tag:blogger.com,1999:blog-2822241717937321692024-03-12T15:11:31.094+08:00Eyelid Surgery by Prof Dr CN CHUA 蔡鐘能This blog looks at the works performed by an oculoplastic surgeon. The blog discusses the common eyelid conditions that an oculoplastic surgeon dealed with on daily basis with real patient photos (consent obtained).Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.comBlogger288125tag:blogger.com,1999:blog-282224171793732169.post-2298222690964506172019-05-12T22:55:00.001+08:002019-05-12T22:55:14.982+08:00Tumour Excision and Reconstruction<div style="text-align: justify;">
<span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;">This 70-year-old woman had an expanding lower lid lesion for the past three years. Initially, she ignored it until it started to bleed and causing irritation. Biopsy confirmed cell carcinoma. The lesion was excised in total and reconstructed using nasojugal flap. The bottom picture was taken about two months later.</span></div>
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Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com2tag:blogger.com,1999:blog-282224171793732169.post-77149176121279420112019-05-12T22:53:00.000+08:002019-05-12T22:53:05.365+08:00Lower Lid Reconstruction after Tumour Excision<div style="text-align: justify;">
<span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;">This renal dialysis patient had a rapidly growing left lower lid lesion that destroyed the lower eyelashes. Biopsy by dermatologist showed it to be a squamous cell carcinoma. Complete excision was performed followed by Tenzel’s flap reconstruction.</span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhEvZ9TyqOFURhnhYdOkJEbjPikKAhNsd9GHU304SyTsdzTPDuVKf-dGu801bqo_30Fne1sMKA354n9rDBAY0Z30JC-4QJsVCO2nrci2Rw_C7ONCD8iwcL7rXZi-_zYe-rq7wa4tG2bvYPP/s1600/Lowerlidreconstructionaftertumourexcision.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="668" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhEvZ9TyqOFURhnhYdOkJEbjPikKAhNsd9GHU304SyTsdzTPDuVKf-dGu801bqo_30Fne1sMKA354n9rDBAY0Z30JC-4QJsVCO2nrci2Rw_C7ONCD8iwcL7rXZi-_zYe-rq7wa4tG2bvYPP/s640/Lowerlidreconstructionaftertumourexcision.jpg" width="443" /></a></div>
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Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-62657463781889506082019-05-12T22:49:00.000+08:002019-05-12T22:49:02.096+08:00Reconstruction of Lower Lid from Windscreen Injury<div style="text-align: justify;">
<span style="background-color: white; color: #1c1e21; font-family: , , , ".sfnstext-regular" , sans-serif; font-size: 14px;">This patient had right cicatricial ectropion from car windscreen injury. The pictures below was taken immediately post-reconstruction.</span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhtzhIZKI7piw_u9da1pOUBsXZyAgM8Y525UJTlTmzKL-iMDoY1KgDbA-O8bPzE09lfmrcVTsEFHStKj3ehkrb_PU6eiq3F0iGbHgclF8FOazYJo6bUfLLMaO-lx3UzX5TqIVDe3VEIGWY2/s1600/Eyelidreconstructionmalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em; text-align: justify;"><img border="0" data-original-height="716" data-original-width="960" height="296" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhtzhIZKI7piw_u9da1pOUBsXZyAgM8Y525UJTlTmzKL-iMDoY1KgDbA-O8bPzE09lfmrcVTsEFHStKj3ehkrb_PU6eiq3F0iGbHgclF8FOazYJo6bUfLLMaO-lx3UzX5TqIVDe3VEIGWY2/s400/Eyelidreconstructionmalaysia.jpg" width="400" /></a></div>
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Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-39660434731013355972019-02-28T15:35:00.001+08:002019-02-28T15:35:38.410+08:00Combined Double Eyelids and Epicanthoplasty<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgpDLWk4EheVvgv9JSxLtZSmkOtLmzt_H7RK4OFosCWSsguezkYhZtnhJMSJv-hGosDWX39kVE47nH5U5LsWUBHvuNRAzUa5xSvtCwH8mlwWYgHbQwOE_fdhfKRt6wVvOiDkBvjYcI74FQr/s1600/%25E5%258F%258C%25E7%259C%25BC%25E7%259A%25AE.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="960" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgpDLWk4EheVvgv9JSxLtZSmkOtLmzt_H7RK4OFosCWSsguezkYhZtnhJMSJv-hGosDWX39kVE47nH5U5LsWUBHvuNRAzUa5xSvtCwH8mlwWYgHbQwOE_fdhfKRt6wVvOiDkBvjYcI74FQr/s320/%25E5%258F%258C%25E7%259C%25BC%25E7%259A%25AE.jpg" width="320" /></a></div>
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<span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;">This young woman wanted her eyes to look bigger and less tired. The middle photo shows the height that the patient desired. The bottom photo was taken three weeks after Asian blepharoplasty (double eyelid surgery) and epocanthoplasty (using skin redrawing technique).</span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/asianblepharoplasty?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#asianblepharoplasty</a><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"> </span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/doubleeyelid?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#doubleeyelid</a><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"></span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/doubleeyelidsurgery?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#doubleeyelidsurgery</a><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"> </span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/epicanthoplasty?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#epicanthoplasty</a><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"> </span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/%E5%8F%8C%E7%9C%BC%E7%9A%AE%E6%89%8B%E6%9C%AF?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#双眼皮手术</a><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"> </span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/%E5%8F%8C%E7%9C%BC%E7%9A%AE?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#双眼皮</a><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"> </span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/%E5%BC%80%E7%9C%BC%E8%A7%92?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#开眼角</a><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"> </span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/drchuachungnen?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#drchuachungnen</a><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"></span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/eyelidsurgery?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#eyelidsurgery</a><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"> </span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/%E8%94%A1%E9%90%98%E8%83%BD%E7%9C%BC%E7%A7%91%E5%8C%BB%E7%94%9F?