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Cosmetic Facial Interventions
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
The term blepharoplasty refers to the modification of the eyelid aesthetics, while maintaining function. Tissues including the skin, orbicularis oculi muscle, septum and fat are variably are excised or repositioned depending on the anatomical defects and desired aesthetic outcome. The indications may be functional, aesthetic or often a combination of both.
Blepharoplasty
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
The term blepharoplasty is used to refer to an operation in which redundant tissues including skin, or skin and muscle, are excised from the eyelid, and in which fat may be excised, sculpted or repositioned. The appearance of the eyelids, and the periorbital region, plays a pivotal role in maintaining facial harmony through expression of human character, mood and emotions, and a successful outcome from this surgery requires great attention to detail.
Medical Negligence in Otorhinolaryngology
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Loss of vision is the most feared complication following blepharoplasty. It is very rare but, because it is such a serious complication, all patients considering a blepharoplasty should be warned of the risk of it happening. The mechanism of action is not clear but it may be due to acute elevation of intra-ocular and intra-orbital pressures due to retrobulbar haemorrhage from a bleeding artery retracting into the retrobulbar space. The elevated intra-orbital pressure leads to optic nerve head ischaemia and central retinal artery occlusion. Meticulous haemostasis is the best prevention.
Single-stage repair of large full thickness lower eyelid defects using free tarsoconjunctival graft and transposition flap: experience and outcomes
Published in Orbit, 2022
Chau M. Pham, Kevin D. Heinze, Mariah Mendes-Rufino-Uehara, Pete Setabutr
Average patient follow-up time was 36.7 weeks (range 3–129, SD = 48.1). Flap complications were rare and included early necrosis in one patient in whom bolsters were used which resolved without issue. One patient experienced lower lid retraction post-operatively with 1.5 mm of lagophthalmos, while the others maintained good lid position and contour. Donor site complications were also rare and included one instance of pyogenic granuloma formation at post-operative month 3 which was excised. Mild asymmetry in upper eyelid appearance caused by a deepening of the sulcus or elevation of the ipsilateral eyelid crease was noted in most cases. Although blepharoplasty on the contralateral upper eyelid was offered, all patients were satisfied with their appearance and deferred further surgery.
Delayed periorbital hemorrhage in oculoplastic surgery patients on oral anticoagulants
Published in Orbit, 2021
Lilly H. Wagner, Elizabeth A. Bradley, Isaiah Giese, Viraj J. Mehta, Stuart R. Seiff
Hass et al. surveyed members of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) and reported that the majority of severe hemorrhagic complications after blepharoplasty occurred within 24 hours of surgery.5 However, several cases of delayed postoperative hemorrhage requiring surgical intervention have been reported.6,7 In the large study by Jacobs et al., one patient on aspirin developed a delayed orbital hemorrhage after fracture repair with resulting NLP vision.1 To our knowledge, there is only one published case in the literature of delayed hemorrhage in a patient on a novel oral anticoagulant that occurred after an oculoplastic procedure (evisceration).8 When a postoperative hemorrhage occurs after the patient leaves the controlled recovery room or hospital environment, the time to intervention and risk for adverse events is increased. In this report, we describe four cases of severe delayed postoperative hemorrhage associated with NOACs, in addition to three cases in patients on traditional antithrombotic agents, and highlight risk factors and management of this rare complication in oculofacial plastic surgery patients.
The Histopathological Findings of Patients Who Underwent Blepharoplasty Due to Dermatochalasis
Published in Seminars in Ophthalmology, 2018
Ali Karnaz, Yasemin Aslan Katircioglu, Evin Singar Ozdemir, Pınar Celebli, Sema Hucumenoglu, Firdevs Ornek
Patients were administered local and sedative analgesia. Eyelid fold and borders of excessive skin were marked. One ml of 2% lidocaine solution containing 1:100.000 epinephrine was injected subcutaneously as a local anesthetic to the marked area. Blepharoplasty operations were performed bilaterally in each patient by the same surgeon during the same surgery. Following an incision made to the eyelid with a No. 15 lancet, skin and subcutaneous tissue were excised with Westcott scissors. The upper eyelid fold was reconstructed by three single sutures passed through the skin, levator aponeurosis, and then through the skin again. The skin incision was closed with a 6.0 vicryl suture.