How to Achieve Symmetry in Eyelid Ptosis Surgery скачать в хорошем качестве

How to Achieve Symmetry in Eyelid Ptosis Surgery

A woman has unilateral ptosis. She wants to know the procedures that would achieve symmetry in both eyes. This is a situation that is very well known to oculplastic or oculofacial plastic surgeons. These are surgeons who are trained first in eye surgery though ophthalmology and then specialized in surgery of the eyes. Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon practicing in New York for over 20 years, explains about his process and how he makes decisions about whether or not to operate on one eye or to operate on both eyes. In terms of making the decision in operating in one eye or two eyes, Dr. Prasad measures the upper eyelid height, called the margin reflex distance, which is the distance from the eyelid margin to the light reflex of the pupil. He also tests the muscle function which is the amount of movement that the eyelid makes when looking down and up. Then he does a test for Hering’s Law, a physiologic manifestation of how the brain sends a signal to the upper eyelids to open. He lifts the eyelid that’s more droopy and looks to see what happens to the other eyelid. Very often, when the droopy eyelid is lifted, the other eyelid will actually droop. For people who have congenital ptosis, it is not unusual for the ptosis to be manifested in both eyes, but it can be more significant in one eye. In such cases, Dr. Prasad makes the decision with the patient to operate in both eyes because it is not advisable to lift one eye and then the other eye drops. During surgery, Dr. Prasad lifts the eye less in order to try to get the symmetry. In addition, he lets the patient sit up to make sure that the height, contour, shape and maximized symmetry are achieved. As for the eyelid crease if there’s more soft tissue and fat on one side versus the other, then Dr. Prasad will do a blepharoplasty or remove some extra skin and fat to try to maximize the symmetry. If she wants fullness in the contra lateral eye that has less volume, then procedures such as fat transfer or even hyaluronic acid filler can be entertained. However, Dr. Prasad tends to discourage that because getting the eyelid height, contour, shape, balance and symmetry is already a significant challenge. A small percentage of patients may have the eye too open or over corrected, or even too low or under corrected - it’s always about customizing to the individual situation. Dr. Prasad recommends that she meet with experienced oculofacial plastic surgeons. He doesn’t think that general plastic surgeons who are boarded by the American board of plastic surgeons are interested in doing this. He thinks she’ll find oculoplastic surgeons who are comfortable and more than qualified to do this surgery. For more information on ptosis correction surgery, go to: http://prasadcosmeticsurgery.com/pras...