August 22, 2021 could have been another ordinary Sunday, but it wasn’t. As part of St. Luke’s Eye Institute’s 25th post graduate course, we were treated by the founding member and past president of the British Ophthalmic Plastic Surgical Society (BOPSS) Professor Naresh Joshi to two exciting oculoplastic EYEdventures! The thrilling session was moderated by our PSOPRS secretary Dr. Yvette Santiago-Gatmaitan. Joining her as panellists are our PSOPRS treasurer and public relations officer, Dr. Mark Imperial and Dr. Sandra Worak-Tan, respectively.
Case #1 Hooding of the right upper eyelid in a middle-aged woman.
Professor Joshi emphasized the importance of volume as one of the main factors in aesthetic eyelid surgery. He showed several patients for whom he performed blepharoplasty in varying combinations of skin resection only, skin and orbicularis oculi muscle resection, skin-muscle-orbital fat resection, skin and muscle resection with orbital fat prolapse; blepharoplasty with upper blepharoptosis repair; upper blepharoptosis repair only.
In the case of the middle-aged woman with mild left upper eyelid ptosis and mild deep sulcus who came to him for hooding of the right upper eyelid, he opted to perform bilateral blepharoplasty with skin resection only, with prolapsing of orbital fat on the left upper eyelid. At the end of this case, he reminded us about the importance of taking pre-operative photos since eyelid measurements may vary with a few patients squinting their eyes in their desire to undergo eyelid surgery, and to deliberately open their eyes after the eyelid surgery.
Case #2 Large lower eyelid defect allowed to heal spontaneously
The second case Professor Joshi presented was on woman in her fifties who had a large (more than half the horizontal length) lower eyelid defect after Mohs microsurgical resection for basal cell carcinoma. The woman is a foreigner who had undergone a four-eyelid blepharoplasty and facelift/necklift twice. With normal upper eyelid function, corneal sensation, and Bell’s phenomenon, Professor Joshi left the lower eyelid defect to heal spontaneously, with the option of doing further reconstruction in the future.
The two cases that Professor Joshi presented left our PSOPRS members wanting more. He promised to engage us in another exciting oculoplastic session soon!