Author: Lin Lin (Plastic Surgery Hospital, Chinese Academy of Medical Sciences)
Large medial canthal surgery, also known as medial canthal opening and epicanthal correction, can improve the angle and appearance of the inner canthus, and can also shorten the distance between the eyes. Combined with eyelid (double eyelid) surgery, it comprehensively changes the shape of the eye.
1. Who is suitable for opening the inner corner of the eye?
This surgery is usually considered for those who:
1. Too much skin at the inner corner of the eye covers the corner of the eye, that is, the epicanthus is obvious.
2. The distance between the inner canthus (medial canthus) of both eyes exceeds 1.3 times the length of the eye (cross diameter of the palpebral fissure).
3. The distance from the central point of the cornea to the inner canthus is less than the distance to the outer canthus (lateral canthus).
The following conditions are generally not suitable for this procedure:
The fleshy protrusion at the inner corner of the eye (caruncle) and its surrounding dimple (tear lake) are poorly shaped, or the caruncle is abnormal.
Eyes are too close together.
Mental disorder or a mental disorder.
Abnormal blood coagulation function, or serious heart, brain, liver, kidney and blood system diseases.
Severe scarring from previous trauma or surgical incision is commonly known as scar constitution.
I don’t have a clear understanding of myself and have excessive expectations for “beauty”.
Pregnant or breastfeeding.
If you are taking antithrombotic drugs such as warfarin and aspirin, or Chinese patent medicines with the effect of promoting blood circulation and removing blood stasis, such as apocynum, it is recommended to stop the drugs for 1 week before surgery. If you cannot stop the drug due to illness, you can consult a doctor in the relevant department.
Have an infection or inflammation inside or outside the eye, such as conjunctivitis, blepharitis, severe trachoma, etc. Antibiotic eye drops can be applied to patients with mild eye inflammation, and surgery can be considered after the inflammation has disappeared.
In addition, those who are in the menstrual period should wait until the menstrual period has completely ended before surgery, preferably 3 days after the end of the period.
Image source: Zhanku Hailuo
2. What should I do before opening the inner corner of the eye?
This surgery is usually done on an outpatient basis without the need for a hospital stay.
1. Preoperative examination
Routine blood tests are sufficient before surgery. Blood test items include blood routine, coagulation function, liver and kidney function, etc.
Middle-aged and elderly patients usually need to measure blood pressure and do an electrocardiogram before surgery to rule out cases where surgery is impossible.
In addition, the blood test items also include infection indicators such as hepatitis B and syphilis. The purpose is to disinfect the instruments used by infected persons to protect other patients and avoid cross-infection between patients.
Preoperative eye disease examination and vision examination are usually carried out to understand the basic condition of the eye and rule out the situation that cannot be operated.
2. Preoperative preparation
Do not take medicines containing aspirin and Chinese patent medicines with the effect of promoting blood circulation and removing blood stasis 2 weeks before surgery, otherwise it will easily lead to bleeding.
If you have high blood pressure, diabetes and other diseases, please communicate with your doctor in advance to confirm whether you need to adjust your medication.
Shampoo and shower 1 day before surgery and wear open-front clothing on the day of surgery to facilitate post-operative changes.
Remove and clean the eye area before surgery, and remove contact lenses if you wear them.
Consult your doctor before surgery and discuss your desired outcome with your doctor.
3. Anesthesia
The surgery is usually done under local anesthesia with the patient fully awake.
3. What is the process of open eye surgery?
The doctor will first design, draw out the skin incision for surgery, and design the size and course of the skin to be incised according to the condition of the eye.
Then anesthesia is applied to the outer corner of the eye, the needle will be a little painful, but there will be no pain during the operation.
According to the designed incision line, the doctor will cut and adjust the skin appropriately, and then suture.
The wound is usually covered with antibiotic ointment.
Simple canthoplasty takes about 30 minutes.
Image source: Zhanku Hailuo
Fourth, what should I pay attention to after inner canthoplasty?
1. Postoperative complications
Scarring may develop at the incision after surgery. After surgery, you can use scar removal drugs as prescribed by your doctor. If the scar is too obvious or hyperplasia is obvious, you can consult a doctor. Sometimes it may be necessary to surgically remove the scar.
Patients may also think that their shape is not good after surgery, and can communicate with the doctor about this. Communication issues can include aesthetic standards, the possibility of further restoration and improvement of shape in the future, etc. Perform surgical revision.
2. Precautions after operation
After the operation, the head can be tilted back appropriately, and local ice compresses can be applied.
Continue the cold pack for 48 hours. When cold compressing, take a sitting or semi-recumbent position with head back and avoid lying down; one cold compress is about 10-15 minutes, 3-4 times a day;
Keep the wound clean and dry when applying cold compresses to avoid wound infection. Change to hot compress after 72 hours, which can accelerate blood circulation and help reduce swelling.
Oral antibiotics, eye drops, etc. are prescribed by the doctor after surgery, usually oral antibiotics for 3 days and anti-swelling drugs for about 7 days.
Usually, return to the hospital for wound debridement on the 2nd postoperative day and stitches removed on the 7th postoperative day. After the stitches are removed, you can wash your face normally with water.
It is normal for the wound to bleed and bruise slightly 1 to 2 days after the operation. After 3 days, the local blood scab can be cleaned up with a cotton swab dipped in normal saline.
After surgery, some patients are prone to tears and even blurred vision. This is usually because the eyelid and conjunctiva have varying degrees of edema and irritation after surgery, and eye ointment enters the eye, which is generally not caused by infection. , can be washed with eye drops as prescribed by a doctor.
Stand up more during the day, sit and lie down, and try to lie down as little as possible. Sleep with a higher pillow at night to help reduce swelling. Do not overuse your eyes, take proper rest, and go about your daily life normally. Be careful not to bow your head suddenly.
The diet should be as light as possible, and fasting of spicy stimulants.
Image source: Zhanku Hailuo
3. Recovery process
In the first 2 days after the operation, the swelling is usually relatively swollen, and the swelling gradually subsides after 3 days, and the swelling basically subsides in 7 to 10 days. There may be local yellowing of the skin, which usually subsides in about 2 weeks.
Usually, the scarring is the most severe 1-2 months after the operation, gradually improves after 3 months, and becomes less obvious after 6 months, but some patients need 1-2 years to recover Expect.
After the stitches are removed and the scabs completely fall off, anti-scar drugs can be applied to prevent scarring, usually once a day in the morning and evening.
4. Review
On the 2nd day after the operation, you should come to the hospital for a re-examination. If there is excessive eye bleeding or unbearable pain, or eye infection, etc., please contact the doctor in time for treatment.
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