Klapper Eyelid & Facial Plastic Surgery

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Mon - Fri:	9:00 am - 5:00 pm

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Categories: Physicians & Surgeons, Plastic & Reconstructive, Physicians & Surgeons, Physicians & Surgeons, Allergy & Immunology, Physicians & Surgeons, Cosmetic Surgery, Physicians & Surgeons, Dermatology, Physicians & Surgeons, Family Medicine & General Practice, Physicians & Surgeons, Oncology, Physicians & Surgeons, Ophthalmology, Physicians & Surgeons, Otorhinolaryngology (Ear, Nose & Throat), Physicians & Surgeons, Psychiatry, Physicians & Surgeons, Surgery-General, Skin Care, Surgery Centers

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Phone: (317) 818-1000

Address: 11900 Pennsylvania St Ste 104, Carmel, IN 46032

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Klapper Eyelid & Facial Plastic Surgery

General Practitioners

Arthritis
Sinusitis
Tearing (epiphora) may result from a small or absent lacrimal punctum, narrowing of the canaliculi, or blockage of the nasolacrimal duct. The nasolacrimal duct may become blocked from previous trauma (nasal or orbital fracture), chronic sinusitis, nasal congestion or disease, or from progressive narrowing of the duct (most common). When the nasolacrimal duct becomes blocked, your tears do not flow into the nose like they should and they may overflow onto the cheek. Pooling (stagnation) of the tears in the lacrimal sac can create repeated infections of the sac. These infections are called dacryocystitis and can be serious if untreated.
Primary Care
The amount of swelling and bruising varies from patient to patient and even from the left and right sides in the same patient. Mild bruising may resolve in 2-4 days, whereas more significant bruising may last 10-14 days. Patients may wish to hold blood thinner medications (such as aspirin, ibuprofen, some arthritis medications, Plavix, Coumadin, etc.) prior to surgery in order to minimize the risk of severe bleeding and bruising. Patients should only modify their medication regimen with the advice of their primary care physician, cardiologist, or other prescribing physician.
Smoking Cessation
Smoking is an established risk factor for poor postop healing. Smoking cessation prior to surgery and during recovery will help diminish the risks of infection and other complications. Diabetic patients have similar increased risks associated with surgery.
Family Practice

Ophthalmologists

Glaucoma
Losing an eye to trauma, tumor or end-stage ocular disease such as glaucoma or retinal detachment is a challenging situation for any patient. It is normal for such a loss to have a major impact on one’s self-image and self-confidence. Monocular vision (single eye) may require significant adjustments in the workplace (e.g. commercial drivers, airline pilots, law enforcement, etc.)
Ophthalmology
As an expert in the field of ophthalmology and oculoplatsic surgery, Dr. Klapper has published many original articles in peer-reviewed journals. He has also contributed numerous book chapters on eyelid and orbital reconstruction, anophthalmic surgery, and periorbital infections.
Laser Eye Surgery
The most common type of adult onset ptosis is due to a weakening of the attachment between the levator muscle (the muscle that raises the upper lid) and the eyelid. This may occur as a result of the aging process, after cataract or other eye surgery, contact lens wear, or from an injury. Adult ptosis is less frequently due to other causes such as diabetes, myasthenia gravis, or eyelid or orbital tumors.
Cataracts
Eye Exam
A preoperative comprehensive eye examination is essential to document a patient’s visual acuity, tear film stability, strength of eyelid closure, symmetry of palpebral fissures (eyelid height), previous eyelid surgery, etc. For those considering surgery for functional reasons, a visual field test (with the eyelids relaxed and elevated) is required. Preoperative photos are routinely performed prior to both functional and cosmetic blepharoplasty.

Anxiety

Endocrinologist

Diabetes Care
Thyroid

MRI
Hemifacial spasm is characterized by involuntary contractions of the muscles of one side of the face. The condition typically begins with an intermittent twitching of one eyelid that progresses over months to years to involve other areas of the involved side of the face. Hemifacial spasm is believed to be caused by compression of the facial nerve. While the source of compression is not frequently identified, a magnetic resonance imaging study (MRI and MRA) is typically recommended to identify an anomalous brainstem vessel or brainstem mass lesion. Patients with a known area of blood vessel compression may benefit from microvascular decompression surgery performed by an experienced neurosurgeon.