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#蔡鐘能眼科医生</a><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"> </span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/optimaxpenang?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#optimaxpenang</a><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"></span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/ttdioptimax?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#ttdioptimax</a><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"> </span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/kleyelid?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#kleyelid</a><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"> </span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/sibuisec?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#sibuisec</a><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"> </span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/kichingoptimax?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#kichingoptimax</a><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"></span><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/miricolumbiaasia?epa=HASHTAG" style="background-color: white; color: #365899; cursor: pointer; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-decoration-line: none;">#miricolumbiaasia</a>Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-37942417968549369012019-02-28T15:28:00.002+08:002019-02-28T15:28:26.712+08:00Multiple Eouble Eyelids Corrected by Lifting the Eyelids<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgixFeVnnw0na6sudVtBYqLoAZOUjzYPvXqDYOA3b_US1iGt_2pHEd0yvsWDBylsrNR6rS5hYKcHYGGUBDlUZrBKHOm4Pry2pDIIde4ErVaqZpTs_QcWOISG9IjJWGoEWHtXvcvs1LMO1uh/s1600/eyelidmalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="605" data-original-width="600" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgixFeVnnw0na6sudVtBYqLoAZOUjzYPvXqDYOA3b_US1iGt_2pHEd0yvsWDBylsrNR6rS5hYKcHYGGUBDlUZrBKHOm4Pry2pDIIde4ErVaqZpTs_QcWOISG9IjJWGoEWHtXvcvs1LMO1uh/s320/eyelidmalaysia.jpg" width="317" /></a></div>
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<br class="Apple-interchange-newline" /><span style="background-color: white; color: #1c1e21; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-align: left;">This middle-aged woman was bothered by her multiple skin creases in the upper eyelids and asked for Asian blepharoplasty (double eyelid surgery). However, examination revealed the underlying cause was droopy eyelids (ptosis) and Asian blepharoplasty will only create unnaturally high skin creases (double eyelids) and sleepy look. Instead bilateral posterior approach ptosis correction was performed.</span><span class="text_exposed_show" style="background-color: white; color: #1c1e21; display: inline; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-align: left;"> At two weeks follow-up (bottom picture) the multiple skin creases not only disappeared by the eyes also appeared more alert.</span></div>
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<span class="text_exposed_show" style="background-color: white; color: #1c1e21; display: inline; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; text-align: left;"><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/optimaxttdi?epa=HASHTAG" style="color: #365899; cursor: pointer; font-family: inherit; text-decoration-line: none;">#optimaxttdi</a> <a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/optimaxpenang?epa=HASHTAG" style="color: #365899; cursor: pointer; font-family: inherit; text-decoration-line: none;">#optimaxpenang</a> <a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/eyelid?epa=HASHTAG" style="color: #365899; cursor: pointer; font-family: inherit; text-decoration-line: none;">#eyelid</a> <a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/optimax?epa=HASHTAG" style="color: #365899; cursor: pointer; font-family: inherit; text-decoration-line: none;">#optimax</a><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/droopyeyes?epa=HASHTAG" style="color: #365899; cursor: pointer; font-family: inherit; text-decoration-line: none;">#droopyeyes</a> <a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/ptosis?epa=HASHTAG" style="color: #365899; cursor: pointer; font-family: inherit; text-decoration-line: none;">#ptosis</a> <a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/malaysiaeyespecialist?epa=HASHTAG" style="color: #365899; cursor: pointer; font-family: inherit; text-decoration-line: none;">#malaysiaeyespecialist</a><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/oculoplastic?epa=HASHTAG" style="color: #365899; cursor: pointer; font-family: inherit; text-decoration-line: none;">#oculoplastic</a> #ptosis <a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/drchuachungnen?epa=HASHTAG" style="color: #365899; 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cursor: pointer; font-family: inherit; text-decoration-line: none;">#styes</a> <a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/%E8%94%A1%E9%92%9F%E8%83%BD%E7%9C%BC%E7%A7%91%E5%8C%BB%E7%94%9F?epa=HASHTAG" style="color: #365899; cursor: pointer; font-family: inherit; text-decoration-line: none;">#蔡钟能眼科医生</a> <a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/%E5%8F%8C%E7%9C%BC%E7%9A%AE?epa=HASHTAG" style="color: #365899; cursor: pointer; font-family: inherit; text-decoration-line: none;">#双眼皮</a><a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/%E7%9C%BC%E7%9A%AE?epa=HASHTAG" style="color: #365899; cursor: pointer; font-family: inherit; text-decoration-line: none;">#眼皮</a> <a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/%E7%9C%BC%E7%9A%AE%E4%B8%8B%E5%9E%82?epa=HASHTAG" style="color: #365899; cursor: pointer; font-family: inherit; text-decoration-line: none;">#眼皮下垂</a> <a class="_58cn" data-ft="{"type":104,"tn":"*N"}" href="https://www.facebook.com/hashtag/multipleskincrease?epa=HASHTAG" style="color: #365899; 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<br />Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-58371996705262204652018-11-28T23:30:00.001+08:002018-11-28T23:30:15.739+08:00Epicanthoplasty to make the eyes bigger <div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjKufYxKKuVWcfLhZ6zh1vrhTHFUzfnC4rXdQQUaCVYJxS1VbvhtRZaWV6bxxyHITM3q83_gH6MYy8uYhVZXzVybO7aK9U1pCq-xoGeFcnbmjGFtPL042R5VU8FnoIUTUSEdnz1rwLwjfY6/s1600/023C4081-7624-4C44-B82A-6FE424C32E01.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="561" data-original-width="597" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjKufYxKKuVWcfLhZ6zh1vrhTHFUzfnC4rXdQQUaCVYJxS1VbvhtRZaWV6bxxyHITM3q83_gH6MYy8uYhVZXzVybO7aK9U1pCq-xoGeFcnbmjGFtPL042R5VU8FnoIUTUSEdnz1rwLwjfY6/s320/023C4081-7624-4C44-B82A-6FE424C32E01.jpeg" width="320" /></a></div>
