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Fixing Botched Lower Eyelid Surgery Case Study

Fixing Botched Lower Eyelid Surgery Treatment

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Procedure: Fixing Botched Lower Eyelids Case 1

Fixing Botched Lower Eyelid Cosmetic Concern: 64-year-old woman with a history of prior eyelids surgery.  In addition to her cosmetic concerns related to the pulled down lower eyelids.  The muscle of the lower eyelids was damaged by her surgery and she has chronic dry eye symptoms. Diagnosis: The lower eyelids had aggressive surgery that damaged both their appearance and function Treatment: The patient’s lower eyelids were reconstructed using graft material obtained from the roof of her mouth.  This material was place behind the lower eyelid and avoided the necessity of a skin graft to the outside of the eyelid, which are difficult to conceal.  To facilitate her repair, the cheek was also modestly lifted onto an ePTFE implant at the orbital rim.   Due to the complexity of this repair, the right and left sides were repaired at separate surgeries that were 1 week apart. The result is an actual before and after photo of one of Dr. Steinsapir’s patients. Your results will vary.

Procedure: Fixing Botched Lower Eyelids Case 2

Fixing Botched Lower Eyelids Cosmetic Concern: 33-year old woman whose lower eyelids were left pulled down after lower transcutaneous lower blepharoplasty
Diagnosis:
  1. Vertical and horiztonal inadequacy of the lower eyelid.
  2. Lateral canthal dystopia.
  3. Bilateral midface ptosis
Treatment:
  1. Bilateral lower eyelid reconstruction
  2. Harvest and placement of hard palate graft
  3. Placement of hand carved custom ePTFE orbital rim implant
  4. Vertical midface lift.
Discussion: Many surgeons use half measures to correct the issues that occur after unsatisfactory lower eyelid surgery.  The result is incomplete correction of the lower eyelids.  By taking a comprehensive approach, Dr. Steinsapir is able to provide definitive reconstruction of these issues, The result is an actual before and after photo of one of Dr. Steinsapir’s patients. Your results will vary.

Procedure: Fixing Botched Lower Eyelids Case 3

Fixing Botched Lower Eyelid Cosmetic Concern: 51-year old man whose lower eyelids were left pulled down after lower transcutaneous lower blepharoplasty.  Several revisional surgeries to correct the lower eyelids actually made them worse
Diagnosis:
  1. Vertical and horiztonal inadequacy of the lower eyelid.
  2. Lateral canthal dystopia.
  3. Bilateral midface ptosis
Treatment:
  1. Bilateral lower eyelid reconstruction
  2. Harvest and placement of hard palate graft
  3. Placement of hand carved custom ePTFE orbital rim implant
  4. Vertical midface lift.
Discussion: Dr. Steinsapir developed the use of the custom hand carved ePFTE orbital rim implant.  This should not be confused for other cheek and tear trough implants that are used to create volume.  This implant is designed for supporting the vertically lifted cheek soft tissue. This permits the recruiting of skin and soft tissue into the lower eyelid with minimal tension.  This sets the stage for the rehabilitation of the lower eyelids. The result is an actual before and after photo of one of Dr. Steinsapir’s patients. Your results will vary.

Procedure: Fixing Botched Lower Eyelids Case 4

Fixing Botched Lower Eyelid Cosmetic Concern: 55-year old woman whose lower eyelids were left pulled down after lower transcutaneous lower blepharoplasty.  She had two revisional surgeries to correct the lower eyelids but these surgeries were unable to correct her issues and made the scars of her lower eyelids more visible.
Diagnosis:
  1. Vertical and horiztonal inadequacy of the lower eyelid.
  2. Lateral canthal dystopia.
  3. Bilateral midface ptosis.
  4. Unacceptable lower eyelid surgical scars.
Treatment:
  1. Bilateral lower eyelid reconstruction
  2. Harvest and placement of hard palate graft
  3. Placement of hand carved custom ePTFE orbital rim implant
  4. Vertical midface lift.
  5. Revision of lower eyelid scars
Discussion: Using the techniques that Dr. Steinsapir has pioneered, he is routinely able to correct issues that frustrate other surgoens. His results combine is detailed and meticulous technical skills, advanced knowledge of the midface and lower eyelid anatomy, and artistic touch. The result is an actual before and after photo of one of Dr. Steinsapir’s patients. Your results will vary.

Procedure: Fixing Botched Lower Eyelids Case 5

Fixing Botched Lower Eyelid Cosmetic Concern: 50-year old man whose lower eyelids were left pulled down after lower transcutaneous lower blepharoplasty.  He had three revisional surgeries to “tuck” the lower eyelids but these only seemed to make the eyes worse.
Diagnosis:
  1. Vertical and horiztonal inadequacy of the lower eyelid.
  2. Lateral canthal dystopia.
  3. Bilateral midface ptosis.
Treatment:
  1. Bilateral lower eyelid reconstruction
  2. Harvest and placement of hard palate graft
  3. Placement of hand carved custom ePTFE orbital rim implant
  4. Vertical midface lift.
Discussion: Unfortunately well-meaning surgeons are not trained in the repair of these complex lower eyelid issues.  Trying to tighten the lower eyelid with canthal surgery will actually worsen the lower eyelid position by futher pulling the lower eyelid down.  These attempts to fix the eyelid use up critical material that is needed for definitive repair. The result is an actual before and after photo of one of Dr. Steinsapir’s patients. Your results will vary.