Anophthalmia, Socket Reconstruction, Ectropion, False Eye – Rejuvenating the Prosthetic Eye or False Eye
The loss of an eye (anophthalmia) is a very traumatic psychological event. After an eye is removed a false eye (prosthetic eye) is placed for appearance and function. Even when this goes well, eyelid ectropion, socket problems, and ptosis can occur. This often leaves the patient concerned and depressed. The loss of the eye is enough hardship –making the prosthetic (false) eye look natural is important.
There is no reason to be unhappy with your appearance if you have a prosthetic eye. There is no reason a prosthetic eye cannot be made to look better. Prosthetic eyelid surgery can be done in an aesthetic way so that appearance as well as function is preserved. Below is an example of a patient Dr. Massry assisted with surgery to improve the appearance of her prosthetic eye.
If you have a prosthetic eye and need a surgeon to make the eye and eyelids look better, please contact Dr. Guy Massry (Beverly Hills Ophthalmic Plastic Surgery). Dr. Massry will be happy to evaluate your prosthetic eye condition and make appropriate suggestions for surgical repair of eyelid ectropion, ptosis or other associated issues related to the prosthesis. Dr. Massry can be contacted at his office (310) 453-8474 or through his web site listed above. While Dr. Massry is located in Beverly Hills, he often sees patients from surrounding areas such as Newport Beach, San Diego and Irvine and other areas around the country.
An ectropion (out-turning lid) can occur after blepharoplasty. This can lead to an impairment in appearance and vision. In addition, ocular pain and irritation and tearing can occur. When an ectropion occurs after blepharoplasty surgery an expert in revision eyelid surgery is needed to correct the problem. Eyelid surgery experts are called oculoplastic or ophthalmic plastic surgeons. These are eye trained cosmetic facial/eyelid surgeons. They are certified by the American Society of Ophthalmic Plastic and Reconstructive Surgery http://www.asoprs.org. Only a select group of physicians are approved by this society with approximately 500 members in the United States.
Below is an example of a woman who had an ectropion after lower blepharoplasty surgery. Note the improvement in lower eyelid position after Dr. Massry repaired the lower lid ectropion.
Lower Blepharoplasty surgery traditionally consisted of the excision of fat from the lower eyelids (eyelid bags). Over the last decade we have learned that preserving fat with fat grafting to the eyelids, or repositioning one’s own eyelid fat (lower lid blepharoplasty with fat repositioning) is a better option as it prevents postoperative eyelids hollows. Fat repositioning is an advanced eyelid technique which yields excellent results to surgery. Dr. Guy Massry, a cosmetic eyelid specialist in Beverly Hills performs many of these procedures every month. He is an expert in fat repositioning surgery, and has published extensively on the subject http://www.drmassry.com/pdf/comp%20ll%20rejuv%202010.pdf, http://www.drmassry.com/pdf/sculpting%20the%20eye.pdf
Dr. Massry recently has completed his second textbook in the field which covers this topic extensively. Open this link for information on the upcoming text. http://www.springer.com/medicine/ophthalmology/book/978-1-4614-0066-0?detailsPage=authorsAndEditors
Below is a surgical series demonstrating how fat is repositioned in surgery. In (A) the fat is made into flaps to place into the lower eyelid hollows. On the right side illustration you can see the muscle sandwiched between two fat pads, and the bone exposed where the fat will be placed. In (B) the fat flap is engaged with a suture so that it can be redirected over the bone. In (C) you can see the fat pads over the bone and muscle acting as an implant to fill the hollow.
Below is an example of a patient who had this surgery performed. Note the significant reduction in eyelids bags and improvement in hollows (dark circles)
Often times after lower lid blepharoplasty (eyelid surgery) the lower lids can slant too much as they meet the outer corner where the upper and lower eyelid meet. This can result in a “Cat Eye” look, or simply “Slanted Eyes.”
Slanted eyes can be a great bother to patients as it changes their appearance drastically. In addition slanted eyes can impart a smaller eye opening which makes eyes appear “squinty.”
Slanted eyes typically occur when the lower lid has been tightened (canthoplasty, canthopexy or other form of canthal suspension). Canthoplasty/canthopexy is a very specialized and intricate form of surgery requiring an eyelid specialist to get it right.
Eyelid surgery (blepharoplasty, ptosis repair, canthoplasty, etc.) can certainly improve aesthetic appearance greatly. However, today many patients are seeking a less invasive way to improve the way they look – especially around the eyes. For this patients are seeking eyelid filler. Eyelid fillers are materials like Restylane, Juvederm or Perlane which fill depressions, dark circles and hollows around the eyes. Unlike surgery, eyelid filler with any of these materials (Restylane, Juvederm or Perlane) is reversible. This means if the patient is unhappy with the result it can be erased with another injection which dissolves the filler. This second injection is either Hyaluronidase or Vitrase.
All these fillers (Restylane, Juvederm and Perlane) are made of hyaluronic acid gel. This is normal material found in our body which tends to be lost with age. This loss causes changes in our joints, hair and skin (and other areas). By injecting Restylane, Juvederm or Perlane into the skin and deeper tissue we can replace what is lost to fill depression and reduce hollows and dark circles.
It is generally thought that these filers (Restylane, Juvederm and Perlane) last 6 months when injected. I have found that in the areas around the eyes they last up to a year or more. While these are temporary solutions – this is a viable option for those patients averse to surgery and for those who want subtle, yet definitive changes.