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Just done 6 eyelid operations for the day. In addition to removing the epicanthus (the excess skin that cover the nasal side of the eye), epicanthoplasty also lengthens the eyes and make the eyes appear bigger. There are several ways to perform epicanthoplasty and some methods create more scars than others, the one I prefer is skin redraping procedure which leave inconspicuous scars along the lid margins. This young woman under such technique, the first picture was taken before the procedure, the middle one immediately after the operation and the bottom 10 days later. #epicanthoplasty #双眼皮 #开眼角 #蔡鐘能眼科医生 #眼角 #epicanthus #blepharoplasty #eyelengthening #skinredraping #doubleeyelidsurgery #drchuachungnen #isecsibu #kuchingoptimax #ttdiopyimax #kliptimax #penangoptimax #miricolumbiaasia #sarawakeye #malaysiaeyelids #malaysiaeyelidsurgery #kuchingeyespecialist #sibueyespecialist #mirieyespecialist #oculoplastic #eyespecialist</div>
Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-1347672577682457602018-08-30T21:56:00.004+08:002018-08-30T21:56:47.917+08:00Double Eyelids for a 5-year-old Boy<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqM9gxGaAqg_xxHHhgyp3atLsLakbZapDs7h2Hs4ojaHhSsN1hJ5HeNz5Psb4E-3FVaI050Cd_eWFPIspyPgIAILGMzUEB2Y9fphowUbt6XlcYq9ILk0cCAUceEIo4RK9mrfeyspOJYXkd/s1600/Doubleyelids.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="515" data-original-width="699" height="293" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqM9gxGaAqg_xxHHhgyp3atLsLakbZapDs7h2Hs4ojaHhSsN1hJ5HeNz5Psb4E-3FVaI050Cd_eWFPIspyPgIAILGMzUEB2Y9fphowUbt6XlcYq9ILk0cCAUceEIo4RK9mrfeyspOJYXkd/s400/Doubleyelids.jpg" width="400" /></a></div>
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<span style="background-color: white; color: #1d2129; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;">Not all double eyelid surgery (Asian blepharoplasty) are done for aesthetic purposes. This 5-year-old boy had a long history of eye irritation and blurred vision. Examination showed ingrowing eyelashes exacerbated by his puffy eyelids and lack of skin creases (double eyelids). I created low skin creases (for boys double eyelids should be made low and girls higher) and everted the eyelashes. The creation of skin creases (double eyelids) not only made the eyes appear bigger but</span><span class="text_exposed_show" style="background-color: white; color: #1d2129; display: inline; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;"> also prevent the upper eyelid skin from coming over the eyes and push the eyelashes inwards. The operation was done under general anaesthesia and the lower pictures were taken 6 months later.</span></div>
Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com1tag:blogger.com,1999:blog-282224171793732169.post-16543023758025219782018-08-20T11:20:00.002+08:002018-08-20T11:48:28.884+08:00An elderly man with droopy eyelids<div style="text-align: justify;">
This 75-year-old had ptosis (droopy eyelids due to weak levator muscles) since since young. He did not seek help as he was able to see by lifting his head slightly. However, over the last 5 years, he was unable to see well even by lifting his chin by 45 degrees. This was because the ptosis has been compounded by dermatochalasis (droopy eyelids due to excess upper eyelid skin). To improve his vision, bilateral upper blepharoplasty was combined with frontalis suspension. The bottom picture was taken at 4 weeks follow-up. </div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiC4rcyVGp_1_2HYt-fWpZalcNec1FTwv-hRUSZ6dF0qvymoOeRU5d-n73IIlWI0lQ8IyZZB70e9F2yEjUKVjj17E-hPt1D8ugPzI_sLhlFk6bfjS8x2KEpadz3xUq859T1AKOZ2ugn1JeC/s1600/Bilateralptosismalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="755" data-original-width="649" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiC4rcyVGp_1_2HYt-fWpZalcNec1FTwv-hRUSZ6dF0qvymoOeRU5d-n73IIlWI0lQ8IyZZB70e9F2yEjUKVjj17E-hPt1D8ugPzI_sLhlFk6bfjS8x2KEpadz3xUq859T1AKOZ2ugn1JeC/s400/Bilateralptosismalaysia.jpg" width="343" /></a></div>
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Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-15505531592325261372018-07-24T16:00:00.000+08:002018-07-24T16:00:25.744+08:0020 Minutes to Correct Triangular-shaped Eyes<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdmIByNWeaVVAub4X8Q6w1M9PFFFgWT4UmzuD2wZgIjIT93uBvd8e73s8SLetBMfPw59SvA2gCq9Go_1js_3qXfOJZ_jnCn2MrUo3ipYwvsW5ZYb5CBx1h9DRasNs0NnxY62NlPYdeMIVC/s1600/suturetechniquemalaysiadoubleeyelids.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="500" data-original-width="602" height="265" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdmIByNWeaVVAub4X8Q6w1M9PFFFgWT4UmzuD2wZgIjIT93uBvd8e73s8SLetBMfPw59SvA2gCq9Go_1js_3qXfOJZ_jnCn2MrUo3ipYwvsW5ZYb5CBx1h9DRasNs0NnxY62NlPYdeMIVC/s320/suturetechniquemalaysiadoubleeyelids.jpg" width="320" /></a></div>
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<span style="background-color: white; font-family: -apple-system, system-ui, "Segoe UI", Roboto, Helvetica, Arial, sans-serif; font-size: 14px;">This young man was unhappy with the shape of his eyelids which made him look tired and uninterested. To make the eyes appear more animated without making the skin creases too high. Bilateral suture techniques were done and the creases set at 6mm. The lower picture was taken 10 days after the procedure.</span></div>
Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com1tag:blogger.com,1999:blog-282224171793732169.post-83302335573367746942018-06-25T09:50:00.001+08:002018-06-25T09:50:11.622+08:00Advantages of Posterior Approach Ptosis Operation for Mild to Moderate Ptosis<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwZjE1WT6rVwcMRdUuX8YcQkZm5PFw4J-L6sclWCcWmgj5WiIBP2b_b5pI8SO_-bjCUfNfCRoYnlKqQ6AaTbsty-ZQrsjdzJVzjQ6cPFKTvO5TxYA9Fq7P8OeaTKZlBRaSlPkK2UgsEk_j/s1600/droopyeyelid%2528ptosis%2529malaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="656" data-original-width="665" height="315" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwZjE1WT6rVwcMRdUuX8YcQkZm5PFw4J-L6sclWCcWmgj5WiIBP2b_b5pI8SO_-bjCUfNfCRoYnlKqQ6AaTbsty-ZQrsjdzJVzjQ6cPFKTvO5TxYA9Fq7P8OeaTKZlBRaSlPkK2UgsEk_j/s320/droopyeyelid%2528ptosis%2529malaysia.jpg" width="320" /></a><span style="background-color: white; color: #1d2129; font-family: system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px;">I</span></div>
