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New Treatment of Facial Paralysis by

Microsurgery with NTL (Viterbo Technique)

Facial paralysis is a disfiguring disorder with significant psychological impact, emotional and family, leading to these suicidal patients, because these patients are marginalized in their families, work and their social environment ...

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ARTICLES

 

Blepharoplasty
 

It is a cosmetic procedure that involves removing excess skin over the eyelids and / or re-positioning to its original position with eyelid bags which can be achieved more naturally, this surgery provides a remarkable facial rejuvenation approximately 5 years.
                       
Directions:

Patients who have skin laxity of the eyelids and / or hypertrophy of palpebral bags, featuring a tired and aged appearance of the patient's face. (Figure 1)

 

Fig 1. Scheme palpebral bags hypertrophy with excess skin. 

 

As the surgical procedure?
This is a cosmetic procedure it performed in an operating well equipped, under sedation and monitoring surface of an expert anesthesiologist in order to provide hemodynamic safety.

How long does the surgery?
The surgery takes about 1 hour 30 minutes, then the patient goes into the recovery room for 6 hours and is then discharged to continue their checks every 48 hours at the office.

At what time I can return to my job?
After 72 hours of surgery, in jobs that do not require physical exertion and / solar exposure.

Goal of surgery:
Reset the anatomical elements that are lax, repeatedly associated with additional procedures such as canthoplasty, as the case tarsoplastia, returning an expressive and youthful look.

 

A

Figure 2: Skin laxity in the upper and lower eyelids but eyelid bags hypertrophy, providing a look aged and tired.

 

B

Figure 3: rejuvenation come after blepharoplasty, canthoplasty associated with and / or tarsoplastia.

 

Post-operative care:
1 .- Apply ice bag on the eyelids during the first 12 hours.
2 .- intake of medication prescribed by your doctor.
3 .- Relative rest.
4 .- Control every 48 hours doctor remove stitches, and then when the surgeon feels necessary.
5 .- No sun exposure during the first 3 months.
6 .- Food is normal since discharge from the clinic, additional intake of citrus fruits (tangerine, lemon, passion fruit, pineapple).

Complications:
May occur in 2% of patients, in skilled hands can be reduced to 0.1%.
Hematoma.
Undone sutures.
infection
Ectropion.

Surgical techniques:
External: subciliary
Internal: Trasconjuntival.

 

Fig.4 Schematic of the procedure of blepharoplasty approach was subciliary

 

Transconjunctival technique
This technique is indicated in young patients, when there is hypertrophy of the palpebral bags without skin redundancy.

Has the advantage that the incision is made on the inside of the palpebral conjunctiva and scar marks left on the skin.

 

Fig.5 Scheme transconjunctival blepharoplasty incision.

 

Advantage
No scars on the outside (skin).

Complications:
This technique can provide:
Infection, hematoma, suture dehiscence, chemosis, ocular perforation.

How long does the surgery?
The surgery takes about 2 hours, then the patient goes into the recovery room for 6 hours and is then discharged to continue their checks every 48 hours at the office.

 

preoperative

18 months postoperatively, external incision

 

 

preoperative

18 months postoperatively, external incision

 

 
 
 

 

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