Ronald Mancini, M.D. Answers Questions On: Oculoplastic Surgery

An oculoplastic surgeon is an ophthalmologist who’s had extra fellowship training to specialize in plastic and reconstructive surgery around the eye. This area may be small in size, but our training is comprehensive and rigorous. We cover everything from orbital fracture repairs caused by trauma to cosmetic procedures. There aren’t many oculoplastic specialists; our professional organization, the American Society of Ophthalmic Plastic and Reconstructive Surgery, has fewer than 600 members worldwide. Despite this, two are at UT Southwestern (Dr. Kamel Itani and myself).

Definitely not. As a matter of fact, oculoplastics is moving increasingly toward less-invasive procedures with smaller incisions that can be done in the office. We now know that nonsurgical options are, for certain conditions, simply better than surgery. When I work with patients, my goal is to give them the results they want in the most minimally invasive way possible and with the least downtime so they can get back to their families and busy lives sooner rather than later.    

We used to think gravity was the main villain in aging: sagging, bagging, drooping, etc. The idea was, surgery was needed to undo the effects of gravity: pulling and tugging skin “up” with surgery to address sagging tissues. While gravity certainly does play a role in making us look older, the latest research shows that the primary hallmark of facial ageing is volume loss. Think of a ball that’s lost some air: its surface is not as taut as it is when pumped up. Our maturing skin is the same. We now have injectable fillers to volumize areas that have lost soft tissue below the skin’s surface. In other words, cosmetic oculoplastic procedures are more “fill and volumize” and less “nip and tuck.”