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<span style="font-family: Times, Times New Roman, serif;"><span style="background-color: white; color: #1d2129;">I </span><span style="background-color: white; color: #1d2129;">saw this 70-year-old man yesterday who had had trouble opening his right eye for the past 5 years. The levator function was 10mm in the right eye and 13 Mum in the left eye. The ptosis occluded his right visual axis making driving difficult due to the lack of binocular vision. The eyelid did not open in response to mydfrin (2.5% phenylephrine). A posterior approach levator advancement was perfor</span><span class="text_exposed_show" style="background-color: white; color: #1d2129; display: inline;">med with good result. The bottom picture was taken this morning. Two of the great advantages of posterior approach ptosis correction is fast recovery and no need for suture removal.</span></span></div>
Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-90972707059773571102018-02-02T10:56:00.001+08:002018-02-02T10:56:46.756+08:00Relationship between skin crease and ptosis surgery<div style="text-align: justify;">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-7jiHamWuXdDS6xZ3KtBV2taGgFQE1msrZWhOdHKrdb_vP-dS4z8rEDBJfI2JUSSbGMXIAAtndQto-TQmQF0I66fyrMFopF6-S6zIfnTf1LBqPqB-PhaWwlZnmnLdkm00E4z3jywBox9X/s1600/ptosisMalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="740" data-original-width="693" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-7jiHamWuXdDS6xZ3KtBV2taGgFQE1msrZWhOdHKrdb_vP-dS4z8rEDBJfI2JUSSbGMXIAAtndQto-TQmQF0I66fyrMFopF6-S6zIfnTf1LBqPqB-PhaWwlZnmnLdkm00E4z3jywBox9X/s400/ptosisMalaysia.jpg" width="373" /></a></div>
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<span style="background-color: white; font-family: , "blinkmacsystemfont" , "segoe ui" , "roboto" , "helvetica" , "arial" , sans-serif; font-size: 14px; line-height: 18px;">The show of double eyelids (the amount of double eyelids visible when the patient look ahead) after ptosis correction is best illustrated in this patient. This patient had bilateral droopy eyelids and multiple skin creases (top picture). However, she attributed her sleepy appearance to indistjnct double eyelids. When the droopy eyelids was pointed out to her she agreed to have ptosis correction via posterior approach. The double eyelid heights were set at her original skin creases at about 7mm (middle photo, the blue dots indicate the height of the skin crease set). After the operations, she no longer appeared sleepy but was unhappy that her double eyelids were barely visible. The reason for this is because the patient had associated dermatochalasis (excess skin) which covered the skin creases (double eyelids). To make the double eyelids visible, the excess skin above the skin crease need to be excised for this patient. </span></div>
Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com2tag:blogger.com,1999:blog-282224171793732169.post-82320742893714115982018-01-24T21:30:00.000+08:002018-01-24T21:30:46.624+08:00Ptosis may present as multiple and indistinct double eyelids<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEil70sShzffm-zGX7UPMfdW_uT9xpdun9GaiuH6Gv9mA2TedBLZ5c38xTnbTEA55qIQbAOxhOG1IRi8TmhnVuQBjNsGTThtlFjydhloYSBIHC0Zfn6t8weybqDcs1oqUTasmfBDeVuwNrJB/s1600/doubleeyelidsandptosis.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="958" data-original-width="784" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEil70sShzffm-zGX7UPMfdW_uT9xpdun9GaiuH6Gv9mA2TedBLZ5c38xTnbTEA55qIQbAOxhOG1IRi8TmhnVuQBjNsGTThtlFjydhloYSBIHC0Zfn6t8weybqDcs1oqUTasmfBDeVuwNrJB/s400/doubleeyelidsandptosis.jpg" width="326" /></a></div>
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<span style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; text-align: left;">Although patients with ptosis usually complain of droopy eyelids or tired looking eyes, some may present with multiple skin creases (double eyelids, red arrow) or sunken upper eyelid (sunken sulcus, blue arrow). It is important for doctors to detect Ptosis in such patients otherwise double eyelid surgery or filler injection may exacerbate the ptosis. This patient who was a contact lens wearer comp</span><span class="text_exposed_show" style="background-color: white; color: #1d2129; display: inline; font-family: Helvetica, Arial, sans-serif; font-size: 14px; text-align: left;">lained her natural double eyelids (skin creases) were faints and multiple (top picture). She asked for double eyelid surgery. However, examination showed she had bilateral ptosis and creation of double eyelids would only make the eyes more droopy and tired (middle photo). Posterior approach ptosis correction was done and the patient was happy that she looked more alert and the multiple skin creases and sunken sulcus were also corrected (bottom picture taken one week after ptosis correction).</span></div>
<br />Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-55632803077503964462018-01-22T23:17:00.000+08:002018-01-22T23:17:06.228+08:00Transient eyelid asymmetry after ptosis correction<br />
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<span style="background-color: white; color: #1d2129; font-family: "SF Optimized", system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; letter-spacing: -0.12px;">This patient also had contact lens induced left ptosis (droopy eyelid, top picture). Correction of the left ptosis resulted in droopy of the right ptosis which alarmed the patient (middle picture taken at one week after posterior approach ptosis correction). Two main factors may be responsible for this phenomenon: a. The patient had ptosis in both eyes with one eye being more severely affected. Th</span><span class="text_exposed_show" style="background-color: white; color: #1d2129; display: inline; font-family: "SF Optimized", system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; letter-spacing: -0.12px;">erefore, successful correction of one eye will bring out the contralateral ptosis. b. The ptotic eye was overcorrected resulting in the opposite eye becoming droopy. However, most oculoplastic surgeons usually overcorrect droopy eyelid slightly so that any drop of the eyelid during recovery will be compensated. </span></div>
