Advanced Single-Stage Eyelid Reconstruction

Lee, Wendy W.; Erickson, Benjamin P.; Ko, Marcia G.; Liao, Sophie D.; Neff, Ann G.

doi:10.1097/dss.0000000000000117

Cited by 9 publications

(6 citation statements)

References 16 publications

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“…A camada anterior é composta pela pele e pelo músculo orbicular do olho, e a posterior, pela placa tarsal e a conjuntiva 14,15 . A camada posterior não deve ferir a córnea e por esse motivo, as suturas não podem ser dispostas em espessura total 16 .…”

Section: Discussionunclassified

“…O manuseio das pálpebras deve ser realizado com cuidado para evitar a perda do tecido viável. As mesmas devem ser descoladas e aparadas para evitar exposição das bordas do tarso 16 . Nesse caso, não foi necessário Durante muitos anos, a recomendação era que os ferimentos de mordedura permanecessem abertos para cicatrização por segunda intenção para evitar possíveis infecções, devido ao alto índice de contaminação e infecção 21 .…”

Section: Discussionunclassified

“…As complicações encontradas após reconstrução palpebral são relativamente comuns e incluem: deiscência de sutura, hemorragias, ectrópio, ptose, entrópio, retração palpebral, perda de suporte da pálpebra 7,16 . O uso do laser de baixa potência foi utilizado com o objetivo de acelerar o processo de cicatrização tecidual e evitar as complicações pós-operatórias 23 , mantendo os cuidados para não direcionar o feixe diretamente ao bulbo ocular através do fechamento das pálpebras e em uma dose menor.…”

Section: Discussionunclassified

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Reconstrução estético-funcional das pálpebras superior e inferior em paciente pediátrico após ataque canino: relato de caso

Paula

Júnior

Oliveira

2021

Rev Odontol Bras Central

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Ataques caninos podem causar lesões graves e desconfigurantes na face de crianças, ao ponto de necessitarem de atendimentos especializados e de urgência. O acometimento da região periocular requer uma avaliação completa para identificar possíveis fraturas ósseas, lesões palpebrais, oculares e no sistema lacrimal, juntamente com o acompanhamento oftalmológico. O objetivo desse artigo é relatar o caso de uma criança de 07 anos de idade, vítima de mordedura por cão em face. O ataque resultou na avulsão parcial das pálpebras superior e inferior do olho direito. Após realizado o procedimento de reconstrução palpebral e dos cuidados profiláticos antirrábicos, o paciente evolui com satisfatório reestabelecimento estético-funcional e sem sinais e sintomas da doença raiva. Esse relato enfatiza a importância do manejo adequado frente aos ferimentos causados por ataque canino na região palpebral, em um paciente pediátrico.

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Reconstrução estético-funcional das pálpebras superior e inferior em paciente pediátrico após ataque canino: relato de caso

Paula

Júnior

Oliveira

2021

Rev Odontol Bras Central

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“…Traditional teaching states that only one lamella can be formed using a free graft, and the other must be a vascularized flap to minimize the risk of central necrosis (6,7). Larger lid defects often require multi-step, time-consuming reconstructive procedures such as the Hughes tarsoconjunctival flap and the Cutler-Beard procedure.…”

Section: Introductionmentioning

confidence: 99%

The free bilamellar autograft (FBA) procedure: A comprehensive case series of an alternative surgical approach to reconstruction of large eyelid defects

McDonald

McDonald²,

McDonald³

2023

Front. Surg.

