Congenital Ptosis: Patient’s Surgical Experience with Dr. Sean Paul in Austin, Texas

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Earlier this year, Dr. Sean Paul had the pleasure of meeting an incredible patient who was born with congenital ptosis. Although the correction of congenital ptosis is one of the most difficult challenges ophthalmologists face, Dr. Paul knew that this procedure would greatly enhance his patient’s quality of life. After careful discussions with the patient and their family, Dr. Paul was trusted to perform ptosis surgery (frontalis sling) on his patient. This type of surgery is useful in instances where the levator function is very poor. In this procedure, the eyelid is coupled to the frontalis muscle using a sling. The surgery went very well and the patient along with their family couldn’t be happier with the results.

Below you can read about his experience and see the incredible before and after photos as well:

congenitalptosisbeforeandafter“I have congenital ptosis in both eyes. My entire life I felt like my eyes were a source of character and I’d learned to love and live with them. But at 27 years old, I started seeing a difference in my vision and my posture. Mostly, difficulty focusing when driving at night and having soreness in my neck, as my head was always lifted up in order to see properly.
I saw a well-respected facial plastic surgeon to get an opinion, and within a minute he could tell what I needed was a functional surgery, not cosmetic. The first doctor he recommended was Dr. Paul and within a few months I was shaking Dr. Paul’s hand for the first time.

After two meetings with him going over the surgery, meeting my parents to discuss outcomes and risks, and then going over what the recovery would be like, my decision was actually obvious. Even with as big of a decision as this is, I knew I wanted to go through this and I knew Dr. Paul was the right doctor for me.

Four months later, I can say the outcome is great. My eyes are lifted, my vision and posture make life a lot more comfortable. And my friends and family love the change.
At least for me, the recovery process is the most stressful part of the surgery. Dr. Paul made it smooth. He made sure I felt as little pain as possible and he recommended the drops and ointment that really did the job. And if I sent him an email at 8pm on a Saturday asking a question, I could expect a reply or a text back really quickly.

Dr. Paul is one of the most intelligent, professional, and empathetic doctors you’ll find. He is the kind of doctor that ensures you don’t feel like you’re going through the process alone. Even if it’s just for an opinion, I would recommend anyone to contact Dr. Paul, you’ll will feel better about yourself and your situation having done so.”

Contact us if you have any questions or would like more information on this procedure

Patient Lip Enhancement Experience With Dr. Paul

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One of the most popular treatments at Austin Oculofacial Plastics is the non-surgical lip augmentation. Lip augmentation increases fullness in the lips by using one of a variety of minimally invasive techniques. The most popular fillers used at our practice are Restylane and Juvederm (both Juvederm and Restylane are FDA approved hyaluronic acid fillers). There are minor technical differences between the two and both are proven to provide lasting results. Make sure to discuss your expectations with an experienced surgeon like Dr. Sean Paul in order to decide which product would be best suited for your aesthetic goals.

Suffice it to say, it makes our world go round when our patients are happy with their results and even more so when they send us updates and feedback about their experience with Dr. Paul. Below is one of our patient’s shared experience on her very first lip augmentation treatment:

“I’ve always been self-conscious about my thin lips. Every time I went to put on makeup I noticed how small they were and wished they were bigger. I avoided red lipstick because I worried it would only call attention to the issue, so I stuck to natural tones or no lipstick at all. It wasn’t a huge deal, but as a woman who cares about her appearance, it was one that was often on my mind.

I never had filler injections before so I was nervous about having the procedure done all together. Now-a-days it’s not uncommon to see cases of the dreaded “duck lips” and the thought of having overly plumped lips scared me. I did diligent research and read multiple reviews to consider whether I really wanted to take the chance. Lucky for me, I was able find Real Self and I began to follow Dr. Paul’s website for a few months before I decided to bite the bullet. Boy am I glad I did! I seriously love, LOVE my plump lips!