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<span style="letter-spacing: -0.12px;">As this patient did not have right ptosis before the operation, the most likely cause for the imbalance is factor b and she was reassured. At 6 weeks follow-up the two eyes were nearly symmetrical (bottom picture).</span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEipuBIWKvjcxRcHpoj2i_dLx5NJ5AxaMskS6kY5-qcFh7p34MIL2cng8wfowmxSe9_lPezeSlJuSkzKJ00Rlq1K-5NQN0ASv-bfXgt9SD_sHYIhIDjuYyxloLfviE1uoDqT2anqhge4PY31/s1600/droopyeyelidmalaysiakualalumpur.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="799" data-original-width="774" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEipuBIWKvjcxRcHpoj2i_dLx5NJ5AxaMskS6kY5-qcFh7p34MIL2cng8wfowmxSe9_lPezeSlJuSkzKJ00Rlq1K-5NQN0ASv-bfXgt9SD_sHYIhIDjuYyxloLfviE1uoDqT2anqhge4PY31/s400/droopyeyelidmalaysiakualalumpur.jpg" width="386" /></a></div>
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</span>Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-7553128710216031872018-01-22T23:14:00.001+08:002018-01-22T23:14:47.428+08:00Another patient with contact lens induced ptosis<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgORw78Yw6vpauru4c-SO_FrTVL3Bl2rigvf9kLlMqkMrgO-_OvAhcfnPo0gYbnXk83zM06OdESkaN7Xm7RWMfCuwA4GtMpIpigSZOvKcd4l4BvmA0Br8tsZoCesGhokoAZQsiiqCZwY8YS/s1600/droopyeyelidmalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="615" data-original-width="826" height="297" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgORw78Yw6vpauru4c-SO_FrTVL3Bl2rigvf9kLlMqkMrgO-_OvAhcfnPo0gYbnXk83zM06OdESkaN7Xm7RWMfCuwA4GtMpIpigSZOvKcd4l4BvmA0Br8tsZoCesGhokoAZQsiiqCZwY8YS/s400/droopyeyelidmalaysia.jpg" width="400" /></a></div>
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<br />Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-68815737636064927642018-01-17T21:02:00.002+08:002018-01-17T21:02:18.243+08:00Contact lens induced droopy eyelid (ptosis)<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjWw2VGZOKqnlVm6LFALTv0YCgpIcF0fYz2evuomM88WDYS3EdGRcesHDOrZwycZ0QLqVJmiw_frvHrwQp5PugijhTTwGm5BcUR7FRsbpsrxE6QCCBWBZrGsU0H5lb5X6HkIJdNuxTAQo3D/s1600/ptosismalaysiadroopyeyelid.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="612" data-original-width="895" height="272" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjWw2VGZOKqnlVm6LFALTv0YCgpIcF0fYz2evuomM88WDYS3EdGRcesHDOrZwycZ0QLqVJmiw_frvHrwQp5PugijhTTwGm5BcUR7FRsbpsrxE6QCCBWBZrGsU0H5lb5X6HkIJdNuxTAQo3D/s400/ptosismalaysiadroopyeyelid.jpg" width="400" /></a></div>
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<span style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px;">Contact lens wear (both hard and soft) is a known risk factor for Ptosis (droopy eyelid) in people under age of 35. The reasons may be : a. Stretching of the eyelid during contact lens insertion and removal and b. Low grade inflammation from contact lens may weaken the eyelid structure. This 35-year-old woman had been a contact lens wearer for over 20 years in the past 2 years she noticed the lef</span><span class="text_exposed_show" style="background-color: white; color: #1d2129; display: inline; font-family: Helvetica, Arial, sans-serif; font-size: 14px;">t eye had become progressively more droopy. Examination showed no neurological causes and a posterior approach ptosis correction restored the lid to the desirable level (bottom picture taken at two weeks post surgery). For more information, click here for <a href="https://l.facebook.com/l.php?u=http%3A%2F%2Fwww.aaojournal.org%2Farticle%2FS0161-6420(07)00660-4%2Ffulltext&h=ATPVxhCvwwQzJ3EZJszXRH1H8XmOfCxhrQ38FY8S4KE9XXRwV5KM7qrgp7jaE2k7GEz4RgyilHIK_tRa53GhmeySufWvlbnRpAK8KVhjHBLFM0oYD7n4MT38jPuqyDBzRzT4gPA0vjo">contact lens induced ptosis</a></span></div>
Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-31043095020852712102018-01-16T21:13:00.004+08:002018-01-16T21:13:43.269+08:00Droopy Eyelid (Ptosis) after Double Eyelid Surgery<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhWHWNSrx8d82zmPaMyZVF8Lq73Cv2rHPnLehq1d8gBebsjkB0IXi4ozHIdWaTVKXTnNXp8Y5zP5RKu0UAI_03AgUU2GCyNKexgch6ZOtOxX1IttxquutEcSptJBB1HD4_OaS3fnmf6hTjn/s1600/ptosisafterdoubleeyelidsurgerymalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="554" data-original-width="648" height="273" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhWHWNSrx8d82zmPaMyZVF8Lq73Cv2rHPnLehq1d8gBebsjkB0IXi4ozHIdWaTVKXTnNXp8Y5zP5RKu0UAI_03AgUU2GCyNKexgch6ZOtOxX1IttxquutEcSptJBB1HD4_OaS3fnmf6hTjn/s320/ptosisafterdoubleeyelidsurgerymalaysia.jpg" width="320" /></a></div>
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<span style="background-color: white; color: #1d2129; font-family: "SF Optimized", system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; letter-spacing: -0.12px;">This young woman had double eyelid surgery performed in a beauty saloon by a visiting China “doctor” . Postoperatively she noted the right eye to be droopy in the medial two third of the upper lid. She returned to the “doctor” and was reassured that it will correct itself in a few months. But the droopiness persisted. When she returned to the beauty saloon, the owner of the centre told her the “do</span><span class="text_exposed_show" style="background-color: white; color: #1d2129; display: inline; font-family: "SF Optimized", system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; letter-spacing: -0.12px;">ctor” would not return and asked her to see the new visiting “doctor”. The later told the patient that she was unable to correct the droopy eyelid and asked her to seek help in “proper” medical centre. On examination, she appeared to have damage to the medial 2/3 of her levator aponeurosis. Posterior conjunctivomullerextomy was performed with good outcome (bottom picture taken at one month postoperative).</span></div>
Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-15742117772417682622017-12-26T12:00:00.001+08:002017-12-26T12:00:18.174+08:00Multiple Stones in a Woman's Lower Lids<div style="font-family: Helvetica; font-size: 12px; font-stretch: normal; line-height: normal;">
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<span style="font-size: 12pt;">This 60-year-old woman complained of swelling of the medial lower eyelid with discharge. Examination revealed inflammation of the lower canliculus with pus. The canal oculus was incised and curretaged multiple yellow concretions were expressed. The canaliculus was irrigated with antibiotic and treated with iodine application. This was a case of chronic canaliculitis caused by the bacteria<i> Actinomyces Israeli.</i> </span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9HOklILStKzdyfSa5JUIDxeSD7LxiykHFWkYeyNJwvoPyn2Y-g12qyWyXeUKDGyqvW1jdhyphenhyphenMlW2E_bC_TCOofQdBwP-HVL1qlpkdBeU6ch6HSJ-qiJraLKgdo9lwTqk0znJv_fjdLx56V/s1600/chroniccanaliculitismalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="944" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9HOklILStKzdyfSa5JUIDxeSD7LxiykHFWkYeyNJwvoPyn2Y-g12qyWyXeUKDGyqvW1jdhyphenhyphenMlW2E_bC_TCOofQdBwP-HVL1qlpkdBeU6ch6HSJ-qiJraLKgdo9lwTqk0znJv_fjdLx56V/s400/chroniccanaliculitismalaysia.jpg" width="392" /></a></div>
