Upper Blepharoplasty【Surgical Video】
By Surgical method- outline
Preoperative Patient Assessment:
1. General history
2. General ophthalmological survey
a. Inspection of both eyes gross condition
Ptosis, strabismus and other eye condition
b. Visual condition
Visual acuity- myopia, hyperopia, dry eye, trichiasis, Contact lens, etc
3. Periorbital anatomical condition
a. Orbital size
Eyeball position
b. Eyelid skin (texture)
Fullness(orbital fat)
ROOF
c. Eye brow
Eye brow position, symmetry and eye brow-eyelid relationship
d. Forehead - frowning
Preoperative interview: Surgeon’s opinions, Patients' personal demands
Preoperative conversation and consents
1, intra-operative process
2, postoperative progression and changes
a. Bleeding, hematoma
b. Ecchymosis, progression and the managements
c. Recommended postoperative visits for observation and instruction for after care
3, explained the possible changes occurs afterward by different factors
a. The width of lid fold will gradually narrowing after swelling subsided.
b. The brow will contently keep in lower position than before surgery
c. The width of lid folds on both sides will sometimes different because of the the brow
action differently in power on both side, or the brow always in different position (this
should be written in preoperative visit chart).
Postoperative visits; twice at least
1. Postoperative 5-7day for stitches removal
2. Postoperative 7-14days for scar observation and instruction scar care
3. Any additional visit as patients have any doubts of eyelid or scar changes
INTRAOPERATIVE
DESIGN FOR LID FOLD FORMATION
- Width of lid fold
6 - 8 mm according to patient demand can be accepted narrower or somewhat wide ad the
orbit side allowed.
- Lid skin excision
Assess the width of lid skin allowable from 0 to 6mm even wider.
- Lipectomy as need
should be consider patient‘s familial tendency of sunken change at aging
- ROOF manage as needed
POSTOPERATIVE CARE
- Cold compression 10-15 min per hour for the first two day
- warm compression star 3rd or 4th postoperative day till the ecchymosis disappeared.
CASE PRESENTATION
AGE 21 years old lady
Eyelid skin fairly in thickness
Eyelid - brow position medium
Epicanthal fold moderate
As showed in ppt.
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