Before Lip Augmentation

Before Lip Augmentation

After Lip Augmentation

After Lip Augmentation

When I went in for my initial consultation, I knew right off the bat that I had chosen the right place. Dr. Paul’s friendly staff made me feel so at home that it literally melted my nerves away. I was brought back to see Dr. Paul quickly (I hardly remember waiting!) and he was genuinely the nicest doctor I had ever met. We talked about my goals as well as my concerns and all of his answers reassured me that this was exactly what I wanted. I was ready to proceed that same day!

I went with 1 full syringe of Juvederm to achieve the results I was after. Apparently Juvederm and Restylane both have lidocaine so that they numb as they beautify but his staff still applied a topical numbing cream to ensure the pain was virtually non-existent. I waited 10 minutes with the numbing cream before Dr. Paul came back in to plump my lips. He tried to be conservative since it was my first time and we used a little over half the syringe during my first treatment (the treatment took about 15 minutes so I was in and out in less than 45 minutes which is awesome for my busy schedule!) After two weeks I went back to see the doctor so he could see how my lips were settling and I was ready for just a bit more so we used up the rest of the syringe. The day of the treatment my lips were a little swollen but the following two days I saw the most swelling. There was minor bruising in a couple of the injection sites but I was easily able to cover them up with lip gloss. In less than a week the lips settled into their final form and I’m still really enjoying the plump look. I get so many compliments from close friends who are now interested in the procedure as well!

To top it all off, Dr. Paul and his wonderful staff were so compassionate. The doctor’s professionalism and caring personality made me feel so safe and comfortable the entire time. Everything from his consultation, the procedures, and daily phone calls added to my confidence that he was the most exceptional surgeon I could’ve chosen! I would highly recommend Dr. Paul to anyone who is looking for a down-to-earth plastic surgeon to do work around their eyes and face. Surgically and non-surgically he has achieved incredible results. He is truly amazing at what he does and he has earned my trust for life. Thanks Dr. Paul!”

Protect your Eyes this Summer!

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The Central Texas summer is known for a lot of heat and sunshine. And by a lot, we mean just enough to drive you a little bit crazy. The kind of crazy that makes you thank your lucky stars for swimming pools, Barton Springs, and the beautiful bodies of water that Austin and its surrounding towns have to offer. But what we forget is that all that time spent keeping cool near the water leaves us exposed to harmful UV rays. Getting through the Central Texas summer means frequent exposure to powerful sunlight on a regular basis, so whether or not you spend your free time outdoors – there is no better time to review the realities about the damage that ultraviolet radiation can inflict on one’s skin and then take precautions to prevent it.


Be careful when spending time in the blistering Texas sun.

People who spend a lot of time outdoors run the risk of suffering from more than just heat exhaustion or heat stroke. Repeated exposure to ultraviolet (UV) radiation places you at risk for various forms of skin cancer and eye diseases, such as cataracts. The number of skin cancer cases in the United States continues to increase each year. Skin cancer is the most commonly occurring cancer in the United States. The American Cancer Society estimates that over one million cases of skin cancer are diagnosed each year. The most serious form of skin cancer is Melanoma. An estimated 68,720 Americans will be diagnosed with Melanoma this year and about 8,650 of those people will die from the cancer. UV radiation also damages the sensitive retinal and corneal areas of the eyes. Long term exposure can cause macular degeneration, cataracts, pterygium, and cancer of the eyelids. These disorders affect vision and in some cases can cause blindness. Skin cancer is not usually the result of a single, painful sunburn. Farmers, landscapers, and others whose occupations require long hours working outdoors are at a high risk for prolonged exposure to UV radiation. Small changes occur to the skin each time it is exposed to sunlight and repeated exposure can cause progressive damage to the skin’s biological structure. The sun’s rays are most intense and damaging during the summer months. The greatest exposure occurs from 10:00 a.m. until 4:00 p.m., but you can still get a sunburn during cloudy weather, other seasons, and other times of the day.

Your eyelids matter!

When putting on sunscreen, eyelids are often ignored. You might try to avoid getting the sunscreen in your eyes or feel that since you wear sunglasses, you don’t need to apply it around the eyes but because eyelids have thin, delicate skin, they are quite prone to cancer. Untreated, eyelid cancer can lead to blindness or spread into the nasal and orbital cavities.