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Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-47125122793226303312017-12-22T18:37:00.001+08:002017-12-22T18:37:44.783+08:00Social implication of eyelids<div style="text-align: justify;">
<span style="background-color: white; color: #1d2129; font-family: "SF Optimized", system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; letter-spacing: -0.12px;">Eye contact accounts for 90% of face-to-face communication, it’s little wonder that any imperfection of the eyelids can create a negative impression which can affect one’s social life including career prospect. This 25 year-old insurance agent complained that despite his qualification and selling skills, his clients regarded him as distant and uninterested. He attributed this to his heavy eyelids and narrow eyes which gave him an expressionless face. I created 6mm double eyel</span><span class="text_exposed_show" style="background-color: white; color: #1d2129; display: inline; font-family: "SF Optimized", system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; letter-spacing: -0.12px;">ids for him with fat removal to reduce the heaviness of the upper lids. The picture at the bottom was taken one-month later, he was pleased with the results and did not return for further follow-up. I assume he was too busy with his clients to return <span class="_5mfr _47e3" style="font-family: inherit; line-height: 0; margin: 0px 1px; vertical-align: middle;"><img alt="" class="img" height="16" role="presentation" src="https://www.facebook.com/images/emoji.php/v9/fce/1/16/1f600.png" style="border: 0px; vertical-align: -3px;" width="16" /><span class="_7oe" style="display: inline-block; font-family: inherit; font-size: 0px; width: 0px;">😀</span></span>.</span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheSb5e1Ton0CMShQ0jp6z0BdMqlc5ZFb46-yWsXumcqm2drkSQswlFGd9dRrTMKXpwnzioA0oVc8ifh-MnraFE08GTLPXaAjK8l2SSQNO6LYXqvqV5GabhtgICZhCSiZ3yOfIwRQ8VtxdV/s1600/doubleyeyelidsurgerymalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="656" data-original-width="623" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheSb5e1Ton0CMShQ0jp6z0BdMqlc5ZFb46-yWsXumcqm2drkSQswlFGd9dRrTMKXpwnzioA0oVc8ifh-MnraFE08GTLPXaAjK8l2SSQNO6LYXqvqV5GabhtgICZhCSiZ3yOfIwRQ8VtxdV/s400/doubleyeyelidsurgerymalaysia.jpg" width="378" /></a></div>
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Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-39226710658715948902017-12-21T23:05:00.000+08:002017-12-21T23:05:15.062+08:00Treatment of sunken upper eyelid without filler or fat injection.<div style="text-align: justify;">
A 23 year-old woman complained of sunken upper eyelids and absence of skin creases (double eyelids) which made her looked tired and older. She had consulted another doctor who recommended filler or fat injection. However, she was concerned that the injection may not last and the associated period of post-injection swellings. I performed bilateral double eyelid surgery with simultaneous posterior conjunctivomullerectomy to widen the eyes and pulled forward the fat to fill the sunken areas. The picture below was taken 2-month postoperative.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhgDbq1sVivCfaS9W6h8WvqCrNI_8o2VGKg22-rNRmxR3pAqevoYqjEILh8VOieP8qOohgFYMD_e9wEfoikskSCYeGb7DLJNCyKr0oh96-tq8TZgjCnVe63LzGLrGYbETXXoxn1ksMaiRMt/s1600/doubleeyelidmalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em; text-align: center;"><img border="0" data-original-height="510" data-original-width="569" height="286" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhgDbq1sVivCfaS9W6h8WvqCrNI_8o2VGKg22-rNRmxR3pAqevoYqjEILh8VOieP8qOohgFYMD_e9wEfoikskSCYeGb7DLJNCyKr0oh96-tq8TZgjCnVe63LzGLrGYbETXXoxn1ksMaiRMt/s320/doubleeyelidmalaysia.jpg" width="320" /></a></div>
<br />Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com1tag:blogger.com,1999:blog-282224171793732169.post-90527569210356686452017-08-24T19:20:00.004+08:002017-08-24T19:20:48.816+08:00Doc, Can You Show Me Pictures of How You Do Incisional Double Eyelid Surgery?<div style="text-align: justify;">
In my experience, most patients who wanted Asian blepharoplasty (double eyelid surgery) were happy with diagrams detailing the procedure. However, a small group were curious and wanted to see the graphic details. </div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhrrNz3iE2NaOIi7mm3BfZ7umuECcvjDna6YQQPYnG04ofc_P1dLgSMMlI2-Al9iAF1ZXqt-ZMH33nnebyCwVCvhNI6SO5NiT820RKPQxGtG6_vlXqoMMrx-4mqCnbZJ1qxEVMy2OzEB-dU/s1600/doubleyelidmalaysia1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><img border="0" data-original-height="291" data-original-width="750" height="155" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhrrNz3iE2NaOIi7mm3BfZ7umuECcvjDna6YQQPYnG04ofc_P1dLgSMMlI2-Al9iAF1ZXqt-ZMH33nnebyCwVCvhNI6SO5NiT820RKPQxGtG6_vlXqoMMrx-4mqCnbZJ1qxEVMy2OzEB-dU/s400/doubleyelidmalaysia1.jpg" width="400" /></i></a></div>
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<i><span style="font-size: x-small;">This patient had narrow palpebral apertures (width of the eyes) caused by puffy eyelids from fat and absent skin crease (double eyelids).</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiQSf9cITvGLfGKb_ICanPG9TzmPRIMUJ5GglzGHk1o2CjPYTse3teit1IAJLu6aUgAm31ehc42KgJqL9iEOLobSvU2FneL9TKrvV_b4x1z27wy5bOD6gPDe0ufe1VeZz_UctFYH2uAeER/s1600/doubleyelidmalaysiakualalumpur.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="291" data-original-width="750" height="155" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiQSf9cITvGLfGKb_ICanPG9TzmPRIMUJ5GglzGHk1o2CjPYTse3teit1IAJLu6aUgAm31ehc42KgJqL9iEOLobSvU2FneL9TKrvV_b4x1z27wy5bOD6gPDe0ufe1VeZz_UctFYH2uAeER/s400/doubleyelidmalaysiakualalumpur.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">The desired height of the skin crease was discussed prior to the operation. </span></i></div>
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<i><span style="font-size: x-small;">Indentation </span></i><i><span style="font-size: x-small;">was made with a paper clip to give an impression how the eyes </span></i></div>
