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Oculoplasty (Eyebrow Aesthetics)
Oculoplasty is a surgical method applied in cases such as eyelid drooping, crow's feet, brow drooping, under-eye bags, and hollowness between the cheeks and the under-eye.
What is Oculoplasty?
With aging, various changes can be seen in the eyelids. These include bagginess under the eyes, excess skin and sagging on the upper eyelids, and wrinkles known as "crow's feet" at the outer corners of the eyes.
For these changes around the eyes, a surgical operation called "blepharoplasty" is performed. This surgical procedure is commonly known as oculoplasty.
Eye Surgery and Aftercare
- Anesthesia: Generally local anesthesia,
- Duration: Total of 60 minutes for both eyelids
- The eyes are not bandaged. Only a thin strip is placed on the eyelids.
- Postoperative care: For the first 24 hours, cold compress (with an ice pack) is applied. The eyelids may be swollen and bruised for the first 5 days. Water should be avoided on the eyelids for 1 week.
- Sutures: Are removed after 7 days.
- Follow-ups: The day after surgery, 7 days later, and 1 month later.
Eyelid Drooping (Ptosis)
The condition of having a drooping upper eyelid is called "ptosis." Eyelid drooping can occur at any age. This condition is treated within the framework of oculoplasty.
Causes of Eyelid Drooping
- Neurogenic causes: Problems in the nerve that holds the eyelid up
- Myogenic causes: Defects in the eyelid muscle (in congenital cases of drooping, this muscle is poorly developed)
- Senile causes: Aging, eye surgeries
- Mechanical causes: Factors that add weight to the eyelid (e.g., tumors, hematomas, etc.)
Treatment of Eyelid Drooping
The treatment is surgical. The two most common techniques used are:
- Levator resection: This technique is preferred when the function of the eyelid muscle is sufficient.
- Frontal suspension technique: This technique is used when the eyelid muscle is very weak. It is applied in cases of congenital drooping, paralysis of the eyelid nerve, and in individuals who have previously had surgery for eyelid drooping but whose eyelids have not improved. The disadvantage of the technique is that during eye closure, the operated side may remain slightly open.
If drooping of the eyelids is covering the pupil in children, immediate surgery is required; if not, surgery should be performed before starting school.
Eyelid Drooping Surgery
- Anesthesia: Local anesthesia; general anesthesia in children
- Duration: 30 minutes for a single eyelid
- Bandaging: A thin strip is placed on the eyelid.
- Postoperative care: No water on the eyelid for 1 week. There may be swelling and bruising on the eyelid, and cold application is done.
- Sutures: Are removed after 7 days.
- Follow-ups: The day after surgery, 7 days later, and 1 month later
- Eye drops and ointment: For 1 week, antibiotic and corticosteroid ointment on the eyelids; eye drops
Frontal Suspension Technique
- Anesthesia: Local anesthesia on the eyelids and forehead area; general anesthesia in children
- Duration: 30 minutes for a single eyelid
- Bandaging: A thin strip is placed on the incision site.
- Postoperative care: There may be swelling and bruising on the eyelids. A thin strip is placed on the incision sites.
- Sutures: Are removed after 7 days.
- Follow-ups: The day after surgery, 5 days later, and 1 month later
- Eye drops and ointment: For 1 week, antibiotic and corticosteroid ointment on the eyelids; eye drops
Inward Turning of the Eyelids (Entropion)
The inward turning of the eyelids is called "entropion." Entropion usually occurs in the lower eyelid. It can very rarely also occur in the upper eyelid. Although entropion is primarily caused by age-related (senile) eyelid laxity, it can also result from scarring or be congenital.
Symptoms of Entropion
- Inward turning of the eyelid
- Burning sensation, tearing, redness in the eye
- The treatment is surgical. The surgery can be performed with various techniques.
Surgery for Entropion and Aftercare
- Anesthesia: Local anesthesia on the eyelids.
- Duration: Approximately 30 minutes total.
- Bandaging: The eye is not bandaged. Only a thin strip is placed on the eyelid.
- Postoperative care: The next day, the strip is removed. No water should touch the eyelid for 1 week.
- Sutures: Are removed after 7 days.
- Follow-ups: The day after surgery, 7 days later, and 1 month later
- Eye drops and ointment: For 1 week, antibiotic ointment on the eyelids; eye drops
Outward Turning of the Eyelids (Ectropion)
The outward turning of the eyelids is referred to as "ectropion." It can be corrected with oculoplastic surgery. Ectropion occurs in the lower eyelid. Ectropion primarily results from age-related (senile) eyelid looseness, but it can also develop due to scarring (scarring), facial nerve paralysis, and masses in the lower eyelid (mechanical).
Symptoms of Ectropion
- Outward turning of the eyelid
- Due to the eye drainage duct not pointing towards the eye, there is burning, watery discharge like crying
- Drying of the cornea
- The treatment of ectropion is surgical.
Surgery and Aftercare
- Anesthesia: Local anesthesia.
- Duration: Approximately 30 minutes
- Bandaging: The eye is not bandaged. A thin strip is placed on the eyelid.