Eyelids take up such a small amount of skin surface that most people don’t connect eyelids with skin cancer. Surprisingly, skin cancers on this small space make up about 10 percent of all basal cell carcinomas, squamous cell carcinomas and melanomas according to the Skin Cancer Foundation. The large majority of skin cancer on the eyelid is basal cell carcinoma (about 90%) with the second largest type being squamous cell carcinoma. About one percent of eyelid cancer is melanoma. Don’t risk these outcomes and make sure you apply sunscreen to your eyelids any time they will be exposed to direct sunlight for long periods of time.

Signs and Symptoms of sun damage

Tumors on the eyelids often grow under the surface of the skin, making it difficult to detect. Some of the signs you might notice are:

  • An unexplained loss of eyelashes
  • Red eye or inflammation of the eyelids that doesn’t go away or doesn’t respond to treatment
  • A small bump that doesn’t go away
  • Lesions or growths with irregular borders

In most cases, lesions on the eyelid are painless and benign. If they look similar to a scar, grow or change shape and bleed or crust you will want to seek treatment. If they do not clear up with treatment. If you think you may be experiencing these symptoms, make an appointment to see Dr. Paul immediately.

Who is at Risk?

Everyone is vulnerable to damage from UV radiation, however people who burn easily and rarely tan, have freckles, light complexions, blonde or red hair, and/or blue or gray eyes have a greater risk of developing skin cancer. Early detection of skin cancer is truly the first step for successful treatment. If you notice the growth of a new mole, discoloration change to an existing mole on your eyelids, call our office at 512-642-5050 to see Dr. Paul as soon as possible.

Protective Measures

Areas of the body that are most at risk to exposure of UV radiation are the back of the neck, ears, face, eyes, and arms. These and other body parts can be easily protected by wearing proper clothing, sunglasses, and sunscreen. You can reduce your risk by taking precautions and avoiding repeated exposure to the sun.

You will want to find sunscreen options that are SPF 15 and above for the best protection. Sunglasses are also very important. You want to look for sunglasses that provide UV protection. Check to make sure they offer protection from both UVA and UVB rays. Keep in mind that sunglasses should be worn year round, not just in the summer. Make sure the lens are large enough to cover your entire eye area.


Hats also provide excellent protection from the sun’s rays. We suggest wearing hats with at least a 3 inch brim; these hats will block as much as half of the sun’s rays from reaching your eyes.

Now that you have the best tips to keep your eyelids and skin safe this Texas summer, have fun!




You can look years younger! with Cosmetic Eyelid Surgery (Blepharoplasty)

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Your eyes are far too important to take for granted. Trust your eyes to an ophthalmic plastic surgeon like Dr. Sean Paul, MD the ultimate eyelid expert!

Blepharoplasty, also known as cosmetic eyelid surgery, can do some wonderful things to one’s overall appearance and self-esteem. If you have bags above or beneath your eyes, this procedure can address your areas of concern by removing or repositioning the fat. If your upper eyelids are droopy, or have excess skin that hangs, the muscles can be tightened or skin can be removed to give you a more rested and youthful look. Depending on your particular case, Dr. Paul may even be able to perform your eyelid surgery with no visible skin incisions and have you back to your regular routine in a few days!

What are my options?

Board Certified Oculofacial Plastic Surgeon, Dr. Sean Paul will choose the right procedure for you based on your physical characteristics and aesthetic concerns.

Upper Eyelid Surgery: As the name suggests, this procedure addresses the drooping or sagging of the upper eyelids. During the procedure, incisions are created in or under natural skin folds while excess skin, muscle, and fat are removed. If “crow’s feet” or wrinkles are a concern, the incisions may extend past the eye’s outer corner to allow the surgeon to smooth these wrinkles.

