Drs. Marc Hirschbein & James Karesh

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Dr. Marc J. Hirschbein


Krieger Eye Institute

Sinai Hospital of Baltimore

2411 West Belvedere Avenue
Baltimore, Maryland  21215

(410) 601-8283

Director of Aesthetic Eyelid 

and Facial Surgery

Krieger Eye Institute


Cosmetic Eye Surgery.  More options and greater expertise right in your own backyard.

  • If you've been considering cosmetic surgery to correct the appearance or function of your eyes, you've chosen a good time.  
  • Eyelid and facial surgical techniques are more sophisticated than ever, treating everything from drooping upper eyelids, baggy or sagging eyelid skin, tearing the, and dry eyes.  
  • And the good news is, Baltimore has one of the finest cosmetic eye surgery centers around - the Krieger Eye Institute at Sinai Hospital.

The Eyelids

  • The eyelids are extremely complex and delicate structures that are vital to the preservation of sight.  
  • They protect the eye and keep the eye moist.  The position and contour of your eyelids are important features of a normal facial appearance.  
  • Abnormalities in the eyelid position, function and appearance are caused by a variety of circumstances including birth defects, aging, tumors, injury, or medical diseases such as thyroid disorders.  Depending on the cause of the eyelid abnormality and the purpose of its surgical repair, eyelid operations may be either reconstructive or cosmetic.

What is eyelid surgery?

  • Eyelids surgery encompasses a wide range of different procedures.  Many of these are directed at correcting drooping or sagging eyelids as well as eyelid puffiness and wrinkles. 
  • Lasers as well as other modern techniques are employed to correct these problems by removing excess skin and fat, and by tightening the muscles and tendons of the eyelid.  Often, surgery can be performed from behind the eyelid leaving no visible scars in the skin.  
  • Eyelid surgery is performed in an outpatient setting.  Surgery often takes less than one hour, with minimal discomfort and rapid healing.  
  • More and more men and women are having these procedures performed each year.

Drooping of the upper eyelids

  • Drooping of the upper eyelid (ptosis) is a condition that can affect one or both eyes. 
  • Symptoms included decreased ability to keep your eyes open, headache, eyestrain, and eyebrow fatigue from the increased effort needed to raise your eyelids-especially when reading.  
  • Ptosis may be present from birth; or more often it develops as we age.  It may also be the result of trauma, muscular, or neurologic disease. 
  • A variety of surgical techniques are employed which are tailored to the individual patient and the underlying condition. 
  • Excess upper eyelids skin may occur as well.  This is repaired with a common surgical technique called a blepharoplasty - where skin, muscle, and some fat is removed from the upper or lower eyelids.  In some cases where the eyelid position is blocking the vision, the surgery may be covered by insurance.

 Aesthetic Eyelid Surgery

  • Aesthetic eyelid surgery describes any surgical procedure designed to enhance someone's appearance.  An upper or lower eyelid blepharoplasty is a common procedure.  The carbon dioxide laser (CO2) is often used during blepharoplasty.  It allows for precision skin cutting and sculpting of fat with minimal bleeding and reduced post-operative swelling. 
  • The laser may also be used to resurface the skin of the eyelids and face to produce a younger, healthier, wrinkle free appearance.  
  • Eyebrow surgery can be performed to improve the position and contour of the eyebrows.  Surgery may be performed through the same incision that is used for blepharoplasty, or an endoscope may be used to perform the surgery through hidden incisions.  Both methods allow for reduced swelling and more rapid healing. 
  • Botox injections are an increasingly popular way to reduce wrinkles around the eyes.  The medication is a purified strain of the toxin from the bacteria that causes botulism.  In the small doses used, the medication can safely paralyze the small muscles in the face that contribute to wrinkles.

Advanced Techniques at Sinai



  • At Sinai’s Krieger Eye Institute, surgeons have special expertise in cosmetic eyelid and laser eye surgery.  The division of oculoplastic surgery is one of the only departments in the Baltimore region to boast two board certified ophthalmologists who belong to an elite group of surgeons fellowship trained by the American Society of Ophthalmic Plastic and Reconstructive Surgery.  Their training makes them uniquely qualified to approach each patient as an individual; and to tailor the treatment plan to the patient's needs. 
  • Eyelid surgery is the focus of their practice - they do not perform surgery on the other parts of the body, nor do they perform laser vision correction or other common ocular procedures.  In addition to the procedures listed here, they also treat a variety of other conditions, including: dry eyes, tearing, growth and tumors of the eyelids an orbits, eyelid and orbital trauma, thyroid related eye disease, and other eyelid abnormalities.

James W. Karesh, MD, FACS, is the Zanvyl Krieger Chairman-of-Ophthalmology and the director of oculoplastic surgery at the Krieger Eye Institute.  He was elected one of the region's "Top Docs" by his peers in Baltimore magazine in 1998.  He is a member of the American Society of Ophthalmic Plastic and Reconstructive Surgery. He has performed over 10,000 procedures in the field of ophthalmic plastic and reconstructive surgery and has advanced training in the use of lasers for correcting eyelid abnormalities.

Marc J. Hirschbein, MD, is the director of aesthetic eyelid surgery at the Krieger Eye Institute.  He completed his fellowship under the auspices of the American Society of Ophthalmic Plastic and Reconstructive Surgery in Albany, New York-where he trained with some of the world leaders in this field.  He has completed additional training in most facets of cosmetic eyelid surgery including:  endoscopic brow lifts, laser resurfacing, and cosmetic Botox injections.  He has a particular interest in the use of lasers for cosmetic eyelid surgery.  His practice philosophy strives to combine an artistic eye with the surgeons skills to make his patients goals a reality. 

