Periorbital Region and Tear Trough
Ali Pirayesh, Dario Bertossi, Izolda Heydenrych in Aesthetic Facial Anatomy Essentials for Injections, 2020
Patients who would benefit from surgery are those with orbital fat herniation and significant skin laxity. These patients are unlikely to obtain good results from injecting the TT alone and should be thus advised. It is helpful to simulate the effect of filling in the less-than-ideal candidate by pushing on the soft tissues just under the TT with the patient observing in the mirror while their reaction is assessed. This procedure is an effective adjunct to lower-lid blepharoplasty and can be recommended as part of the rejuvenation plan at the time of consultation.
Medical Negligence in Otorhinolaryngology
John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie in 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.
Blepharoplasty
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in 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.
‘Viewer discretion advised when preparing for surgery’ – why YouTube cannot teach you how to do an upper blepharoplasty. An evaluation of the educational potential of surgical videos on blepharoplasty on YouTube
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Inga S. Besmens, Semra Uyulmaz, Sophie Knipper, Pietro Giovanoli, Nicole Lindenblatt
A video scoring system consisting of 8 items was developed in accordance with the technical details described in the literature [11] (Table 1). Blepharoplasty can be considered a short surgical procedure that requires certain steps like preoperative markings or tissue types resected (skin, muscle, fat). Each video received 1 or 0 if the specific item was addressed in the video. As the presence of 8 items relevant to the surgical process were evaluated the total score for each video was between 0 and 8. Video scores were categorized into 3 groups, as poor (0–3), moderate (4–5) or good (6–8) in terms of their contribution to the surgical education. While the score thus evaluates if topics relevant to education are addressed, it does not aim to evaluate the quality of the surgery performed. It also does not aim to assess whether certain steps of a blepharoplasty surgery i.e. muscle resection are deemed necessary but rather evaluates if a potential surgical step is mentioned. This type of scoring was chosen as preferred surgical techniques vary and will be surgeon and patient dependent. Videos were scored independently by 2 authors (resident and attending surgeon) and agreement of both authors was sought. In the case of controversy, a third author could be consulted and his decision regarded would be the final score.
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.
Related Knowledge Centers
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