Lower Eyelid Surgery: There are a number of options for performing lower eyelid surgery:

  • The traditional approach places the incision just below the eyelashes, trimming and/or repositioning excess skin and fat, and tightening the lower eyelid muscle.
  • In the transconjunctival approach, effective in improving lower eyelid bags and puffiness, Dr. Paul places the incision inside the eyelid. Your surgeon can remove excess fat through a transconjunctival incision, but not excess skin.
  • The ‘skin pinch’ blepharoplasty removes only a bit of skin. This is effective if you have strong lower eyelid support and only a little extra skin. In some patients laser resurfacing can both tighten excess skin and remove wrinkles.
  • The use of hyaluronic acid (HA) fillers is a nonsurgical alternative for the lower eyelids. Restylane, Juvéderm, and other soft tissue fillers can be injected into the tear trough (crescent-shaped under-eye area) to rejuvenate the appearance of the under-eye area. Results are varied and last approximately six months.

Oftentimes, these procedures are performed on both eyes during the same surgery session, as the cost is lower to treat both sets of eyelids at once than to perform them separately. However, when most of the excess tissue is located in either the upper or the lower lids, surgery can be performed on just one set of eyelids. In some cases, eyelid surgeries are performed simultaneously with a forehead lift (also known as a brow lift) to correct drooping brows or deep lines in the eyebrow or forehead area.

Recovery Time: Varies from 5 days to 20 days depending on the extent of your procedure.

Why Choose an Oculoplastic Surgeon?: Ophthalmic Plastic Surgery (Oculoplastic Surgery) is a unique specialty combining training in plastic surgery and ophthalmology. This specialty has developed because of the amount of knowledge, expertise and special techniques needed to treat patients with conditions involving the eyelids and eyebrows. The primary difference between general and ophthalmic plastic and reconstructive surgery is on the emphasis of the health of the eye. Browse some before and after pictures and see for yourself why Dr. Paul is one of Austin’s top eyelid surgeons.

If you are interested in Eyelid surgery, feel free to give us a call at 512-642-5050 to schedule a consultation with Dr. Paul at any of our convenient South Austin, North Austin, New Braunfels, Westlake, or Lakeway locations today!

Blepharoplasty Before Image
Blepharoplasty After Image

Before / After

Blepharoplasty Before Image
Blepharoplasty After Image

Before / After

Blepharoplasty Before Image
Blepharoplasty After Image

Before / After

Austin Oculofacial Plastics’ 5 Top Botox Facts & Myths

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At some point in your life you may have been faced with finding a less than flattering Instagram or Facebook photo of yourself – tagged by a friend who obviously doesn’t understand the “rules”…Instantly you feel 15 years older and before you know it, you’re in front of a mirror, stretching and pulling at your skin, trying to imagine what you’d look like if you had bathed in coconut oil every day and worn sunscreen since you were born.


Panic sets in when a Google search confirms that time travel still hasn’t been invented and you’re not going to be able to go back and fix that anytime soon. Then you realize that anti-aging skin care is advancing at the speed of light…but who to trust with such a delicate matter? Board Certified Oculofacial Plastic Surgeon and a member of the American Society of Ophthalmic Plastic and Reconstructive Surgeons, Dr. Sean Paul is an expert of the eyes and face. With extensive knowledge and experience working on the muscles of these vital areas, he knows exactly how to take years off your face with a simple injection. Botox has been extremely popular throughout the years with more and more people using it to regain a youthful appearance. It is 100% FDA approved and can help to ease wrinkles around the eyes and forehead safely, quickly and virtually painlessly. Of course, as with all advancements in medicine, there are always doubts, myths and questions like “does it actually work?”, “will I turn into an angry frozen version of myself”, “is it going to hurt”? While strange stories and misconceptions about Botox are not uncommon, only you and Dr. Paul can determine whether Botox is a good fit for you and your lifestyle. Before you decide to get a treatment, you should probably see which of these stories are true and which are just myths…

  1. MYTH: Botox stays in your body forever.

FACT: Botox is not forever. It normally lasts for 3-4 months depending on how active your metabolism is. After this time passes you will have to get Botox again to restore the desired effects. After your initial treatment with Dr. Paul, you may want to schedule your follow-up treatments at any of his convenient South Austin, North Austin, Westlake, New Braunfels locations in advance to ensure you get a reminder when it is time for a touch-up.  If you decide to stop having Botox treatments, you will slowly lose the relaxing effect of Botox and will resume the normal development of wrinkles with movement.

