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Photo Credit: Shutterstock<\/span><\/p>\nI am one of approximately 650 surgeons in the country to have completed an ASOPRS fellowship, the two-year accredited training program in ophthalmic plastic and reconstructive surgery that represents the highest credential in the subspecialty of oculoplastic surgery. Only about 25 surgeons are certified each year. I am also a board-certified ophthalmologist who holds an MD and a PhD. What that means in practice, for a patient sitting across from me in a consultation, is the subject of this article.<\/p>\n
What Is Oculoplastic Surgery?<\/h4>\n
Oculoplastic surgery is a subspecialty that sits at the intersection of ophthalmology and plastic surgery. To become an oculoplastic surgeon, a physician must first complete a full residency in ophthalmology, a four-year program that trains them to understand the eye as an organ, with all of the medical and surgical complexity that entails. Only after completing that residency can a physician apply for and complete the two-year ASOPRS fellowship in oculoplastic and reconstructive surgery.<\/p>\n
The result is a surgeon who brings two distinct and complementary bodies of expertise to every procedure they perform on the eyelid and orbit. They understand the eye as a functioning organ, including the lacrimal system that produces and drains tears, the levator muscle that opens the upper eyelid, the orbital septum that separates the eyelid from the deeper orbital structures, and the intricate neurovascular anatomy that determines both function and appearance. And they understand the reconstructive and aesthetic principles that govern how the periorbital region looks and ages.<\/p>\n
A plastic surgeon, even an excellent and highly trained one, arrives at eyelid surgery from a different direction. Their training covers the full range of the body, from breast surgery to body contouring to rhinoplasty. The periorbital region is one area among many in which they develop competency. The depth of anatomical knowledge they bring to the eyelid and orbit is necessarily different from that of a surgeon whose entire specialty is built around that specific region.<\/p>\n The eyelid is the thinnest skin in the body. The structures beneath it are among the most functionally and aesthetically consequential in the face. The margin between a result that looks rested and natural and one that looks operated is measured in millimeters, and the consequences of errors in this region extend beyond aesthetics to function.<\/p>\n A blepharoplasty that removes too much skin can prevent the eye from closing fully, a condition called lagophthalmos that exposes the cornea to drying and damage. A lower lid procedure that disrupts the support of the lid margin can cause ectropion, where the lower lid turns outward and creates chronic tearing, irritation, and a visible cosmetic deformity. An injection placed at the wrong depth near the orbit can cause complications that affect vision. These are not theoretical risks. They are known complications that occur when surgery is performed in this region without a complete understanding of the anatomy.<\/p>\n An oculoplastic surgeon understands these risks at a level that comes from training in ophthalmology as well as surgery. They can manage them if they arise, because they have the clinical training of an ophthalmologist alongside the surgical training of a reconstructive surgeon. That combination is not available from any other credential.<\/p>\n My own training reflects the depth that the ASOPRS credential requires. I completed a combined MD\/PhD program at SUNY Downstate Medical Center, followed by an ophthalmology residency, followed by a two-year ASOPRS fellowship at the University of Washington in Seattle. During that fellowship, I trained in the full spectrum of oculoplastic procedures, from cosmetic blepharoplasty and brow lifting to orbital fracture repair, lacrimal surgery, reconstruction after skin cancer removal, and the management of conditions like Graves disease, where thyroid-related inflammation causes the eyes to bulge forward and requires careful surgical management of the orbit.<\/p>\n That breadth is not incidental. It is the point. An oculoplastic surgeon who has repaired orbital fractures understands the three-dimensional anatomy of the orbit in a way that changes how they approach a cosmetic case. A surgeon who manages Graves disease understands the relationship between the eye socket, the eyelids, and the globe in a way that a cosmetic-only practitioner does not. Every complex reconstructive case deepens the anatomical knowledge that makes cosmetic outcomes more predictable and more safe.