Thursday, February 10, 2011

Non-Incisional Suturing Technique

More than thirty techniques have been described that involve placement of one or more permanent sutures into the eyelid from small incisions made on the back and/or front surfaces of the eyelid (while sometimes called "non-incisional," the designation is incorrect).

Preparation before Surgery
·        Get lab testing or a medical evaluation
·        Take certain medications or adjust your current medications
·        Stop smoking well in advance of surgery
·        Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
Special instructions you receive will cover:
·        What to do on the night before and morning of surgery
·        The use of anesthesia during your brow lift
·        Post-operative care and follow-up

Surgical Procedures
One variation known as DST (double sutures with twisting, double stranded twist, or durable suture technique, all of which indicate the same operation) employs two sutures that are tied in three places and twisted around each other four or five times at the central tie. While promoted as yielding a more stable or even permanent result, we have seen many patients who have undergone this operation elsewhere only to have their creases fade as early as one to eight months following surgery.

Post-Operative Care
You should rest as much as possible, preferably in bed on two pillows or in a recliner.  A bandage over the eyes is not needed.  In the evening, you may take a bath if someone is there to help you.  Avoid straining or bending over.  Watching television is acceptable.
 To prevent swelling, apply clean (not sterile) cold compresses to the eyelids as much as possible until you go to sleep.  Gauze pads or a clean towel may be soaked in a basin of ice cubes and applied directly.  Alternatively, a large Ziploc bag may be partially filled with ice cubes or frozen baby peas and placed over a moist gauze or towel.
Pain after surgery is usually mild.  Use Tylenol or any stronger pain medicine you were given. Avoid using aspirin or ibuprofen for two days.  Severe pain should be reported.
It is normal for the eyelids to become red, swollen, and bruised.  A small amount of bloody fluid draining from the wound is normal for a few days.  Occasionally, the eye itself may turn red and swell.  Brisk bleeding not responsive to pressure should be reported.
The eyelid creases will always look too high, too deep, overly rounded, and asymmetrical until swelling resolves and the deep tissues have a chance to soften. The eyelashes may appear to be pointed unnaturally upward.
If you were given an antibiotic drop or ointment, gently apply a small amount to any stitches before going to bed, and then twice a day thereafter.  If your eyes feel irritated, the antibiotic may be applied directly to the eye surface. Avoid the use of dry Q-tips on any stitches.

Possible Risks and Complication
Surgery may be complicated by irritation from sutures rubbing against the cornea of the eye. Since the lid is entered through multiple small cuts without full visualization of the internal eyelid anatomy, suture placement and surgical manipulation may cause tissue injury as well as uneven skin scars. Crease loss is common. If a patient who has undergone suture treatment later elects to undergo an incisional techn
ique, internal scarring and retained suture fragments may limit the precision of the second surgery.
For more information about the procedures you may contact: International Marketing Coordinator: osias05@gmail.com, doctorjuta@gmail.com or call  mobile phone: +66816572522, Tel : (02) 753-9206

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