Blepharoplasty for Eyelid Ekin Cancer .pdf
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Blepharoplasty for Eyelid Ekin Cancer
Mohs surgery and eyelid reconstruction at top London eye hospitals
Not all eyelid surgery is cosmetic. People can suffer from a variety of problems with their eyelids
ranging from entropion (eyelid turning inwards) to treating skin cancer on the eyelid. If there is a
suspicion of skin cancer on the eyelid or around the sensitive tissue around the eyes, it can be
confirmed by biopsy and then treated with Mohs surgery followed by eyelid reconstruction.
Techniques to to remove eyelid cancer
When the eyelid or sensitive skin around the eye area is found to contain cancerous cells, the goal
is to remove the cancer while retaining as much healthy tissue as possible. To do this, surgeons at
London eye hospitals use a microscopically controlled technique known as Mohs surgery.
In Mohs surgery, the entire operation is conducted with microscopic assistance. A tiny amount of
affected skin tissue is removed and examined for cancer cells. In addition, the margins of the
removed skin is examined for healthy tissue. If the margins are found to still contain cancerous
cells, a little more tissue is removed until the margins are clear of cancerous cells.
Why Mohs surgery is preferable
When skin cancer appears on most other parts of the body, the amount of tissue excised to remove
all cancerous skin cells is less important and precision is less important. However, blindly
removing skin on the eyelid can create a bigger scar and may lead to eyelid dysfunction that would
require further treatment.
Mohs surgery is advantageous in blepharoplasty as only those cells that are diseased are removed,
creating less of a scar, less potential for dysfunction and easing the reconstruction surgery required
to restore the eyelid to proper functioning after the cancer has been eliminated. It takes the
guesswork out of skin cancer surgery as cells are examined layer by later, a micrometre at a time.
Mohs surgery has the highest success rate of all treatments for cancer, that is 99% success in
completely removing cancer from the skin tissue. It is important in preserving the integrity of the
functioning of the eyelid as well as the aesthetic outcome.
Mohs surgery and reconstructive surgery
Mohs surgery is carried out by a specialist trained in the technique with the assistance of an
oculoplastic surgeon. Once the cancer has been completely removed, the oculoplastic surgeon will
move onto the functional and cosmetic reconstruction of the eyelid following the Mohs surgery.
Blepharoplasty for reconstruction takes place under general anaesthetic. If the upper eyelid is
being reconstructed, an incision is made along its natural crease. For the lower eyelid, an incision
is generally made just below the lash line. Once the reconstructive procedure is complete, the
incision is closed with small sutures and the eyes are covered.
There is very little chance that cancer will recur on the affected eyelid as Mohs surgery is highly
effective in removing cancerous cells. After the blepharoplasty procedure, the surgeons may
recommend applying lubricating eye drops or ointment as well as cold compresses to aid in the
healing process and minimise side effects such as swelling, bruising, irritation and dry eyes.
There may be some bruising and swelling after blepharoplasty but this usually subsides within two
weeks after surgery. Patients are typically advised to protect their eyes from sun, bright lights and
wind by wearing dark sunglasses for around two weeks. It is advisable to avoid alcohol as it can
cause fluid retention and worsen eyelid swelling.
Typically patients can return to work within a few days to a week but should avoid exercise and
strenuous activities for at least two weeks. Stitches are usually removed seven to ten days after the
procedure. Contact lenses and eyelid makeup may not be worn for two weeks after surgery.
Dr Pari Shams is a full member of the British Oculoplastic Surgery Society (BOPSS), the
American Society of Plastic and Reconstructive Surgery (ASOPRS) and the International Thyroid
Eye Disease Society (ITEDS). She specialises in the treatments of conditions that affect the
eyelids, brow, cheek, eye socket and tear duct system. She is based in London and consults at
Harley Street Practice, Optegra Eye Hospital and Moorfields Private Eye Hospital. Dr Shams has
been actively involved in clinical research over the last 15 years and has contributed to numerous
peer reviewed publications in the field of oculoplastic, lacrimal and orbital disease. She has
presented her research at over 30 national and international conferences and has received
numerous awards and prizes. Dr Shams practices as part of a large multidisciplinary team
including dermatologists and maxillo-facial surgeons to deliver the highest quality of care, patient
experience, outcomes and safety to all her patients. For more information, please visit: