Open the inner corner of the eye
The positive orbital distance is widened, or ptosis correction is needed. Congenital microphthalmia is characterized by narrow palpebral fissure and serious epicanthus, which is often accompanied by widening epicanthus distance and ptosis. The operation needs to be carried out by stages. The operation period should be in preschool age, when the development of nasal bone has been gradually improved, and the appearance, especially the medial canthus spacing, may be improved. [ 1]
Open canthus and common surgical methods
To correct microphthalmia, the medial canthus and lateral canthus must be enlarged. If necessary, the medial canthus ligament should be fixed to correct the widening of orbital distance, or ptosis should be corrected. Congenital microphthalmia is characterized by narrow palpebral fissure and serious epicanthus, which is often accompanied by widening epicanthus distance and ptosis. The operation needs to be carried out by stages. The operation period should be in preschool age, when the development of nasal bone has been gradually improved, and the appearance, especially the medial canthus spacing, may be improved.
Simple microphthalmia can be corrected by lateral canthoplasty and Mohs operation at the same time. If accompanied by ptosis, ptosis can be corrected after 6 ~ 12 months.
For patients with microphthalmia syndrome whose medial canthus distance is obviously widened and epicanthus is serious, Mohs method is the best method at present, which can not only correct the medial canthus distance, but also correct the width of the medial canthus distance, and there is no vertical scar passing through the medial canthus after operation, and no new epicanthus will be produced. Its disadvantage is that the scar is obvious after operation, and it takes a year to gradually recover.
Von Ammon lateral canthoplasty is a simple and commonly used lateral canthoplasty, which can permanently enlarge blepharoptosis. However, this operation is largely limited. If the incision of the outer canthus is too large, the vault and bulbar conjunctiva are not relaxed enough, and the incision is forcibly sutured, the red edge of bulbar conjunctiva will appear in the area with wide canthus angle, which will affect the appearance and cause insufficient blepharoptosis.
The purpose of plastic surgery to correct ptosis is not only to prevent or treat exposure keratitis caused by ptosis, but also to meet the needs of beauty.
Surgical methods include simple suture and blepharoptosis shortening. Simple suture is suitable for patients with simple mild ptosis, and it is simple to operate, but it is easy to recur after operation, so it is rarely used in clinic at present. Fucks blepharoplasty is suitable for patients with excessive ptosis caused by paralytic ectropion, and also for patients who cannot support artificial eyes because of eyeball loss and eyelid skin relaxation. At present, Fucks blepharoptosis has been widely used in clinic, and the effect is good.
Method 1: Single Z-shaped plastic surgery.
Suitable for people: 1. Mild epicanthus or scar epicanthus.
2. People with normal psychology and reasonable requirements can correctly understand the skin scars that may be formed by surgery.
Surgical methods: routine facial disinfection and dressing change, local infiltration anesthesia, design Z-shaped incision line according to the direction of epicanthus, cut the skin to form two flaps, release the subcutaneous orbicularis oculi muscle bundle, and cross stitch the flaps.
Note: 1. Oral anti-inflammatory drugs after operation.
2. Before taking out stitches, the incision should not be stained with water to avoid infection.
3. Take out stitches in four days.
Method 2: Four flaps were used to correct epicanthus.
Suitable for people: 1. Severe epicanthus or scar epicanthus.
2. People with normal psychology and reasonable requirements can correctly understand the skin scars that may be formed by surgery.
Methods of operation: routine facial disinfection and local infiltration anesthesia. According to the principle of Mohs surgical design, the incision line was drawn to form four flaps, and the subcutaneous orbicularis oculi muscle bundle was released and the flaps were cross-stitched.
In addition, there is a W-shaped canthus opening method similar to Z-shaped surgery.
I opened my eyes myself with a Z-shaped operation, and the effect was good three months after operation.
Remember not to drink alcohol after opening the inner canthus, and prohibit things that stimulate your hair, such as peppers and seafood.
I had an operation to open the inner canthus, and I recovered well in about 10 days, and recovered well in one month.
Open the inner canthus process
1, according to the preoperative design, cut the skin and conjunctiva of the outer corner of the eye horizontally with scissors.
2. Bluntly separate from the conjunctival incision with scissors to release the bulbar conjunctival vault.
3. Pull the horizontal bulbar conjunctiva to the apex of the cut outer canthus angle, fix a needle, intermittently suture the upper and lower fornix conjunctiva with the cut skin, and cut off the outer canthus ligament completely or partially if necessary. [2]
4. At the newly formed outer canthus, mattress suture was made through conjunctiva, and the needle was taken out from the skin surface of the outer canthus and tied on a gauze pillow to form a (temporal) vault. When stitching the conjunctiva with the skin, if the tension of the conjunctiva is too high, the bulbar conjunctiva can be cut vertically between the outer cornea and the outer canthus to reduce the tension.
Medical classification
Plastic surgery (eye plastic surgery)
Principles of inner canthus surgery
Clinically, there are mainly "V-Y" suture, "Z" plasty and four-flap method. The former is suitable for mild epicanthus; The latter is suitable for all types of epicanthus. At present, the double V operation method is commonly used, that is, it can be opened very big and in place, and the entrance can be cleverly hidden, so as to achieve the purpose of leaving no scar after the operation of opening the inner corner of the eye, which is an ideal operation method.
Principles of open inner canthus surgery
1, the operation level of opening the inner corner of the eye should be clear. Because of the fine anatomical structure of the inner canthus, if you are not familiar with it, you may inadvertently destroy many important anatomical structures and have irreparable complications, such as lacrimal canaliculus rupture.
2, local skin looks more, actually not much, so try not to remove skin tissue when doing major surgery on the inner corner of the eye.
3. The inner canthus operation can be carried out at the same time as the double eyelid operation, and the change of the skin position of the upper eyelid should be paid attention to when the inner canthus is corrected.
4. The inner corner of the eye can be overcorrected during major surgery.
5. The stitches can be removed 4 to 5 days after major surgery on the inner corner of the eye, and makeup can be made up after one week, and no surgical traces can be seen at all.
Can opening the corner of your eye hurt your eyes?
Opening canthus surgery can improve the aesthetic feeling of our five senses. It is a very small eye plastic surgery, which is mainly divided into opening inner canthus and opening outer canthus. Their incisions are very secret, or overlap with skin folds, or are hidden in the shadows of the corners of the eyes.
Almost no one can find the surgical traces of opening the inner corner of the eye after opening the corner of the eye. So don't worry about appearance.
Opening the corner of your eye won't hurt your eyes, and beauty seekers don't have to worry at all. But beauty seekers need a clear concept, and good postoperative care is very important. This is part of the action and must not be ignored.
After canthotomy, you should have a quiet and comfortable environment to recuperate. Don't watch TV or newspapers within 2 weeks after operation, and it is best to lie on your back (raise your pillow) when you are in bed, so as to avoid eye fatigue or lower your head, which will aggravate the swelling of the wound.
There will be some pain in the wound on the second day after operation, but it will gradually decrease with time. Patients should not rush to take painkillers, because aspirin drugs will aggravate wound bleeding.
Adapt to the crowd
The eyes are too small to be corrected by plastic surgery.
Severe epicanthus or accompanied by deformity of adjacent parts.
Taboo crowd
1, mental disorders or psychological disorders, lack of understanding of their own conditions, blind pursuit of unrealistic double eyelid morphology, serious scar constitution, or abnormal coagulation mechanism should be explained to the doctor in advance.
2. Congenital amblyopia, acute and chronic infections of inner or outer eyes and around eyes have not been cured by manual treatment.
3, facial paralysis, palpebral fissure insufficiency, infectious diseases inside and outside the eye, should be cured before opening the corner of the eye surgery.
4. Those with exophthalmos, fovea or eyelid retraction caused by various reasons should be treated with caution when they know that canthus surgery cannot achieve the expected results.
Precautions before operation
1. Do not take drugs containing aspirin within two weeks before operation, because aspirin will reduce platelet coagulation function;
2. Patients with hypertension and diabetes should inform the doctor of their condition at the time of initial diagnosis, so that the attending doctor can confirm the operation plan;
3. Make sure that you are in good health before the operation, and there is no infectious disease or other body inflammation;
4. No makeup before operation;
5. Women should avoid menstrual period;
6. Men should quit smoking one week in advance.
Matters needing attention after operation
1, and try to avoid water accumulation in the surgical site within 7 days after operation;
2, ensure the surgical site clean, prevent infection. If there is blood scab or secretion on the wound, it can be wiped with sterile physiological saline.
