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Oculoplastic and Lacrimal System

Oculoplastic and Lacrimal System

Oculoplastic and lacrimal system procedures :

1. Ptosis (droopy eyelid) surgery

Oculoplastic and lacrimal system procedures

Ptosis surgery shortens the stretched tendon or re-attaches it back to the eyelid. There is usually no need to make alterations to the muscle that lifts the eyelid, as this tends to remain strong.
It is usually performed under local anesthesia as a day case procedure, with no need for an overnight stay in the hospital. The surgery lasts approximately one hour and aims to restore the symmetrical height and contours of both upper eyelids.

Sometimes the eyelid needs to be attached to the brow muscle, using allograft or synthetic materials, allowing the forehead muscle to lift the eyelid, like in the case of congenital ptosis.

Entropion And Ectropion Procedures

Entropion is the case where the lid margin is turned in, which cause eye irritation due to the misdirect eyelashes. The entropion is usually age related, however it could be related to scaring of the eyelid conjunctiva.
Treatment is with addressing the involutional (age-related) changes, which is usually the lid laxity.
The surgery is made by reattaching the eyelid retractor muscles back to the eyelid tarsus and increasing the tone of the eyelid.

Brow Lift

Brow ptosis, which means the eyebrow dropping, is usually age related, however it could be related to the facial nerve palsy.
Brow ptosis is managed surgically to refixate the brow in a higher position, hereby increasing the eye aperture.
There are a variety of brow lift procedures. For further information you can revert to the review article on brow lift procedure that was publish in the Orbit journal by Mr Radwan Almousa (Almousa R, Amrith S, Sundar G. Browlift-a South East Asian experience. Orbit. 2009;28:347-53.)

Upper And Lower Lid Plastic Surgery (Blepharoplasty) for Eyelid Bags

Tired-looking eyes caused by heavy eyelids or puffy, saggy under-eye bags are one of the most common complaints of patients contemplating cosmetic surgery.

Blepharoplasty could be performed on the upper or lower eyelid or both, and it could be performed by itself or combined with other procedures, such as brow lift, or ptosis surgery.
The surgery is usually made under local anaesthesia. Excess skin from the upper lid is usually removed. As for the lower lid, the usual procedure is to reposition the prolapsed fat that give the lazy appearance, avoiding skin excision, as the lower eyelid have less skin laxity comparing to the upper lid.

HOW MUCH DOES IT COST TO REMOVE EYE BAGS?

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Eyelid Skin Cancer

Suspicious eyelid skin lesions are usually excised completely, and the specimen would be sent for pathological examination. The reconstruction of the defective eyelid usually takes place two to three days after the excision of the lesion, at which time the pathology report confirm the complete excision, and the type of such lesion, at which time the reconstruction will take place.
Most of the skin cancer curable if the excision is complete, and the surgery could be done under local anaesthesia.

Facial paralysis

Facial palsy results in droopy lower lid and eye exposure. In severe cases this could result in blindness due to eye infection in relation to long standing exposure.
Conservative measures are with heavy lubrication with artificial tears and lubricating ointment, until the facial palsy is healed.
Fillers could be an alternative to surgery to help with blinking and avoiding dry eyes. Otherwise surgery is needed to cover the eyeball, and this is accomplished by tightening the lower eyelid, to keep the lower lid in higher position and to support the eyeball.
The surgery could be done under general or local anaesthesia, depending on the patient preference.

Epiphora (watery eye)

The reason for watery eye should be identified, and then the treatment would be tailored according to the aetiology.
Most of the time watery eye is due to dry eye or eye exposure, which trigger the brain to send signals to the lacrimating glands to secret excess tears. The treatment would be to treat the eye exposure and dryness, with conservative measure, such as lubricating eye drops, or surgically to reduce the eye exposure.
Watery eye could be the result of the periocular muscle laxity, which is related to old age or facial muscle paralysis. As a result the pumping machine that pushes the tears from the eye down to the nasal cavity, would be rather weak, and the eye start to waters. The treatment would be to tighten the eyelid surgically.
True lacrimal duct obstruction could be confirmed with simple irrigation of the lacrimal system, and this is done as an outpatient procedure.
The treatment of total or partial lower tear duct obstruction would be surgically with establishing an alternative route for the tears from the lacrimal sac to the nasal cavity through a whole in the lacrimal bone (Dacrycystorhinostomy). The surgery is usually done under general anaesthesia.
The success rate of the Dacrycystorhinostomyis is 80% to 90% in the literature.

Blepharospasm

Blepharospasm is the involuntary blinking of the eyelid which could be mild and does not need any treatment or severe enough to alter the quality of life to the patient.
Treatment is with using Botox A toxin, which is a muscle paralysing agent, when used in a low dose of local infiltration, it could control these annoying eyelid movements.
The toxin, usually last for 6 to 9 months at which time another dose might be needed.
The toxin could infiltrate locally and cause paralysis to the surrounding muscles, which lead to its side effects, such as diplopia, or dropping of the eyelids.
Most of the side effects do not last for more than 3 months.

Botox A for cosmetic use

Glabellar lines, horizontal forehead lines, and crow’s feet (lines radiating from the outer side of the eyes) are common presentations in the aging face. Botox A is a neurotoxin that reduces the face lines by paralysing the underlying muscle.
The simplicity and safety of Botox A treatment are among its most compelling attributes. Its successful use in cosmetic applications demands thorough knowledge of facial masculature and the action of the toxin, as well as a very good understanding of proper injection technique.

HOW MUCH DOES BOTOX AROUND THE EYES COST?

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EYELID FILLER:

Soft tissue and bony volume loss is now thought to be a significant contributor to facial aging. In the brow, upper and lower eyelid, such volume loss deflates the skin and, together with gravitational effects and loss of skin elasticity, leads to a range of effects including brow ptosis, hollowness of the upper and lower lid, droopy eyelid as a result of loss of orbital fat volume.
Hyaluronic acid fillers used for volume replacement are associated with high success rates, high patient satisfaction, with very few complications.
Patients are advised to avoid exercise and alcohol for 1 day and direct pressure on the upper eyelid region area for three days, with regular ice packs.

HOW LONG DO EYELID FILLERS LAST?

Usually, filler last up to 6 months.

HOW MUCH DOES EYE FILLER COST?

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See Fees

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