By Geoffrey J. Gladstone MD, FAACS, Evan H. Black MD, FAACS, Shoib Myint DO, FAACS, Brian G. Brazzo MD, FAACS (auth.), Frank A. Nesi MD, FAACS (eds.)
he wish to educate and the achievement attained from instructing Thave back brought on us to provide a piece that we are hoping might be either worthy and enlightening to our readers. the sector of oculoplastic surgical procedure has grown and advanced to incorporate all features of eyelid and facial cosmetic surgery. Our literature needs to now replicate the developments and course of our box. wisdom of anatomy, the foundation of all surgical procedure and the basis of surgical princi ples and methods, is the foundation of our skill to bring the top caliber care to our sufferers. we've as a result mixed textual content and diagrams, and supplemented them with CD-ROM electronic video know-how to supply to those that desire to practice this surgical procedure the very best guide and prepa ration. we are hoping that our makes an attempt to complete it will be rewarded by means of our fabric through our colleagues and the acknowledgment of our designated and logical development within the box of eyelid and facial cosmetic surgery. destiny volumes during this sequence will disguise different features of eyelid, lacrimal, facial, and orbital surgery.
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Additional info for Oculoplastic Surgery Atlas: Eyelid Disorders
Example text
A skin graft is sutured in place. Paralytic Ectropion 39 placed around the graft to secure a bolster. The Telfa template (or a new one) is placed over the graft and a small, damp piece of cotton is compressed and placed on the Telfa. The sutures are then snugly tied over this bolster to place gentle pressure on the graft against the underlying bed, from which it will receive its blood supply. Unless a large graft (> 4 cm2 ) is being placed, fenestration is usually not necessary with this technique.
Botulinum A has also been used, but relief is only temporary and ptosis a significant potential side effect. Management: Medical 43 MANAGEMENT: SURGICAL Upper Eyelid Retraction When surgical repair of eyelid retraction is appropriate, the goals are to limit scleral show, minimize lagophthalmos, reduce corneal exposure, and restore a normal appearance. In the upper lid this is achieved by vertically elongating the posterior lamella of the eyelid with levator recession and/or mullerectomy. The decision to proceed with an anterior or posterior approach depends on the surgeon's training and comfort level.
The skin is closed with interrupted 6-0 plain gut suture, and a small amount of CPF edge should be incorporated into the three central sutures to form a barrier to prevent overriding of the orbicularis muscle. The lateral canthal angle is reformed with 6-0 plain gut suture. 20 Entropion Edge of lower lid retractors Orbital fat FIGURE 2-2. A subciliary incision has been made, exposing the tarsu and lower eyelid retractors. FIGURE 2-3. A lateral tarsal strip is used to tighten the eyelid. FIGURE 2-4.