For Julie Woodward, M.D., incorporating aesthetics into ophthalmology practice means offering a range of cosmetic procedure options — from surgical to nonsurgical.

“Aesthetics is much more than blepharoplasty,” says Dr. Woodward, associate professor of ophthalmology and dermatology and chief of oculofacial surgery at Duke University Medical Center, Durham, N.C. “Blepharoplasty can be enhanced with lasers and injectable fillers to reduce under eye hollows and rhytids, as well as neuromodulators to reduce dynamic rhytids.”

That’s not to mention the roles of topical cosmeceuticals, such as antioxidants, retinoids, anti-pigment agents and moisturizers, which can brighten, soften and hydrate skin, says Dr. Woodward, whose practice provides neuromodulator and facial filler injections, ablative laser skin resurfacing, laser blepharoplasty, brow lift, vascular laser, micro focused ultrasound skin lifting and micro needling radio frequency skin tightening.

Jacqueline R Carrasco, M.D., F.A.C.S., an oculoplastic and orbital surgeon and attending surgeon at Wills Eye Hospital, in Philadelphia, and Lankenau Medical Center, Wynnewood, Penn., says her practice is 40% medical; 60% cosmetic oculoplastic surgery. However, she says, many of her medical patients want a cosmetic outcome and ask about cosmetic procedures.

“I perform a large amount of cosmetic eyelid surgeries — blepharoplasty of the upper and lower lids and brow lifts,”Dr. Carrasco Dr. Carrasco says.

Oculoplastics is clearly much more than surgery, nowadays.

“When you are performing cosmetic surgeries of the eyelid and/or face, it is natural to segue into injectables,” Dr. Carrasco says. “I perform cosmetic injections with botulinum toxins… and use many fillers for the eyelids and face.”

There are still other options for an oculoplastic practice, according to Dr. Carrasco, including Kybella (deoxycholic acid, Allergan), an injectable to dissolve submental fat, and nonsurgical options, such as Thermage radio frequency tightening, lasers and chemical peels.

High patient demand for cosmetic procedures that don’t interrupt their lives is among the reasons to branch out from surgical options.

“Many patients are looking for less downtime and quick fixes,” Dr. Carrasco says. “Injectables are perfect for this but are limited. The fact is that you may not completely rejuvenate an eyelid without surgery, which many patients in an ophthalmology practice may need ultimately.”