3. After operation, local wounds can be bandaged with pressure or cold compress with ice packs, but the pressure should not be too high, so as not to damage eyes. Once there is bleeding and severe hematoma after operation, you should go to the hospital for follow-up in time;
There should be a quiet and comfortable environment to recuperate after operation. Don't watch TV or newspapers within 2 weeks after operation, and it is best to lie in a semi-supine position (raising the pillow) when staying in bed, so as to avoid eye fatigue or bow your head and aggravate the swelling of the wound;
There will be some pain in the wound on the day of operation, but it will gradually decrease with the passage of time. Patients should not rush to take painkillers, because aspirin drugs will aggravate wound bleeding;
6. Avoid eating irritating foods such as peppers;
7, strictly abide by the doctor's advice and follow-up.
8. Don't smoke or drink heavily within two weeks after the operation.
Due to the ethnic differences in the East, most people have epicanthus in the inner corner of their eyes, which makes their eyes look short. Open-eye double eyelid plasty is to cut the skin of the inner corner of the eye to make the eyes look longer after operation.
Measurement method and aesthetic proportion of open inner canthus
A skin fold appearing in the inner canthus of epicanthus, which goes straight from top to bottom or flips from bottom to top. Epicanthal epicanthus is more common in eastern ethnic groups. Its existence not only increases the inner canthus distance, but also decreases the transverse diameter of the eye, which shows that the eye fissure is short and round. Because it covers part of the field of vision, it reduces the length of the eye fissure and makes the eyes lose their aesthetic feeling. How to deal with the problem of epicanthus or slack medial canthus ligament or too wide medial canthus spacing; First of all, let's understand the position of the corner of the eye and the length of the ligament in the corner of the eye that needs to be shortened.
First, the measurement method
The testee and the measurer sit opposite each other. The subjects looked straight ahead, and the surveyors measured with steel ruler, respectively, and obtained the following data.
1. Cleft eyelid length: the distance from the inner canthus angle to the outer canthus angle.
2. Palpebral fissure width: the distance between the upper and lower eyelid edges passing through the pupil.
3. Upper eyelid height: the distance from the edge of the upper eyelid through the pupil to the lower edge of the eyebrow. 4. Inner canthus spacing: the distance between two canthus on the horizontal line of two pupils.
B, calculation method
1. The length-width ratio of blepharoptosis = the length of blepharoptosis ÷ the width of blepharoptosis.
2. The proportional relationship between inner canthus distance and blepharoptosis length = inner canthus distance/blepharoptosis length.
3. The proportional relationship between the width of palpebral fissure and the height of upper eyelid = the width of palpebral fissure ÷ the height of upper eyelid.
C, analysis
(1). The ratio of length to width of ptosis.
The aspect ratio of ptosis increases. First of all, it shows that the length of ptosis has become longer, which is rare for normal eyes with no abnormal appearance. Secondly, it shows that the degree of blepharoptosis is getting smaller, and orientals account for a considerable proportion. The reasons are: ① ptosis caused by various reasons; (2) ptosis or ptosis. It should be corrected according to different reasons, and the length-width ratio after correction should be between 2.5 and 4.4.
The ratio of length to width of the fissure is reduced, which is mostly pathological, or the ectropion deformity caused by various reasons leads to the widening of the eyelid fissure, or the length of the eyelid fissure is shortened due to the adhesion of the inner and outer canthus and the serious epicanthus.
(2) The proportional relationship between the inner canthus spacing and the length of blepharoptosis.
The increase is due to:
① epicanthus.
② Widening of orbital distance.
③ Relaxation of medial canthus ligament.
④ The length of palpebral fissure became shorter.
The fourth reason is rare, so we should correct epicanthus according to different reasons, widen the orbital distance and shorten the medial canthus ligament.
