Eyelid Esthetical Surgery

Some changes may occur on eyelids caused by aging such as eyelid bags, outgrowth skin and wrinkles at the outer corners of the eye as known as goose’s feet.

Patients have Blepharoplasty operation for those changes around their eyes.

Surgery and Post-operation

  • Anesthesia : Usually local anesthesia,
  • Duration : 45 minutes for 2 eyelids
  • Eye do not need to be covered.
  • Cold compress 1st 24 hours after operation. Eye lids will be swollen and purple.
  • Stitches : Stay one week.
  • Controls : Day after operation, 7 days later and 1 mount later.
  • Eye drops and Pomades: 1 week antibiotic pomades with streoid, 1 week antibiotic eye drop.

Eyelid drop (Ptosis)

Upper eyelid drop is called Ptosis. It could be observed any age.

Facts of Ptosis

  • Nörojenik nedenler: Göz kapağını yukarıda tutan sinirdeki problemlerNeurogenic Facts : Nerves that hold the eyelid up may cause
  • Myogenic Facts : Muscle problem on eyelid (it could be genetical)
  • Senile Facts : Aging and eye surgery
  • Mechanical Facts : Fact that make eyelid heavy (Eyelid tumors and Hematoma)

Treatment of Ptosis

Surgery is the treatment for Ptosis. There are two techniques for ptosis surgery:

  • Levator Resection : This can be used if the eyelid muscle functions strong enough.
  • Frontalis Sling : This can be used if eyelid muscle does not function properly. It can be in patients who have congenital eyelid problems or nerves stroke on the eye and have had ptosis surgery before but didn’t benefit from. After surgery in rare cases, the eyelids may not fully close.

Surgery and Post-operation

  • Anesthesia : Usually local anesthesia.
  • Duration : 40 minutes for 2 eyelids
  • The eyes must be covered with bandage.
  • Eye lids will be swollen and purple.
  • Stitches : Stay one week
  • Controls : Day after operation, 7 days later and 1 mount later.
  • Eye drops and Pomades: 1 week pomade with antibiotic and steroid, 1 week antibiotic eye drop.

Frontalis Sling

  • Anesthesia : Local anesthesia for eyelids and forehead. General anesthesia for toddlers.
  • Duration : 15 minutes per eyelid.
  • The eye must be covered with bandage which will be taken off next day of surgery.
  • Eye lids will be swollen and purple about one week.
  • Stitches : Stay one week.
  • Controls : Day after operation, 5 days later and 1 mount later.
  • Eye drops and Pomades: 1 week pomade with antibiotic and steroid, 1 week antibiotic eye drop.

Introverted Eyelid (Entropion)

When eyelid turns inside it is called Entropion. It is usually observed on the lower eyelid. It is rarely seen on the upper eyelid. Entropion can be related to senile eyelid relaxation or congenital scars.

Symptoms of Entropion

  • Eyelid turns inside
  • Dilution, flagrancy and redness on the eye.

Surgery is the treatment for Entropion. There are different techniques for Entropion surgery.

Eventual Problems after Surgery

  • Eyelid might turn inside again
  • If an excessive correction is made then it may turn outside
  • Infection on the incision area.

Surgery and Post-operation

  • Anesthesia : Usually local anesthesia.
  • Duration : 40 minutes for 2 eyelid.
  • Patients do not need to cover eye
  • Stitches : Stay one week
  • Controls : Day after operation, 7 days later and 1 mount later.
  • Eye drops and Pomades: 1 week pomade with antibiotic and cortisone, 1 week antibiotic eye drop

Ritornal Eyelid (Ectropion)

When eyelid turns outside it is called Ectropion. It is observed on the lower eyelid. Ectropion can be related to senile eyelid relaxtion or congenital scars. Also it may relate to face nerve stroke and mass on lower eyelid.

Symptoms of Ectropion

  • Eyelid turns outside
  • Dilution
  • Dryness on the retina

Surgery is the treatment for Ectropion.

Surgery and Post-operation

  • Anesthesia : Usually local anesthesia.
  • Duration : 40 minutes for 2 eyelids
  • Eyes do not need to be covered with bandage.
  • Stitches : Stay one week.
  • Controls : Day after operation, 7 days later and 1 mount later.
  • Eye drops and Pomades: 1 week pomade with antibiotic and steroid, 1 week antibiotic eye drop

Chalazion

There are fat layer under eyelid connected to eyelash root pores. Inflammation caused by make up, get fat on pores so fat layer under eyelid got swollen. It turns to mass later on.

Treatment of Chalazion

Antibiotic eye drop uses for avoid infection. Hot drains apply to inflamed eyelid to enlarge pores. If not treated on time it might turn to mass it is need to clean with surgery.

Chalazion Excision

  • Anesthesia : Usually local anesthesia
  • Duration : 10 minutes for 2 eyelid
  • Eyes must be covered with bandage which will be taken off on the next day
  • Eye lids will be swollen and purple about one week.
  • Controls : Day after operation and 1 mount later.
  • Eye drops and Pomades: 1 week pomade and eye drop with antibiotic.

Fat Plaque on Eyelid (Xanthelesma)

Xanthelesma is fat-cholesterol plaque on eyelid. Usually observed on women and it is seen inside of both eyelid. Doctors are being suspicious about high cholesterol if patients are early age. Surgery is the treatment for Xanthelesma

There will be no scar after the surgery.

