upper and lower eyelid blepharoplasty– entropion repair ptosis repair– ectropion repair brow...
Post on 17-Dec-2015
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Surgeries Upper and lower eyelid
• Blepharoplasty – Entropion Repair• Ptosis Repair – Ectropion Repair
Brow surgery• Brow ptosis repair
Tear duct• DCR (re-routing of the tear duct)• Lacrimal intubation
Orbital surgery• Fracture repairs• Tumor removal• Decompression resulting from Thyroid Disease
Outpatient Surgery Centers
St. Francis Surgery Center Methodist Germantown Surgery
Center Tri-State Surgery Center LeBonheur East Surgery Center Saint Francis Hospital Methodist Germantown Hospital Baptist East Hospital Regional Hospital of Jackson
Upper Eyelid Blepharoplasty and Ptosis Repair Procedure
Skin to be removed is marked. Incision is made along the skin
markings on the upper eyelid. Skin, muscle, and fatty tissue are
removed. For a ptosis repair, the muscle that
raises the lid is also tightened.
Entropion and Ectropion Repairs
Entropion Repair• Is a surgical procedure to fix an eyelid that
is turning back towards the eye Ectropion Repair
• Is a surgical procedure to fix an eyelid that is turning outward.
Entropion and Ectropion Repairs
For an ectropion repair, the lower tendon at the outer corner of the eye is exposed and tightened using an internal suture.
For an entropion repair, additional sutures are placed in the lower eyelid to help rotate the lid out, away from the eye.
Lower Eyelid Blepharoplasty
As we age, the fatty tissue under our eyelids tends to protrude, and the lids sag.
In order to repair this, an incision is made either inside the lid to remove the fatty tissue (transconjunctival blepharoplasty) or
The incision can also be made below the lashes and extended to the outer corner. This is called a transcutaneous blepharoplasty. With this approach, some excess skin can also be removed.
Surgical Fixes for Excessive Tearing
There are many scenarios which can cause a person to experience excessive tearing• Eye irritation• Dry eyes (ironically)• Lower eyelid laxity• Blocked tear ducts
The first two can be treated with drops
The last two may require surgery
The Tear Duct The tear duct is like the drain in a sink, if
it gets clogged, tears will run over the lid and down the face (epiphora).
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The Tear Duct • There a few reasons a tear duct can fail
to drain properly• The duct can narrow or close due to
•Age (women, generally, have narrower tear ducts)
•Chronic eye infections•Sinus/Allergy problems•Chronic use of eye drops and some
chemotherapy•Previous trauma or placement of punctal plugs
• The duct may have a “stone” blocking the passage.
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Tear Duct Surgery Minor tear duct surgery can be done
in the office with local anesthesia. These procedures usually involve
removing a foreign body or enlarging the opening.
This may also involve irrigation of the lacrimal system.
Tear Duct Surgery Major tear duct surgery which typically
involves re-routing the tear duct is done in the operating room under general anesthesia.
This procedure is called a DCR. To begin, a small, half inch, incision is
made between the eye and the nose. A new, internal opening is made between
the tear sac and the inside of the nose, re-routing the path through which tears drain.
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Tear Duct Surgery• Lastly, a small, flexible, silicone tube is
placed, and acts as a stint to keep the new duct open.
• This tube is generally kept in place for about 6 weeks and is removed easily through the nose, in the office.
Post Op - Eyelids For upper or lower lid surgery
• Bruising generally lasts for 1 to 2 weeks 2 weeks if upper and lower eyelids are done
simultaneously• Swelling can take a full month to go down,
but a majority of it will decrease in the first week
• For the first 24-48 hours, you should keep ice on the lids and sleep with your head elevated.
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Post Op - Eyelids• You will apply antibiotic ointment to the
incisions twice a day, until your post-op appointment one week after surgery.
• This type of surgery is typically not painful and pain medication is not usually needed after 1-2 days.
Post Op – Tear Duct Tear duct surgery
• Is similar to the eyelid surgery course• Bruising and swelling is usually limited to
one side• There is some additional risk of bleeding
from the nose since part of the procedure requires work in the nose.
Blood Thinners•You would need to be off of any blood thinners 5 to 7 days before surgery, unless otherwise discussed.•You may need to get a letter from the physician who monitors this stating that it is fine to be off the blood thinner.
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Blood Thinners Some examples of blood thinners include
Over the Counter Prescription Aspirin Plavix Vitamin E Coumadin (or Warfarin) Ginko Pradaxa Ginseng Aggrenox Garlic supplement Ticlid Fish Oil Efient
Risks Although eyelid and tear duct surgery
is typically safe and uneventful, it is still surgery. Usual risks include:• Bleeding, which could affect your eyesight• Scarring• Infection• Asymmetry• Need for additional surgery• Anesthesia – Anesthesia staff will discuss with you
before surgery
Scheduling If you did not schedule your procedure on
your initial visit, we will get in touch with you over the next few days to set this up.
We are generally booked out about two weeks in advance.
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Scheduling• If you have a commercial insurance
(CIGNA, BCBS, Aetna, United, etc), certain types of eyelid surgery may require pre-authorization. This can take up to 4-6 weeks.
• Medicare does not require pre-authorization.
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