General Surgery
Cosmetic surgical services include: Blepharoplasty; Endoscopic Forehead Lifting; Botox Injections; and Dermal Filler Injections ( Radiesse and Restylane & Perlane ). Specialized Skin Care Products (Jan Marini and SkinCeuticals) for use around the eyes are available at Dr. Klapper's offices.
Orthopedic Surgery
Porous implant materials offer the potential advantages of host tissue ingrowth. These advantages may include long term implant stability and improved socket motility (movement). Hydroxyapatite (Bio-Eye™) is a hydrothermally altered form of sea coral that was introduced as an orbital implant more than 30 years ago. During the past several decades, porous implants have gained wide acceptance among orbital surgeons. These implants are biocompatible, non-toxic, and non-allergenic. Other synthetic porous implant materials are now commonly used including porous polyethylene (MEDPOR®, Porex Surgical Inc., Newnan, GA,USA) and more recently aluminum oxide (Al2O3) or Alumina. Alumina or Bioceramic Orbital Implants (FCI, Issy-Les-Moulineaux, Cedex, France) are made from a ceramic implant material that has been used in orthopedic surgery and dentistry for more than 40 years. Bioceramic orbital implants were approved for use in the United States by the U.S. F.D.A. in April, 2000 and currently are the most common porous orbital implant utilized in Dr. Klapper’s practice.
Otolaryngology
Mohs Surgery
There are two basic approaches to basal cell and squamous cell carcinoma excision. Skin cancer removal can be performed at the time of reconstruction and the tumor margins examined (" Frozen Sections ") by a pathologist to ensure complete removal. Alternatively, microscopic-assisted resection may be performed by a dermatologic surgeon (" Mohs' Surgery "). This technique offers the potential advantages of less tissue removal and slightly greater confidence of complete cancer resection.
Reconstructive Surgery
Klapper SR. American Society of Ophthalmic Plastic and Reconstructive Surgery 50th Anniversary 2019 Fall Scientific Symposium. San Francisco, California. October 11, 2019.

Plastic Surgeons

Botox
Botox® is a U.S. F.D.A.-approved, purified nerve-blocking agent used to treat overactive facial and eyelid muscles. Clostridium bacteria naturally synthesize a protein called Botulinum toxin. Botox® is the medicine derived from Botulinum toxin type A. There are no bacteria in Botox®, only the delicate Botulinum toxin. Botox® is a protein that is gradually degraded by the body over a period of several months. Botox® protein is so delicate, that it is shipped in a freeze-dried state.
Brow Lift
I had my sugery with Dr. Klapper. He performed an endoscopic brow lift with implants and bilateral blepharoplasties, upper and lower. The surgery, which required general anesthesia, went extremely well. Dr. Klapper told my husband while I was in the recovery room that the procedure went well and he was very optimistic about an excellent outcome. My first post-op visit confirmed that this optimistic expectation is right on target. I cannot thank you enough for referring me to Dr. Klapper. In a word, he is simply great. He is low key, very friendly and very informative. His demeanor is quite calm; he never talks to you, simply with you and answers every question completely and to your satisfaction as a patient. He provides you with extensive and thoroughly readable instructions about matters pre-op and post-op care. He and his staff complement these instructions verbally, so that as a patient, one feels very comfortable. To date, there have been no surprises and I anticipate none due to Dr. Klapper's attention to detail. His interaction with the anesthesiologist was wonderful. The facility where the procedure was performed was first-class from admitting to recovery through discharge. As you may know I worked as an R.N. in an Out-patient department for 10 years and accordingly am able to recognize superlative care when I am the recipient. My husband and I are very impressed with Dr. Klapper's patient and organizational skills, his compassion, his respect for us as persons and his ready availability via phone. If in the future you have a patients who would like to talk with former patients (and spouses), we would be more than glad to talk with them by phone.
Eyelid Surgery
PAIN: There may be some minor or moderate discomfort following eyelid surgery. Most patients will only require Tylenol. Plain or Extra Strength Tylenol, one (1) or two (2) tablets every four (4) to six (6) hours is usually adequate to control postoperative pain. If a prescription or pain medicine has been given to you, use it as directed. Most of the general discomfort due to surgery resolves after 3-4 days. Some areas, particularly the outer corners of the eyes (following lower eyelid surgery) or the scalp (areas of endoscopic forehead surgery) will remain tender for 2-3 months. If you have severe or excruciating pain, notify Dr. Klapper immediately at (317) 818-1000 or (877) 818-8101 [toll-free].
Plastic Surgery
Dr. Klapper lectures throughout North America on a variety of topics in eyelid, tear duct, and orbital plastic and reconstructive surgery. Dr. Klapper's research and surgical skills are recognized among colleagues in ophthalmic plastic and reconstructive surgery, facial plastic surgery, and primary eye care.
Blepharoplasty
Eyelid lifting typically refers to blepharoplasty surgery. Blepharoplasty surgery is performed to remove redundant tissue from the upper or lower eyelids. Cosmetic blepharoplasty is performed to provide a more youthful, rested eye appearance. Upper eyelid blepharoplasty, in some cases, may be covered by some insurance carriers or Medicare if significant visual field loss is caused by redundant upper eyelid skin.
Lip Augmentation
Restylane® is injected into the dermal layer of skin in very small amounts through an ultra fine needle. Topical anesthetic cream applied 15 minutes prior to the procedure is helpful to limit the discomfort associated with injections of the nasolabial folds. Dr. Klapper also provides a topical cryo (freezing) spray to some of his patients that may be particularly sensitive to the injections. Some patients undergoing lip augmentation may require local anesthetic injected under the lip. Dr. Klapper will help you determine which technique may be right for you.
Forehead Lift
The Mid-Forehead Lift involves incisions within the furrows (wrinkles) of the mid-forehead. Patients with deep furrows or rhytids and significant lateral brow ptosis are good candidates for this procedure. An ellipse of tissue is removed from the forehead and the incision site is closed with nonabsorbable sutures. Nonabsorbable sutures diminish scarring in this area and require removal 5-10 days following surgery. Women may utilize makeup on the incision sites following suture removal. Scars are well hidden in patients with deep furrows and gradually fade into the natural forehead wrinkles over the ensuing weeks to months.