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<i><span style="font-size: x-small;">would look </span></i><i><span style="font-size: x-small;">postoperatively.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiuCnVAYF2gU_HYhbCnC_pLfR8xHsVl7IcF9_y6mfXi9E8ELXP_doIhD_Uvg1rfsHXljRTzV6DW-Mmbwpxzpplgdmllkbjjcumn4V4CijtGr7LCgmtXFhUaPLhKr3SO8M6LKbEhJoo__ayY/s1600/doubleyeyelidmalaysiakl.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="291" data-original-width="750" height="155" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiuCnVAYF2gU_HYhbCnC_pLfR8xHsVl7IcF9_y6mfXi9E8ELXP_doIhD_Uvg1rfsHXljRTzV6DW-Mmbwpxzpplgdmllkbjjcumn4V4CijtGr7LCgmtXFhUaPLhKr3SO8M6LKbEhJoo__ayY/s400/doubleyeyelidmalaysiakl.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">A side view of the right eye with and without indentation <a href="http://eyelidsurgerymalaysia.blogspot.my/2010/12/why-do-double-eyelids-make-eyes-bigger_05.html">shows that the eye </a></span></i></div>
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<a href="http://eyelidsurgerymalaysia.blogspot.my/2010/12/why-do-double-eyelids-make-eyes-bigger_05.html"><i><span style="font-size: x-small;">appeared </span></i><i><span style="font-size: x-small;">bigger when </span></i></a><i><span style="font-size: x-small;"><a href="http://eyelidsurgerymalaysia.blogspot.my/2010/12/why-do-double-eyelids-make-eyes-bigger_05.html">a skin crease (double eyelid) was created </a>as it pushed </span></i></div>
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<i><span style="font-size: x-small;">the skin away </span></i><i><span style="font-size: x-small;">from the edge of the eyelid.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZ8UECO7dnoE96lXCepYJR1qQlS-_fZfKqcXkLAq9w42iaBD0yPFeDIsQZHVBNvryGH2am2NJ11KJXLPLFMFnLIR6YEo9RDJkoS6hSOBmF85MDe_bzY1ckP8Ybh9G56NF5UUZr_nYDESlA/s1600/doubleeyelidskl.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="291" data-original-width="750" height="155" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZ8UECO7dnoE96lXCepYJR1qQlS-_fZfKqcXkLAq9w42iaBD0yPFeDIsQZHVBNvryGH2am2NJ11KJXLPLFMFnLIR6YEo9RDJkoS6hSOBmF85MDe_bzY1ckP8Ybh9G56NF5UUZr_nYDESlA/s400/doubleeyelidskl.jpg" width="400" /></span></i></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhM4zP5QFoHvHDNu1ouUwXRIlOBVdQlc2qApKDsFQcl-BKTyRPiCGdfdmMsvreTFjWC7xhaB6sTyXb6x6TZq4x5Imv2F_Bhfl1NBTw62S0car0Qxw5xm_L9KMI4YYjAF4XC902A0QgilSQi/s1600/stepsonincisionblepharoplasty.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><i><span style="font-size: x-small;"><br /></span></i></a><i><span style="font-size: x-small;">The desired height was marked. In this patient the height was 8mm.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhM4zP5QFoHvHDNu1ouUwXRIlOBVdQlc2qApKDsFQcl-BKTyRPiCGdfdmMsvreTFjWC7xhaB6sTyXb6x6TZq4x5Imv2F_Bhfl1NBTw62S0car0Qxw5xm_L9KMI4YYjAF4XC902A0QgilSQi/s1600/stepsonincisionblepharoplasty.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="1214" data-original-width="815" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhM4zP5QFoHvHDNu1ouUwXRIlOBVdQlc2qApKDsFQcl-BKTyRPiCGdfdmMsvreTFjWC7xhaB6sTyXb6x6TZq4x5Imv2F_Bhfl1NBTw62S0car0Qxw5xm_L9KMI4YYjAF4XC902A0QgilSQi/s640/stepsonincisionblepharoplasty.jpg" width="427" /></span></i></a></div>
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<i><span style="font-size: x-small;">Steps of incision procedure: A. The desired skin crease was marked; B An incision was made along the marked line; C. The fat was removed to reduce the puffiness and allowed better formation of the skin creases, to get to the fat (F) two overlying layers had to be removed first: OO = orbicularis oculis the muscle around the eye and OS= the orbital septum. D. The fat was teased out to expose the underlying levator aponeurosis (LP the muscle that open the eye) ; E. The fat was clamped and removed; F. The levator aponeurosis that appeared as white was now fully exposed; G. The levator aponeurosis (LP) was sutured to the remaining orbicularis oculi (OO) anteriorly; H. The skin was closed with 6/0 nylon.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwzo3o8WPY-4A3O8Sffqfz4Kk7om-UAK-wmIkA3Lfc7-g1SZqHnTQJE0lmjuuNx94wCcPXV8Gk1PWNt_P3zvkbj7BjXhKMvtyqlKbB7hyphenhyphenXVeFG8UXC1T8U5pj98hJ-eFVGYxJWRaOEC1Dw/s1600/doubleyeelidmalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="291" data-original-width="750" height="155" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwzo3o8WPY-4A3O8Sffqfz4Kk7om-UAK-wmIkA3Lfc7-g1SZqHnTQJE0lmjuuNx94wCcPXV8Gk1PWNt_P3zvkbj7BjXhKMvtyqlKbB7hyphenhyphenXVeFG8UXC1T8U5pj98hJ-eFVGYxJWRaOEC1Dw/s400/doubleyeelidmalaysia.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">Immediately after the surgery. The asymmetry was caused by swelling </span></i></div>
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<i><span style="font-size: x-small;">and reaction to the anaesthesia.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh0d-f6yedu00d2BZ3K-qbxv9KOwcTjVh5hpF_PrbFsU81JIC0CQtHOh2jcpIZjYfdiVrpWQss6V8uvW-KR1CqLfwuPgitrw-wc6PNbBwpJNt1XNeSkV3ErvG9UvwVKBEpBGFaT5hBN_ws_/s1600/doubleyeyelidskualalumpur.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="291" data-original-width="750" height="155" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh0d-f6yedu00d2BZ3K-qbxv9KOwcTjVh5hpF_PrbFsU81JIC0CQtHOh2jcpIZjYfdiVrpWQss6V8uvW-KR1CqLfwuPgitrw-wc6PNbBwpJNt1XNeSkV3ErvG9UvwVKBEpBGFaT5hBN_ws_/s400/doubleyeyelidskualalumpur.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">The appearance of the eye 24 hours later.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjheQJt9XPspdmKzZQQr78azRVGmKfEUc0Gs2qyA_mu5hyphenhyphenLjjQ01oju3mi6YP4fO1meNb1ZrRm3dvLeyT8jQhsf-BW6z1S2YlimBXmEOfa6C0uzJPUpLaA1RbtRp1yWdO2eI8SqdUhrROCF/s1600/doubleeyelidsklmalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="316" data-original-width="750" height="167" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjheQJt9XPspdmKzZQQr78azRVGmKfEUc0Gs2qyA_mu5hyphenhyphenLjjQ01oju3mi6YP4fO1meNb1ZrRm3dvLeyT8jQhsf-BW6z1S2YlimBXmEOfa6C0uzJPUpLaA1RbtRp1yWdO2eI8SqdUhrROCF/s400/doubleeyelidsklmalaysia.jpg" width="400" /></a></div>
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<i><span style="font-size: x-small;">Two weeks after the surgery.</span></i></div>