For more information about cosmetic eyelid surgery call the Krieger Eye Institute at Sinai Hospital at (410) 601-6200.  Or visit us at our website at



Marc J. Hirschbein

James Karesh

Fellowship in Oculoplastic Surgery (ASOPRS) ( Albany Eye Physicians and Surgeons and Albany Medical Center)  

Fellowship in Oculoplastic Surgery (ASOPRS)  Dr. Allan Putterman  Eye & Ear Infirmary, University of Illinois & Michael Reese Hospital  and Medical Center, Chicago, Illinois

Residency in Ophthalmology (Sinai Hospital of Baltimore Department of Ophthalmology)  

Residency in Ophthalmology          University of Maryland School of Medicine, Baltimore, Maryland

Internship in Internal Medicine : Sinai Hospital of Baltimore Internship in Pediatric Medicine  Children's Hospital National Medical Center, Washington, D.C.
Associate chairman, Krieger eye institute





Sinai Hospital of Baltimore  

Sinai Hospital of Baltimore

Wilmer Eye Institute, Johns Hopkins Johns Hopkins Medical Institutions, Wilmer Eye Institute
Mercy Medical Center   Mercy Hospital and Medical Center
Northwest Hospital   University of Maryland Medical System
York Hospital    
Central Maryland Surgicenter  


Yassur I, Hirschbein MJ, Karesh JW.Clinicopathologic reports, case reports, and small case series: 0.01% becaplermin gel for the treatment of a chronic orbital ulcer after exenteration.Arch Ophthalmol. 2001 Dec;119(12):1858-9.

Yassur I, Hirschbein MJ, Karesh JW.  The evaluation and management of lacerations of the eyelids and lacrimal system.  Brunai International Med J  2000;2:187-201.

Karesh JW, Horswell BB. The management of post-traumatic orbital soft tissue injuries. The American Association of Oral and Maxillofacial Surgeons 1999 Annual Meeting and Scientific Session. 

Levey SB, Katz HR, Hirschbein MJ, Abrams DA.  Factors affecting the outcome of ulcerative keratitis.  Ann Ophthalmol 1999;31:322-8.

Karesh JW, Horswell BB. The management of post-traumatic orbital soft tissue injuries. The American Association of Oral and Maxillofacial Surgeons 1998 Annual Meeting and Scientific Session. 

Hirschbein MJ, LaBorwit SE, Karesh JW.  Streptococcal necrotizing fasciitis complicating a conjunctival dacryocystorhinostomy.  Ophthalmic Plast Reconstr Surg 1998;14:281-5.  

Hirschbein MJ, LaBorwit SE, Karesh JW. The use of monopolar cautery in conjunctivorhinostomy surgery (Poster). American Academy of Ophthalmic Plastic and Reconstructive Surgery.

LaBorwit SE, Hirschbein MJ, Dankner S, Karesh JW.  Multifocal langerhan cell (eosinophilic) granulomatosis with orbital involvement in an eight-month-old.  J of Ped Ophthalmol and Strabismus 1998;35:234-6

Dresner SC, Murphree AL, Karesh JW. Conical porous polyethylene implants for enucleation and evisceration. American Academy of Ophthalmic Plastic and Reconstructive Surgery. 29th Annual Scientific Symposium. 

Levey SB, Hirschbein MJ, Abrams DA, Katz HR.  The role of cultures in the management of ulcerative keratitis.  Cornea 1997;16:383-6.

Hirschbein MJ, LaBorwit SL, Karesh JW. The incidence of bacteremia and post-operative infections associated with dacryocystorhinostomy surgery. 
Gradon JD, Hirschbein MJ, Milligan J.  Fragmentation hemolysis: an unusual indication for valve replacement in native valve infective endocarditis.  South Med J  1996;89:818-820 Karesh JW, Dresner SC, Shore JW. New Frontiers in Ophthalmic Implants: High Density Porous Polyethylene (Medpor?) Annual Meeting of the American Academy of Ophthalmology
  Epley KD, Hirschbein MJ, Dresner SC, Karesh JW. Long-Term Postoperative Results of Transconjunctival Entropion Repair. Annual Meeting American Academy of      Ophthalmology. 

Book Chapters:   

Hirschbein MJ, Yassur I, Karesh JW.  Diagnosis of Lacrimal Disorders. Ed. A Agarwal.   Karesh JW. Entropion Repair. In Mauriello JA Jr. (Ed). Eyelid and Lacrimal      Surgery—Prevention and Management of Unfavorable Results. 
Hirschbein MJ, Yassur I, Karesh JW.  Surgical Correction of Lacrimal Disorders. Ed. A Agarwal. Karesh JW. Eyelid Retraction Surgery. In Mauriello JA Jr. (Ed). Eyelid and Lacrimal      Surgery—Prevention and Management of Unfavorable Results. 
Hirschbein MJ, Yassur I, Karesh JW.  Entropion. Ed. A Agarwal Karesh JW. Blepharoplasty: An Overview. Atlas of the Oral and Maxillofacial Surgery      Clinics of North America. 
Hirschbein MJ, Yassur I, Karesh JW.  Ectropion. Ed. A Agarwal Karesh JW, Putterman AM. The Evaluation and Management of the Contracted Ocular      Socket. Migliori MM (ed): Enucleation, Evisceration and Exenteration of the Eye.      Butterworth-Heinemann Publishers. 
Hirschbein MJ, Stasior GO.  The Lacrimal System: Diagnosis and Techniques In:  Oculoplastics: The Essentials.  Ed.  WP Chen.  Thieme Pub.    


Book Reviews   

Hirschbein MJ.  Review:  Radiotherapy of ocular disease: frontiers of radiation therapy and oncology.  Vol 30.  American J of Ophthalmol.  1998:125;256-7  



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