Skin Cancer
Surgical excision is the gold standard for management of most eyelid and facial skin cancers. A majority of skin cancers in the eyelid area are either basal cell carcinoma or squamous cell carcinoma. Other cancer types (such as sebacous cell carcinoma, malignant melanoma, and Merkel cell carcinoma) occur more infrequently and generally require wider excision, more specialized resection and reconstruction techniques, and a comprehensive oncologic (cancer) evaluation.
Acne Treatment
Eczema
Anterior Blepharitis is most commonly associated with a bacterial infection (Staphylococcus, Proprionibacterium) or less commonly a parasitic infestation (Demodex folliculorum). Posterior Blepharitis results from meibomian (oil) gland dysfunction (MGD). Obstructive meibomian gland disease is the most common manifestation of oil gland dysfunction. Less often a hypersecretory condition, usually seen with skin disorders such as rosacea, eczema, or seborrheic dermatitis, is the underlying problem. Without delivery of normal meibomian gland secretions to the tear film, the tears become unstable resulting in dry, irritated, and inflamed eyes.
Lesions
Due to the COVID-19 Health Crisis and National State of Emergency or other extenuating circumstance, the patient (and/or parent/guardian) was offered an opportunity to have a two-way, live interactive virtual Telehealth assessment with Dr. Klapper. The patient was made aware and verbalized an understanding of the limitations of video conferencing and examination including the challenges associated with visualizing smaller lesions and abnormalities of the eyelids and face and technical limitations due to the patient’s mobile phone camera and wireless connection. The patient (and/or parent/guardian) understands that their insurance and/or Medicare will be billed for this visit; however, the patient may be responsible for some or all of the visit charges either due to standard patient responsibilities (co-pay, deductibles) or because insurance/Medicare deem this telehealth service as “noncovered”. By clicking below and joining the scheduled telehealth visit the patient and/or their parent/guardian agree to a telehealth visit.
Chemical Peels
Rashes
Skin Care
Klapper Eyelid & Facial Plastic Surgery also offers skin care products focused on maintaining healthy eyelid and facial skin features.

Allergies
Restylane® is approved by the United States Food and Drug Administration (U.S. F.D.A.) for the treatment of moderate to severe facial wrinkles and folds. It has been used by plastic surgeons worldwide since 1996. It is non-animal based and allergy testing is not required. Is has been widely studies and been shown to have a well-defined safety profile.

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