Surgery and Post-operation

  • Anesthesia : Usually local anesthesia.
  • Duration : 10 minutes for 2 eyelids
  • Eyes do not need to be covered.
  • Eye lids will be lightly swollen and purple about one week.
  • Stitches : Stay one week
  • Controls : Day after operation, 7 days later and 1 mount later.
  • Eye drops and Pomades: 1 week pomade with antibiotic.

Eyelid Masses

There are Benign Mass and Malignant Mass.

Benign Mass

  • Viral wart
  • Dermoid cyst
  • Seborrhoeic Keratosis
  • Actinic Keratosis
  • Cutaneous Horn
  • Pyogenic Granulomatous
  • Mole
  • Keratoacanthoma
  • Cappilary Hemangioma
  • Porto wine spot

Malignant Mass

  • Adenoid – Basal cell carcinoma
  • Squamous cell carcinoma
  • Sebaceous cell carcinoma
  • Melanoma
  • Merkel’s cell carcinoma

After surgery those mass samples should send to pathology.

Eyelash turn inside (Trichiasis)

It can be seen on eyelid disease and long-term infection. Trichiasis is not good as esthetically also it feels sting in the eye. These lashes rub on the cornea and might damage it.

Treatment

  • Eyelashes that turned inside are removed with nipper. It is not permanent solution so eyelash will grow again within 3 mounts.
  • Eyelash that turns inside burned with cautery. It is permanent solution but it might need few sessions.
  • Eyelash roots that turn inside froze with Kryo. It is permanent solution but it might need few sessions.

Lacmiral Duct Occlusion

Liquid that humidifies eye flows through lacmiral duct to inside of nose. Usually occlusion of lacmiral sac leads to Lacmiral Duct Occlusion disease. It is mostly seen in new born babies, middle age woman and patients who have dysmorphosis in the nose. When the lacmiral duct is blocked, liquid can not flow to the nose so it will be leaking out from the eye. It causes infection on eye.

Symptoms of Lacmiral Duct Occlusion

  • Heavy dilution,
  • Blurry eye
  • Infection comes out from duck with pressing on nasal roots
  • Swelling of nasal roots

Treatment of Lacmiral Duct Occlusion on Babies

  • Massage technique applied to nasal roots in first year. It will apply 5 minutes each 3 o 4 times a day. Probability of success is around %95 in massage technique.
  • Antibiotic eye drop is used in patients who have blurry eyes.
  • If massage technique is not successful, doctors will use probing technique. Second probing will apply if the first one is not successful.
  • If Both probing are not successfull, then patients wait until 3 years old and have dacryocystorhinostomy operation.

Treatment of Lacmiral Duct Occlusion on Adults

1- Multidiode Laser operation

Lacmiral Duct Occlusion is very quick and bloodless with Multidiode Laser operation.

What are the advantages of Multidiode Laser operation between other surgeries?
  • Most important advantage of multidiode laser is duration of surgery. It takes about 8 to 10 minutes.
  • It slightly or never bleeds.
  • Tissues may slightly be damaged.
  • Recovery duration is very short. Patients can return their daily lives.
  • There are no lacerations in this operation.
  • Patients who have Lacmiral Duct Occlusion surgery before have more chance to have successful operation.
  • Procedure can be watched with endoscope inside of the nose and the doctor interfere from here if its necessary..
What is the dependences success on surgery? Can surgery reproduce?

Success of surgery depends on the doctor’s experience. Patient should have good examination before the surgery. Success rate is around 90 % in this technique whereas the sucsess rate could only be around 87.5 % in the other surgeries. If another surgery is needed then success rate can be 100 %.

2-dacryocystorhinostomy (Open Surgery)

Doctors apply laceration on nasal root about 1 cm under local or general anesthesia.

  • A small window made on nasal bone.
  • Doctors make straight entrance from lacmiral sac to nasal cavity.
  • Silicon tubes can be used through punctum in some situation.
  • Lacerations closed with stitches and surgery ends.
Complications of Dacryocystorhinostomy operation.
  • Infection on the area
  • Recurrence

Eye Prosthesis

Usually prosthesis is used in patients who have lost their eyes by accident or some other reason. This prosthesis do not provide vision but can make the eye ecstatically look good.

Doctors take out the eyes that lost vision, have bad appearance or steadily ache. There are different techniques for that operation.

  • Taken out whole eyeball (Enucleaction) It is used in case of eye tumors.
  • Taken out inside of eyeball (Evisceration) It is used for other reasons than tumors. There are 2 kinds of prosheses whch are internal prosthesis and external prosthesis.

Internal prostheses are made of special materials and it is used after Evisceration operation to fill inside of eyeball. External prostheses are used after Enucleaction operation.

Complications of Prosthesis

  • Itcy Eye and mucus-like liquid.
  • Displace of the eye hole.
  • Eyelid deformation

Advices for prosthesis user

  • Do not take off the prosthesis while sleeping to keep the shape still and the fluid less
  • Wash your eyelash roots with baby shampoo and rinse with warm water.
  • Use artificial tear on prosthesis in day time.
  • Use glasses. It will protect healthy eye and prosthesis will not take attention