a reversible alternative to suturing the eyelid.

Yes, and this is a lesser-known use. When facial palsy prevents the eyelid from closing completely, the cornea is left exposed and at risk of ulceration. Toxin applied to the levator muscle induces a controlled, temporary drooping of the upper eyelid, which protects the surface of the eye while the nerve recovers. It works as a reversible alternative to suturing the eyelid.

The first changes appear between the fifth and seventh day, and the full result is seen at around ten days. That is why the follow-up appointment is scheduled after that point: before then, the final effect cannot yet be assessed.

In our experience, between four and six months in most patients. The duration varies according to the indication, the dose, the area treated, and each person's metabolism. For medical indications such as blepharospasm, a periodic schedule is usually established to keep the condition under control.

This is assessed case by case at the follow-up appointment. In some patients a minor adjustment is useful to fine-tune symmetry or reinforce an area that responded less; in most cases it is not necessary. The decision is made with the result in view, never in advance.

For the first four hours you should stay upright and avoid lying down. Do not rub or massage the treated area. For the first twenty-four hours, avoid intense exercise, extreme heat — sauna, steam, prolonged sun exposure — and alcohol. These are simple measures that reduce the risk of the product migrating to a muscle that was not meant to be treated.

The cost depends on the indication, the number of areas, and the units required in each case. The assessment is included in the treatment. At that appointment the plan and the exact cost are defined before anything is applied. Contact our team to find out more about the cost of this procedure.

Cataract Surgery

Cataract surgery is one of the safest and most commonly performed surgical procedures in the world, with a very high success rate. As with any surgery, there are infrequent risks, such as inflammation, infection, increased intraocular pressure, or, in exceptional cases, retinal detachment. Dr. Diener performs a thorough preoperative evaluation and a structured postoperative follow-up to minimize these risks and promptly detect any complication.

Cataracts often present with blurry or cloudy vision, sensitivity to light, halos around lights (especially at night), difficulty reading or driving at night, colors that appear faded or yellowish, and a frequent need to change your glasses prescription. If you notice these symptoms, an eye exam is recommended to confirm the diagnosis.

When both eyes have cataracts, the eye with greater impairment is typically operated on first, and depending on postoperative healing, the second eye is scheduled between 1 and 4 weeks later. This interval allows us to confirm a good recovery of the first eye before proceeding with the second.

There are several types of intraocular lenses: the standard monofocal lens, which provides good distance vision but usually still requires glasses for near tasks; the toric lens, which also corrects astigmatism; and premium lenses (multifocal or EDOF), which reduce dependence on glasses for both distance and near vision. Dr. Diener recommends the most suitable lens type based on each patient's visual profile and expectations.

Most major medical insurance providers cover cataract surgery in full or in part, since it is considered a medically necessary procedure. The exact coverage depends on your specific policy and the type of lens chosen, as some premium lenses may not be fully covered. We recommend confirming the details of your coverage directly with your insurance provider and with our administrative team before surgery.

The cost of cataract surgery varies depending on the type of intraocular lens chosen, whether one or both eyes are treated, and your insurance coverage. We invite you to schedule a consultation with Dr. Diener to receive a personalized evaluation and an exact quote tailored to your needs.

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