How to Correct Lower Eyelids Pulled Down from Previous Surgery with an Oculofacial Specialist скачать в хорошем качестве

How to Correct Lower Eyelids Pulled Down from Previous Surgery with an Oculofacial Specialist

A woman in her late 60s has hollows in her lower eyelids and some rounding due to a previous surgery done many years ago. She is asking if AlloDerm and fat transfer may help correct it. Dr. Amiya Prasad is an oculofacial plastic surgeon practicing for about 20 years. He is boarded with facial cosmetic surgery as well as body, breast and extremity surgery. He does everything from head to toe including hair restoration. So with no limitations with his scope of surgical procedures, he explains the different things he has done to patients who come to him who have the same issue known as lower eyelid retraction. The lower eyelid has three essentials parts that helps its position: the lateral canthal tendon which is the attachment of a very important connection between the lower eyelid and the bone of the orbital rim; the internal support of the lower eyelid which are like pillars - these support underneath the eyelid is referred to as the posterior middle lamella; last is the amount of skin available to physically move upward. A lot of people have come to Dr. Prasad who had too much skin removed from their lower eyelid resulting in the combination of eyelid retraction or a rotation of the eyelid away from the eye called ectropion. When a patient comes to Dr. Prasad, he'll do an assessment to evaluate all of these factors. He assesses if they have enough skin and if they have enough support in the lower eyelid. He also assesses if their eye is projected outward and the strength and position of the lateral canthal tendon. These make up the dynamics and physics of the way the lower eyelid is positioned. Dr. Prasad has had experiences using posterior middle lamellar grafts such as hard palate mucosa and Alloderm but what he has been doing in his practice for the past couple of years is using a material called Enduragen. Enduragen is a material derived from pig dermis. This doesn't mean that Alloderm is not an acceptable choice; every surgeon has their own ideal way of combining their procedures and materials with what works with them. Fat transfer can also be a good option. However, Dr. Prasad doesn't do fat transfer as part of his primary procedure which is to restore the anatomy. He would reposition the lower eyelid into its proper anatomical position. Lower eyelid position is very important for proper eye function such proper distribution of the tear film. A bowed eyelid cannot contribute to good ocular health. Since this is a more advanced and complex procedure and there's grafting involved, there is a time frame for things to heal. After the eyelid has healed and is in proper position, then fat transfer may be appropriate. Dr. Prasad also does adjuvant therapies such as the use of platelet-rich plasma and extracellular matrix for improvement of wound healing. This is a type of procedure that requires a lot of initial care after the surgery. At this point, it is best that she meet with several oculofacial plastic surgeons and get some opinions as to what will be their approach. After that, she can move forward with choosing one she is comfortable with. For more information, visit our website: http://prasadcosmeticsurgery.com/pras...