<\/p>\n I have also authored and co-authored over 30 abstracts and peer-reviewed publications and written several textbook chapters, presenting my research annually at national ophthalmology and oculoplastics meetings for over 15 years. That academic engagement keeps me current with the literature that should inform every clinical decision in this subspecialty.<\/p>\n The practical implication of all of this for a patient is straightforward: when you are considering surgery on or near your eye, the credential of the surgeon matters in a way it does not for most other procedures.<\/p>\n This is not to say that an excellent facial plastic surgeon cannot produce beautiful eyelid results. Some of the most technically gifted plastic surgeons in the country perform excellent blepharoplasty. But the surgeon who has trained specifically in oculoplastic surgery, who understands the eye as an organ and the orbit as a three-dimensional structure, who can manage the functional complications that can arise as readily as they can achieve the aesthetic ones, brings a level of specificity to this work that is genuinely different.<\/p>\n When you research your surgeon, look for the ASOPRS credential specifically. It means the surgeon completed ophthalmology training, passed the ophthalmology board examination, completed a two-year accredited oculoplastic fellowship, and met the additional requirements for ASOPRS certification. There are only about 650 of us in the country. That number is not a marketing point. It is a reflection of how rigorous the pathway is and how specifically trained the surgeons who complete it are.<\/p>\n One final point that is specific to my own approach: I am also the founder of my own branded skincare line, developed out of the conviction that good skincare and good surgery are not separate pursuits. The quality of the periorbital skin, its thickness, elasticity, pigmentation, and hydration, directly affects both the outcomes of surgical procedures and the rate at which those outcomes age over time.<\/p>\n A patient who arrives at surgery with compromised barrier function, photodamaged skin, or significant pigmentation irregularities will have a different surgical experience and a different long-term result than one who has invested in the skin's health. The skincare line I developed reflects an approach to periorbital care that is informed by the same anatomical knowledge that guides my surgical practice: treating the eye area as a complete system, not as a cosmetic surface to be managed in isolation.<\/p>\n That is, ultimately, what the difference between an oculoplastic surgeon and a general plastic surgeon comes down to. Not prestige. Not a name on a diploma. Specificity. An entire career of training, research, and clinical practice built around one region of the body and the organ at its center.<\/p>\n Dr. Nora Siegal, MD, PhD is a board-certified oculoplastic surgeon and one of approximately 650 ASOPRS fellowship-trained surgeons in the country. She is the founder of LNC Oculoplastics in Lancaster, Pennsylvania, and the creator of her own periorbital skincare line. For consultations, visit lncoculoplastics.com or call 717.819.9011.<\/p>\n","protected":false},"excerpt":{"rendered":" Why your eyelid surgeon’s credential matters more than you think. Dr. Nora Siegal on what sets an oculoplastic surgeon apart.<\/p>\n","protected":false},"author":261,"featured_media":675629,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1402],"tags":[19187,19185,2302,19188,2153,19189,4309,19190,3466,14036,19186],"class_list":["post-675626","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-doctors-talk","tag-blepharoplasty-near-me","tag-dr-nora-siegal","tag-eyelid-lift","tag-eyelid-lift-near-me","tag-eyelid-surgery","tag-haute-beauty-nora-siegal","tag-haute-md","tag-nora-siegal-haute-md","tag-oculoplastic-surgeon","tag-oculoplastic-surgery","tag-oculoplastics-pennsylvania","market-pennsylvania","speciality-eyelid-oculoplastic"],"yoast_head":"\n![\"\"](\"https:\/\/hauteliving.com\/hautebeauty\/wp-content\/uploads\/2026\/07\/shutterstock_2709227695.jpg\")
Photo Credit: Shutterstock<\/span><\/p>\nWhy the Eyelid Is Different From Every Other Surgical Site<\/h4>\n
What the Training Actually Looks Like<\/h4>\n
What This Means for a Patient Considering Eyelid Surgery<\/h4>\n
The Skincare Dimension<\/h4>\n