The Challenges of Reversing Almond Shaped Eye Surgery Performed at a Very Young Age

Описание: A 20-year-old man had almond shaped eyes. However, he had multiple surgeries to change his eye shape at age 11. He wants to know if his eyes can go back to their original shape.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, observed from his photo that the outer corner of the eyes appear to have been pulled outward. It’s possible that as the bones grow, the corners which were fixated have shifted outward. He also noticed that the lower eyelids appear to be rounded or over-rounded for his facial features and structure, called relative lower eyelid retraction. A strategy is the correction of the outer corner as well as vertical correction of the lower eyelid.

In order to be able to do a repair or reconstruction of the eyelid structure, Dr. Prasad has to determine the anatomic elements of the eyelids that need additional tissue. The lower eyelid position is dependent on the lateral canthal tendon which is responsible for stabilizing the lower eyelid. It is attached to the bone, the lower eyelid retractors, orbicularis oculi muscle and the skin. All of these factors determine the eyelid position.

If there’s a shortage of support that causes eyelid retraction, Dr. Prasad does grafting using a material like Enduragen or human acellular dermis. These structural benefits or grafts need to be placed on the inside to give the eyelids vertical support. Unfortunately, a lot of plastic surgeons try to pull the lower eyelid up without any vertical support and end up creating a bold look that doesn’t really work out. In addition, patients may also benefit from waiting and seeing how their face matures over time which may be the most practical decision.

The upper eyelids are also dependent on how much available skin there is. If there’s a skin shortage, then patients may require skin grafting. Skin grafts are beneficial to younger patients because they have good healing. When Dr. Prasad does skin grafts, he maximizes the aesthetic result by the use of platelet-rich plasma to improve the healing. He also uses extracellular matrix. Good surgical technique is also important to get optimal and natural results.

Dr. Prasad does a fair amount of Asian eyelid surgery and has had patients who come for revision surgery. One of the most common reasons for their revision surgery is that as they got older, their upper eyelids got more hollow. The solution for hollowness in the upper eyelid is fat grafting. He takes fat from one part of the body and places it into the space just below the brow and the orbital space to to restore some volume.

In the absence of a physical exam, Dr. Prasad can’t tell the elasticity of the skin and how much skin is available. He concludes that as a young person, he doesn’t have a lot of skin laxity thatlimits the amount of stretch that any type of surgery would be able to use in order to move tissue from one point to another.

Dr. Prasad suggests that he meet with qualified experienced cosmetic surgeons. He should get some opinions and understand the strategy is and what he’s willing to accept. With the help of experienced surgeons, he’ll come up with a game plan that he can live with.

To learn more about almond eye surgery, please go to our website:

http://prasadcosmeticsurgery.com/pras...