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PurposeThe free bilamellar autograft (FBA) procedure involves harvesting a free, full-thickness section of eyelid tissue from one of the patient’s healthy eyelids to reconstruct a large defect of the involved eyelid. No vascular augmentation is employed. The purpose of this study was to determine the structural and cosmetic results of this procedure.MethodsA case series was performed, looking at patients who underwent the FBA procedure for large, full-thickness eyelid defects (>50% eyelid length) between 2009 and 2020 at a single oculoplastic surgical centre. Basal cell carcinomas most frequently met criteria for the procedure. OHSN-REB waived ethics approval. All surgeries were performed by one surgeon. A single operation, with surgical steps reported in detail, was completed with follow-up documentation at ideally 1 day, 1 week, 1 month, 3 months, 6 months, and 1 year. The mean follow-up period was 28 months.ResultsThirty-one patients (17 males, 14 females, mean age 78-years-old) were included in the case series. Comorbidities included diabetes and smoking. Most patients had known basal cell carcinomas removed from the upper or lower eyelid. The mean widths of the recipient and donor sites were 18.8 and 11.5 mm, respectively. All 31 FBA surgeries resulted in structurally functional, cosmetically pleasing, and viable eyelids. Six patients developed minor graft dehiscence, 3 developed an ectropion, and 1 developed mild superficial graft necrosis secondary to frostbite, which fully recovered. Three healing phases were identified.ConclusionThis case series adds to the currently sparse data on the free bilamellar autograft procedure. The surgical technique is clearly articulated and illustrated. The FBA procedure is a simple and efficient alternative to current surgical techniques in the reconstruction of full-thickness upper and lower eyelid defects. The FBA provides functional and cosmetic success, despite the absence of an intact blood supply, with decreased operative time and faster recovery.

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“…A number of studies have examined the outcomes and complication rates following combined single-stage cosmetic procedures with mixed results. [10][11][12] Currently, no consensus exists on best practices for FFS. In a recent study of 121 patients by Chou et al, the authors concluded that F-FFS is safe and efficient, with an acceptably low incidence of complications in the postoperative period.…”

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confidence: 99%

Comparative Outcomes of Partial and Full Facial Feminization Surgery: A Retrospective Cohort Study

Chaya

Boczar

Colon

et al. 2021

Journal of Craniofacial Surgery

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Background:The demand for facial feminization surgery (FFS) amongst transgender women is on the rise, and requests for a singlestage full FFS (F-FFS) are becoming more frequent. The specific aim of this article is to present our institutional experience with both partial-FFS (P-FFS) and F-FFS with a specific emphasis on safety of each approach. Methods: We examined the electronic medical record of all patients with the diagnosis of gender dysphoria that were referred to the senior author for FFS consultation at our institution, between June 2017 and October 2020. Patients were sub-grouped into those who underwent F-FFS (upper, middle, and lower facial thirds in a single anesthetic event) and those who underwent P-FFS. Univariate analysis was used to assess for difference in postoperative complications. Results: We identified 77 patients who underwent 382 total procedures. The mean follow-up time was 7.5 months (Sd ¼ 7.3) (interquartile range 1.75-12.0 months). Fifty-one (71.4%) patients underwent F-FFS and 21 (28.6%) patients underwent P-FFS. Compared to P-FFS, F-FFS was not associated with an increase in postoperative complication (1 out of 21 [4.8%] versus 4 out of 51 [7.8%]) ( P < 0.556). When comparing characteristics of patients with postoperative complications to patients with no postoperative complications, the average body mass index was significantly higher (30.9 versus 25.4, respectively). ( P < 0.029). Conclusions: Full-FFS is a set of procedures that has gained increased popularity among male-to-female transgender patients. Our results support the understanding that F-FFS is a safe and reliable approach, which may be preferable to patients and providers alike.

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Advanced Single-Stage Eyelid Reconstruction

Abstract: Despite the challenges of periocular skin cancer reconstruction, excellent cosmetic and functional results can be achieved with appropriate technique.

Cited by 9 publications

References 16 publications

Reconstrução estético-funcional das pálpebras superior e inferior em paciente pediátrico após ataque canino: relato de caso

Reconstrução estético-funcional das pálpebras superior e inferior em paciente pediátrico após ataque canino: relato de caso

The free bilamellar autograft (FBA) procedure: A comprehensive case series of an alternative surgical approach to reconstruction of large eyelid defects

Comparative Outcomes of Partial and Full Facial Feminization Surgery: A Retrospective Cohort Study

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