  1. MYTH: Botox and Filler injections are the same thing.

FACT: While they both lessen the appearance of wrinkles, Botox and Dermal Fillers do not function in the same way. Botox relaxes the muscles that create wrinkles on the face while Dermal Fillers restore and add volume to facial tissue, giving you a youthful, plump look. Fillers “fill” and Botox “relaxes” the treated areas. Once you understand that the muscle movement is what’s creating the wrinkle, especially on the forehead, then it’s easier to understand. Botox relaxes the muscle that’s creating the wrinkle, as opposed to filler which works by filling in the wrinkle with product.

  1. MYTH: If I get Botox, everyone is going to know I got something “done”.

FACT: Like all plastic surgery and cosmetic treatments, anything done correctly and in moderation can and should look natural. Our goal at Austin Oculofacial Plastics is for you to be able to walk out of here and once the slight swelling has settled, no one should know you have had anything done unless you decide to tell them. To avoid bruising (one tell-tale sign that does eventually fade) Dr. Paul advises that you stop taking Advil, Aleve, aspirin, etc. a week before any injection treatment. These medications thin your blood making you more likely to bruise. If you aren’t sure how much Botox you need or where on your face you should get it to achieve beautiful and natural results, Dr. Paul can evaluate your face and skin in order to provide a customized treatment recommendation at your initial consultation.


  1. MYTH: The best time to get Botox injections is when lines first begin to appear.

FACT: If you are looking to stay ahead of the curve, Botox can help with premature aging and wrinkle development. If you wait until lines start to etch into your skin then it will be far more difficult to smooth their appearance. Botox is often used for lines and wrinkles that are formed by muscle movements like scowling, squinting, raising eyebrows, and smiling. Both men and women can benefit from preventative Botox and treatment may be recommended for patients that are 18 and older if there is a need to do so.

  1. MYTH: Botox will make me look frozen and unnatural.

FACT: This is the most common misconception about Botox injections. When done correctly and in proper moderation, Botox will look natural and emotions will still be expressed on your face. The truth of the matter is that Botox will enhance facial expressions rather than erase them entirely. When you have your treatment performed by a trained and skilled physician like Dr. Paul, you should still able to display the entire range of facial expressions including frowning, smiling and appearing surprised as the treatment should simply relax the muscle at the injection point.


If you have any questions regarding Botox, we are here to help at 512-642-5050!


Want a more youthful glow, but don’t have time for a facelift? Injectables may be the answer!

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Some people may not know this, but the summer time is actually a perfect time to rejuvenate your face with injectable treatments. These types of non-surgical treatments are ideal facial rejuvenation therapies for the social yet busy summer season ahead. Wrinkle reduction treatments such as Botox and Dysport or dermal fillers such as Restylane and Juvederm can take as little as 15 minutes in our office and are ideal ways to renew the skin’s complexion with little to no down time before any summer activity or getaway. While injectable treatments are considered temporary, the results (depending on the product) can be maintained for as long as 6 to 12 months. A summertime treatment with Dr. Paul at at any of our convenient South Austin, North Austin, New Braunfels, Westlake, or Lakeway locations will typically last until the winter holiday season, at which time it can be repeated.

Some injectable treatments offer results immediately, while others develop over a short period of time. With the Texas summer now approaching, we wanted to share some of our most popular and favorite treatments for a non-invasive liquid facelift at Austin Oculofacial Plastics. Before you pack your bag for Barton Springs, check out some great options with little to no recovery time:


This popular filler treatment yields immediate results and adds volume to the skin. It can be used for lip and cheek enhancement as well as moderate to severe facial wrinkles and folds, such as nasolabial folds (lines from the nose to the corners of the mouth) and may sometimes help with dark circles under the eyes. One can expect minimal discomfort when performed by a skilled facial plastic surgeon like Dr. Paul.

prelips3 postlips3   Before / After

Procedure: Upper & Lower Lip Filler


Like the product noted above, Restylane also produces immediate results and adds volume to the skin. It is commonly used for plumping and lifting jawlines, cheeks, temples, thin lips, and nasolabial folds. If you are uncertain about which product may be the best fit for you, give us a call to schedule your cosmetic consultation today.