- Postoperative care: The next day, the strip is removed. No water should touch the eyelid for 1 week.
- Sutures: Are removed after 7 days.
- Follow-ups: The day after surgery, 7 days later, and 1 month later
- Eye drops and ointment: For 1 week, antibiotic ointment on the eyelids; eye drops
Chalazion
The openings of the sebaceous glands in the eyelids are the pores at the base of the eyelashes. When these pores become blocked due to reasons such as oiliness, makeup, or infection, it leads to swelling and inflammation in the underlying sebaceous gland. If this progresses to form a cyst over time, it is called chalazion.
Treatment of Chalazion
In the initial phase, antibiotic drops are used to prevent infection. Warm compresses are applied. The warm compress can help the inflammatory tissue to organize, and expand the pores at the base of the eyelashes for drainage. However, if it is not treated timely and adequately, the body will encapsulate the inflammatory tissue with a cyst. This may require surgical drainage and removal of the cyst.
Chalazion Excision
- Anesthesia: Local anesthesia
- Duration: 5 minutes
- Bandaging: The eye is bandaged. The bandage is removed the next day.
- Postoperative care: There may be slight swelling and bruising on the eyelid.
- Return to work: Can return to work the next day.
- Follow-ups: The day after surgery, 1 month later
- Eye drops and ointment: 1 week of antibiotic drops and ointment.
Fat Plaque on the Eyelid (Xanthelasma)
Xanthelasma is a fat-cholesterol plaque seen mainly in women. It appears on the inner sides of the lower and upper eyelids. In cases of xanthelasma seen at a young age, high cholesterol should be suspected.
The treatment is surgical. Due to the thinness and high vascularity of the skin in these types of eyelid surgeries, there is no scarring postoperatively.
Xanthelasma Surgery and Aftercare
- Anesthesia: Local anesthesia on the lesion area.
- Duration: 10 minutes
- Bandaging: The eye is not bandaged. A thin strip is placed on the eyelid.
- Postoperative care: The next day, the strip is removed. There may be slight bruising on the eyelid. No water should touch the eyelids for 1 week.
- Sutures: Are removed after 7 days.
- Return to work: The next day.
- Follow-ups: The day after surgery, 7 days later, and 1 month later.
- Eye drops and ointment: For 1 week, antibiotic ointment on the eyelids.
Eye Lid Masses
Oculoplasty can be applied for the treatment of masses that develop in the eyelids. These masses can be benign or malignant.
Benign Masses
- Viral warts
- Dermoid cyst
- Seborrheic keratosis
- Actinic keratosis
- Cutaneous horn
- Pyo granuloma
- Nevi (moles)
- Keratoacanthoma
- Capillary hemangioma
Malignant Masses
- Basal cell carcinoma
- Squamous cell carcinoma
- Sebaceous gland carcinoma
- Melanoma
- Merkel cell carcinoma
- The treatment for these types of masses is often surgical. The removed mass must be sent for pathology examination.
Inward Turning of the Eyelashes (Trichiasis)
The inward turning of the eyelashes is referred to as "trichiasis." It can occur in prolonged infections and eyelid diseases. Inward curling eyelashes not only create an unsightly appearance but also cause burning and discomfort in the eye. These eyelashes can damage the cornea by rubbing against it, causing permanent scars and reducing vision.
Treatment
Inward curling eyelashes are plucked with tweezers: This is not a permanent solution. They will regrow in 3 months.
Inward curling eyelash roots can be cauterized with radiofrequency: This is a permanent treatment and may require multiple sessions.
Inward curling eyelash roots can also be frozen with a device called "cryo": This is a permanent treatment and may require multiple sessions.
Eye Prosthesis
Eye prostheses are used when the eye has been surgically removed due to accidents or diseases. These prostheses do not provide vision but offer a good aesthetic appearance.
The non-functioning eyes are removed when they create an aesthetically unpleasant appearance or when they are painful. The removal of the eye can be done with various techniques:
Removal of the entire eyeball (enucleation): Used in eye tumors.
Emptying the inside of the eyeball (evisceration): This technique is used when the eye is removed for reasons other than tumors.
Prostheses are divided into internal and external eye prostheses. The internal eye prosthesis is made from special materials, compensating for the volume loss in the emptied eye. After the healing of the wound tissues, the size of the cavity is measured to prepare the external eye prosthesis.
Potential Problems Associated with Eye Prostheses
- Itching and discharge from the eye
- Slippage of the prosthesis holder
- Deformities of the eyelids
- Recommendations for Prosthesis Users
- Do not remove your prosthesis at night; sleep with your prosthesis in. This prevents the holder from compressing and reduces eye discharge.
- In the mornings, wash your eyelash roots with baby shampoo, lather, and rinse thoroughly with warm water.
- Throughout the day, apply artificial tears onto your prosthesis.
- Wear glasses. This protects your good eye, and draws less attention to your prosthetic eye.
- If there is itching or discharge from the eye, consult your eye doctor. Use the anti-allergic drops they recommend.