How to Manage Styes and Recurring Chalazions
An Exploration of Eyelid Reconstruction REVIVE YOUR RADIANCE
At Eye Plastic Associates, the most common question I get regarding eyelid cancer reconstruction surgery is, “Where do you get the parts for the lids?” Since I can’t find them at the local hardware store, I need to perform specialized procedures to make your eyelid look and feel normal again. Eyelid reconstruction surgery is commonly performed to close the hole/defect left in the eyelid following Mohs surgery to remove a tumor. Specialized dermatologists perform Mohs surgery in their office to fully remove any eyelid cancer by immediately checking all the surgical edges before declaring the patient free of the tumor. Following their surgery, the patients are sent for eyelid reconstruction to Fair Oaks Hospital outpatient surgery center. To provide a brief walkthrough of how it’s done, let’s say there’s a post-Mohs “hole” with one-third of a lower eyelid removed. First, I would determine whether the skin has enough laxity to pull and stitch the surrounding sides together to close the defect without causing excessive tension. This option is most common among older patients whose skin has loosened with age.
the outside corner of the eye on the inside of the lid — where no one will see — and release a tendon, which will add about two to three millimeters of extra leeway to help seal the hole. A second option is to take a small vertical sliver of full-thickness eyelid from the upper lid and transpose it into the lower lid to fill a portion of the defect. My third choice for reconstruction is the Hughes procedure, or a “transconjunctival flap advancement.” This procedure was named after Dr. Wendel Hughes — an industry legend I had the honor of meeting several years ago — who developed this surgical technique back in 1937. The Hughes procedure is essentially an “eyelid- sharing” surgery that takes a tissue flap from the upper eyelid and applies it to the lower eyelid to reconstruct the posterior lamella (the back layer of the eyelid). To reconstruct the anterior portion of the eyelid, called an anterior lamella, a skin muscle flap is rotated up to make a new full-thickness eyelid. This is only a brief overview of eyelid reconstruction. To discuss your particular surgical needs or for a more thorough explanation, please contact us to schedule a consultation.
But often, the hole is too large or awkwardly shaped to be closed in this manner. Fortunately, there are several ways to address the issue. One option is to go to
CREAMY TORTELLINI VEGETABLE SOUP
Inspired by EatingWell.com
INGREDIENTS •
2 tbsp extra virgin olive oil
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2 tbsp fresh basil, chopped
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1 cup peeled and chopped carrots 1 cup chopped yellow onion 1 tbsp finely chopped garlic 3 cups reduced-sodium vegetable broth 1 (15-oz) can (no salt added) diced tomatoes with basil, garlic, and oregano
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1/2 tsp ground pepper 1/4 tsp plus 1/8 tsp salt 1 (9-oz) package refrigerated cheese tortellini
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1 (5-oz) package baby spinach 1 cup heavy cream
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DIRECTIONS 1. In a large Dutch oven, heat olive oil over medium-high heat. Add carrots and onions and cook for about 5 minutes or until onions are softened. Add garlic and cook for 1 minute or until fragrant. 2. Add broth, tomatoes, fresh basil, pepper, and salt. Bring to a boil, stirring occasionally. Reduce heat to medium, cover, and let simmer for about 5 minutes or until carrots are slightly tender. 3. Stir in tortellini. Cook until pasta is tender. Reduce heat to medium-low. 4. Add baby spinach and cream. Cook until spinach is wilted. Serve and garnish with additional basil if desired.
“Life begins at the end of your comfort zone.” –Neale Donald Walsch
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