Botox injections can improve one’s facial appearance and complexion by relaxing the expressive muscles which cause prominent face wrinkles. The injections block signals from the nerves to the muscles so the injected muscle can’t contract, thus making the wrinkles relax and soften. It is most commonly used to treat forehead lines, crow’s feet (lines around the eye), and frown lines. Although the results are not immediate, the effects of the treatment are apparent within three to five days, and last for several months before you’ll need a touch-up.


Overall Botox and Dysport are very similar. Both are a type of botulinum type A used to relax the overactive muscles that cause moderate to severe frown lines, forehead lines and crow’s feet. Dysport provides patients with the possibility to get natural-looking results at an affordable price by limiting muscle movement, making existing wrinkles smooth and new ones take longer to appear. If you are unsure which product would be best for you, give us a call to schedule a cosmetic consultation today.

032016-botox1 032016-botox2Before / After

Procedure: Wrinkle reduction on the forehead and glabella


Dr. Paul now also offers Kybella, an injectable treatment which addresses the double chin. It permanently kills fat cells, giving one’s profile and jaw area a more contoured appearance. Traditionally, this area of excess fat under the chin has been treated surgically using liposuction to remove the fat. Alternatively, Kybella is a wonderful non-surgical option for patients bothered by excess fat under the chin. Most patients will require 2-3 treatments spaced 4-6 weeks apart. The best way to determine whether or not you are a good candidate for Kybella treatment is to undergo a personalized examination by Dr. Paul who can determine whether Kybella is a good option to help provide a nice cosmetic improvement.


Now what do I do?!

Of course, if you decide to get an injectable treatment of any kind, you’re going to want to increase positive outcomes and minimize risks. Although injectables are among the safest procedures performed today, there are things you can do to ensure your treatment is safe. For example:

  • Avoid getting injectables from sources that are outside of a doctor’s office. Make sure you know what you’re being injected with and ask your physician if the filler is FDA-approved and if it was bought directly from the maker.
  • Don’t be guided by price. It is likely that compromises are being made in either the quality of the product or the skill of the provider if you are offered a treatment that costs far less than usual. It’s not worth making a bargain with your face.
  • Make sure the procedure is done in a medical setting with instruments that are sterile. No matter who is doing them, treatments done in hotels, resorts, or homes are not being administered in medical environments.

If you’ve never received injectable treatments and want to know more about the benefits of each minimally invasive session, call us to schedule a cosmetic consultation with renowned Austin face doc and rejuvenation expert Dr. Paul at 512-642-5050

Dr. Sean Paul on Eyelid Revision and Reconstruction

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There are a number of reasons patients need to undergo eyelid revision and reconstruction procedures. When patients have defects around the eyes in either the face or the mid-face, it is generally caused by a tumor excision or tissue loss after a trauma. Eyelid reconstruction is commonly used to treat these issues. On the other hand, eyelid revision is typically used to treat a patient who has previously had surgery but still have some pulling down of the lower eyelid or pulling upward. The pulling sensation is otherwise known as eyelid retraction.

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Dr. Sean Paul featured in Cosmetic Town Journal

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A brow lift, sometimes called a forehead lift, is a cosmetic procedure that involves lifting up the tissues of the brow on the forehead. This can be done through a variety of techniques: the use of neurotoxin injections and dermal fillers, or via surgery through various types of incisions. The most conservative of the brow lift surgeries is via an eyelid lift incision, while the more invasive ones include coronal, pre-trichial, and endoscopic brow lift. Coronal and endoscopic lifts will be discussed further in this article.

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