(3) the proportional relationship between the width of eyelid fissure and the height of upper eyelid
The upper eyelid height of normal people is about 65438+ 0.5 times the width of eyelid fissure. Exceeding this value is mostly caused by eye fissure stenosis, ptosis or ptosis, which should be corrected separately. Less than this value is mostly caused by drooping eyebrows, and the distance from the lower edge of eyebrows to the upper eyelid edge decreases. Most of the aging faces of the elderly are accompanied by drooping eyebrows, so the eyebrows should be raised to a suitable position during wrinkle removal surgery. For people with high upper eyelids, the height of double eyelid line should be wider to make up for the uncoordinated proportion caused by high upper eyelids; If the upper eyelid is narrow, a narrow double eyelid line should be designed or it is not suitable for European double eyelid surgery.
D, canthus surgery design points:
1. When designing the operation to open the inner canthus, we must consider the direction of tension and choose the operation method according to the direction;
2. The innermost corner of the inner canthus angle should not exceed the vertical line of the eyebrows, otherwise the distance between the eyes will be too close;
3, tears are exposed at most 2/3, otherwise it will appear that the eyes are "godless";
4. The design that the inner canthus angle is slightly lower than the horizontal line of the long axis of the eye will be more natural.
Incision of canthus is minimally invasive, and there is no need for dressing after operation, which has no effect on vision. Suture can be removed 5 days after operation, or absorbable suture can be used to avoid suture removal. A small eye crack will seriously damage a person's image and his confidence will be greatly reduced. Many people whose eyes are too small can be corrected by opening the corner of their eyes. Doctors will choose different surgical methods according to the specific situation of patients. For example, some eyes are too small and the epicanthus is serious, and then the condition of too small eyes can be improved by trimming the epicanthus. Of course, the choice of this operation is to complete the outer canthus by open surgery.
Choose the right way to open your eyes;
According to different situations, different canthotomy methods are adopted to correct microphthalmia.
(1) Incision of inner canthus, aimed at people whose facial features are scattered due to the wide distance between eyes. In addition, this kind of surgery will correct those whose eyes are not bright enough and the root of the bridge of the nose is too collapsed, and it will enlarge the skin of your eyes, especially for those very European faces.
(2) Outer canthus is suitable for patients with ptosis caused by congenital, severe trachoma and burns.
(3) Baggy plastic surgery is to correct the corner of the eye by adjusting the position and angle, which is actually a surgical method of corner plastic surgery.
Although it is a minor operation, the nursing after opening the corner of the eye can not be ignored. Excessive use of eyes should be avoided in the short term after operation to prevent eye inflammation, because this situation may cause adhesion of new wound and affect the effect of canthotomy.
The benefits of opening the corner of your eye
Open canthus surgery can broaden your horizons and make your eyes more beautiful. Your eyes can naturally become bigger and more beautiful by opening the corner of your eyes.
Personalized overall eye shape is a differentiated plastic surgery according to the beauty seeker's own temperament and individual conditions. It does not simply copy patients with a certain standard, but embodies personal charm through subtle differences in plastic surgery, which is better than the charm of plastic surgeons. The surgeon must have a high artistic accomplishment and taste in order to dig out the unique personality and temperament beauty of the beauty seeker.
Recovery of inner canthus after opening
The recovery after opening the inner corner of the eye has a great relationship with personal physique. Generally, the swelling can be reduced in about 7- 10 days after opening the inner corner of the eye, basically recovered in about one month, and fully recovered in two to three months. A few people may take a long time to recover, up to five months.
Besides personal physique, reasonable postoperative nursing can also shorten the recovery time of inner canthus. Clinically, the recovery time of inner canthus can be effectively shortened by reducing eye activity, cleaning the surgical site locally, not rubbing the eyes hard, and avoiding or reducing spicy diet in the postoperative recovery period.
Five principles to be followed in opening the inner corner of the eye
1, the operation level of opening inner canthus should be clear.
2, the local skin looks more, not much actually, so try not to remove skin tissue when opening the inner corner of the eye surgery.
3. When the operation of opening the inner canthus can be carried out at the same time as double eyelid surgery, we should pay attention to the change of the skin position of the upper eyelid when correcting the operation of opening the inner canthus.
4, opening the inner corner of the eye surgery can be overkill.
5, 4 to 5 days after the operation of opening the inner corner of the eye, the stitches can be removed, and makeup can be made after one week, and no traces of the operation can be seen at all.