Upperlid Blepharoplasty Operation

We have provided a sample copy of an Operative Report. The procedure is subject to change per the patients needs.

Upperlid Blepharoplasty

PREOPERATIVE DIAGNOSIS: Upper lid asymmetry

POSTOPERATIVE DIAGNOSIS: Upper lid asymmetry

OPERATION: Upper lid blepharoplasty, anchor technique

ANESTHESIA: General(Local)

OPERATIVE PROCEDURE:
After induction of General(Local) anesthesia, the patient was prepped and draped in the usual sterile fashion. 3ml of 1% Lidocaine with epinephrine was injected to the upper lid. A total of 6ml were used. The patient had premarking of the upper lid excess skin prior to the surgery in a sitting position where 2 mm of skin was resected from the right and 2 mm was resected from the left. A strip of orbicularis muscle was taken out. The septum was opened, only a small amount of fatty tissues were excised. The medial fat pocket was opened, and a small amount of medial fat bulging was taken out. The flap of upper lid skin was anchored to the aponeurosis of the levator using a 6.0 Vicryl and 6.0 Prolene in multiple spots to secure the fixation. This was done bilateral.

Lowerlid Blepharoplasty/Subcilliary Approach

REOPERATIVE DIAGNOSIS:
1. Pseudo herniation of the lower lid, bilateral

POSTOPERATIVE DIAGNOSIS:
1. Pseudo herniation of the lower lid, bilateral

OPERATION:
1. Subcilliary lower lid Blepharoplasty, bilateral

ANESTHESIA: LOCAL

OPERATIVE PROCEDURE: After the induction of local anesthesia, the patient was prepped and draped in the usual sterile fashion. 2 ml of 1% Lidocaine with Epinephrine was injected to the lower lid bilaterally. Subcilliary incision was made using a needle-tip Bovie cautery and 15 blade. A Q-tip applicator was utilized as well as Desmarres retractor pulled the lower lid down where the septum was revealed. Three fatty compartments were released. Small amounts of fatty tissues were removed. Good hemostasis was obtained. This was done on the left side as well, using subcilliary incision and blunt dissection was carried out using Q-tip applicator. The septum was revealed. The three fatty compartments were released. Only small amounts of fatty tissues were taken out with good hemostatsis obtained. 2 mm of skin resection was done bilaterally. Incision was closed using 6-0 Prolene. 2 mm of skin was resected from the right eyelid and 2 mm was resected from the left eyelid, using a 15 blade and Bovie cautery. The incisions were closed using 6.0 Vicryl and 6.0 Prolene.

Lowerlid Blepharoplasty/Transconjunctival Approach

REOPERATIVE DIAGNOSIS:
Pseudoherniation of the lower lid fat pad, bilateral

POSTOPERATIVE DIAGNOSIS:
Pseudoherniation of the lower lid fat pad, bilateral

OPERATION:
Transconjunctival approach, lower blepharoplasty, bilateral

ANESTHESIA: General

OPERATIVE PROCEDURE:
After induction of general anesthesia in a supine position, she was prepped and draped in the usual sterile fashion. 2 ml of 1% Lidocaine with epinephrine were injected to the transconjunctival area bilaterally. A total of 4 ml were injected. The capsule of palpebral fascia was lifted using 5-0 silk, and the transconjunctival incision was made using the Bovie where the septum was exposed by peeling the connective tissues away from the septum using Q-tip applicators. Three fatty compartments were identified, and puncture incisions were made using the scissors where a small amount of fatty tissues were released and excised using the Bovie cautery. Good hemostasis was obtained. One 6-0 Vicryl was applied to the connective tissues of the lower lid above the septum to the capsule of palpebral fascia to reinforce the interior lining so that the herniation will be minimized. The left side of the lower lid was also opened transconjunctivally where the septum was opened in three different spots and the fatty tissues were released and cauterized. Only a moderate amount was resected, not the entire fatty tissues were taken out anticipating that the patient will require the fatty cushioning as he/she advances in aging. The transconjunctival lining was reattached without sutures, and good alignment was obtained.