
This is a follow up video showing the second step of alar reconstruction using a nasobial flap...
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Resection and advancement of the levator aponeurosis is a technique often used in correction of ptosis in patients with greater than 5 mm of levator function. This technique is performed via the exposure of the levator aponeurosis through an anterior approach, traditionally using an incision running the entire length of the upper eyelid crease, then advancing the levator aponeurosis by folding or excising the muscle, and reattaching the aponeurosis to the anterior surface of the tarsus. This method results in an elevation in the contour of the upper lid by effectively shortening the levator muscle itself. This approach has the...
Before undertaking repair of a ptotic eyelid you have to select your patient. The consultation might reveal a systematic etiology of their blepharoptosis (Myasthenia). All patients should routinely have their visual acuities, pupillary function and extraocular motility documented. There is a myriad of surgical techniques. We describe the external levator resection...
This video presents a case of a whole full-thickness defect of the lower eyelid reconstructed with the Hughes procedure. This technique recreates the posterior lamella of the lower eyelid through use of a tarsoconjunctival flap from the upper eyelid. At least 4mm of tarsus is preserved proximal to the lid margin for lid stability and to prevent the complication of upper lid entropion. The tarsoconjunctival flap is advanced into the defect of the lower eyelid and secured with a medial and lateral periosteal flaps. A laterally based myocutaneous transposition flap from the upper eyelid (Tripier flap) reconstructs the anterior lamella....