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<i style="margin-left: 1em; margin-right: 1em;"><span style="font-size: x-small;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMipNGhJV-ZDXgwGEX31PK7UvWuWHbFvOv4dQjaDXJSlnql_afY1B6LZGOdQrxGq0jYZHf9-R_FvdmTr7nws6gn8t9FRWST78iGUAlv4z5BF9Ekyom6S2nxcHvE6HRs_Ojg2e0zqIux6GF/s1600/doubleyeelids3weeks.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="291" data-original-width="750" height="155" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMipNGhJV-ZDXgwGEX31PK7UvWuWHbFvOv4dQjaDXJSlnql_afY1B6LZGOdQrxGq0jYZHf9-R_FvdmTr7nws6gn8t9FRWST78iGUAlv4z5BF9Ekyom6S2nxcHvE6HRs_Ojg2e0zqIux6GF/s400/doubleyeelids3weeks.jpg" width="400" /></a></span></i></div>
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<i><span style="font-size: x-small;">Three weeks after the surgery. Most swellings have subsided.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgSiWny-MZ3T0viJHGlfX5QMx_lyKY64ozXETWj9TJJalEDwIcH-7O4o1gGDwp_oKKDRKoj2y0V_3fOuXwG_2Ip6auHLv4iCLxoe_vvvL62ZYW6OFDVYsRK3LQxd_mp3GVqlAQZehkStb86/s1600/Beforeandafterdoubleeyelids.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="598" data-original-width="750" height="318" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgSiWny-MZ3T0viJHGlfX5QMx_lyKY64ozXETWj9TJJalEDwIcH-7O4o1gGDwp_oKKDRKoj2y0V_3fOuXwG_2Ip6auHLv4iCLxoe_vvvL62ZYW6OFDVYsRK3LQxd_mp3GVqlAQZehkStb86/s400/Beforeandafterdoubleeyelids.jpg" width="400" /></a></div>
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<i><span style="font-size: x-small;">Before and after pictures for comparison.</span></i></div>
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The following are some other patients who had had incision Asian blepharoplasty. </div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhI4uxdV4KB7n9cziMdzpq1k6QEXztDtdzazQDrEJHgjfWrqiuORPrXAv2nvQJUMxVTUtVVXbCn9jETOkz1Bv9xG55ZX_uMfOv_VXRgYoNoTYoAWxz1bfRE8WEO_uyliVoBYcdRBJ2mC3Xs/s1600/malaysiadoubleeyelids.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="156" data-original-width="750" height="81" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhI4uxdV4KB7n9cziMdzpq1k6QEXztDtdzazQDrEJHgjfWrqiuORPrXAv2nvQJUMxVTUtVVXbCn9jETOkz1Bv9xG55ZX_uMfOv_VXRgYoNoTYoAWxz1bfRE8WEO_uyliVoBYcdRBJ2mC3Xs/s400/malaysiadoubleeyelids.jpg" width="400" /></a></div>
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<i><span style="font-size: x-small;">Before and one month after operation.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjBJwtWB_qdE0WQ5PNW9AZ5PsWn6EosGlv2TFOzWV77fMx63WWHKrb65MExWWKn9FIwGiXPqVaBg5-mPfRKFo0DqtLJK5Dzw0ZL2GYStmn0v_Wt-YeZkFqbPFK2WMaKMfbKiAeSZQ-QiwL5/s1600/Malaysiadoubleyeelids.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="189" data-original-width="750" height="100" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjBJwtWB_qdE0WQ5PNW9AZ5PsWn6EosGlv2TFOzWV77fMx63WWHKrb65MExWWKn9FIwGiXPqVaBg5-mPfRKFo0DqtLJK5Dzw0ZL2GYStmn0v_Wt-YeZkFqbPFK2WMaKMfbKiAeSZQ-QiwL5/s400/Malaysiadoubleyeelids.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">Before and two months after operation.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtVhLKatqlIZW5xJfV4apbj94WaHPZ6f-IHMFrTHVeeUABm3uROLPXUZPwtB79Lcspoq7LuvbuBjaHyAEw5551HhO8UzQQcUMkXfSESM736tjo8GHc7mI6hlvFgdKwDTS7ZtO4rA-Fea6x/s1600/malaysiaeyelidsurgeryKL.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="163" data-original-width="750" height="86" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtVhLKatqlIZW5xJfV4apbj94WaHPZ6f-IHMFrTHVeeUABm3uROLPXUZPwtB79Lcspoq7LuvbuBjaHyAEw5551HhO8UzQQcUMkXfSESM736tjo8GHc7mI6hlvFgdKwDTS7ZtO4rA-Fea6x/s400/malaysiaeyelidsurgeryKL.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">Before and two months after operation.</span></i></div>
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Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com1tag:blogger.com,1999:blog-282224171793732169.post-60661267430060720022017-08-11T13:03:00.000+08:002017-08-11T13:03:03.854+08:00A hyperthyorid patient with eye protrusion and severe dry eyes.<div style="text-align: justify;">
Hyperthyroidism is associated with ocular changes which can cause eye protrusion and severe dry eyes. This patient developed hyperthyroidism three years ago. Despite medical control of the condition, she noticed her eyes were becoming more protruded with eyelid retraction and frequent tearing that cause blurring of vision. The tearing was a reflex response to dryness as a result of ocular exposure. In order to reduce the exposure, the lateral aspects of the eyelids were closed surgically (lateral tarsorrhaphy). The operation was performed as followed:</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFdFDIOx28t3FFo_ZUWaW6xsLjyT2BeOr-ZktxtY6XpBbEkls1SqtC6NoBsM_Bvb8naRvE5ROUD4rk_vQviuDtNRB3-MOtHhPGdbqeiHnHgXXdOHV0omrD4h8dckvOxEDGc_h-rsmIVw8Z/s1600/thyroideyediseasemalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="289" data-original-width="750" height="153" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFdFDIOx28t3FFo_ZUWaW6xsLjyT2BeOr-ZktxtY6XpBbEkls1SqtC6NoBsM_Bvb8naRvE5ROUD4rk_vQviuDtNRB3-MOtHhPGdbqeiHnHgXXdOHV0omrD4h8dckvOxEDGc_h-rsmIVw8Z/s400/thyroideyediseasemalaysia.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">Hyperthyroid patient with ocular exposure due to eye protrusion </span></i></div>
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<i><span style="font-size: x-small;">and lid retraction.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgahgWMh7LP1jXE3qQyvEtLnb9G85mCpNmdSXYWGS8q204ZPiRE35LwWxwSLe4dc7iqFeD7Rnu6OP0o3nFIdlWGlOa602Y1yxHmDHI52hKI5EAbjMjVJZpSvt6RCQy97i0Esihs07TfU7uG/s1600/malaysiaeyelidsurgery.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="285" data-original-width="748" height="151" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgahgWMh7LP1jXE3qQyvEtLnb9G85mCpNmdSXYWGS8q204ZPiRE35LwWxwSLe4dc7iqFeD7Rnu6OP0o3nFIdlWGlOa602Y1yxHmDHI52hKI5EAbjMjVJZpSvt6RCQy97i0Esihs07TfU7uG/s400/malaysiaeyelidsurgery.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">Before surgery, the amount of lid closure was determined by closing </span></i></div>
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<i><span style="font-size: x-small;">the upper and lower lid laterally.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgOZkeTe1A-J_20Es7OAVCRYU6NIg9rTytOwg8fHqhSJ1SjZp4x059NN-qU4vpFzjPOm13CzGyKBrJWbNEnOtQibmM-6BCtPPaaj4g1ZQSxWPVHLdV5CIs2rD3NrQlhMmpLfrsEa-LQQpMH/s1600/thyroideyediseaselateraltarsorrhaphymalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="288" data-original-width="750" height="152" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgOZkeTe1A-J_20Es7OAVCRYU6NIg9rTytOwg8fHqhSJ1SjZp4x059NN-qU4vpFzjPOm13CzGyKBrJWbNEnOtQibmM-6BCtPPaaj4g1ZQSxWPVHLdV5CIs2rD3NrQlhMmpLfrsEa-LQQpMH/s400/thyroideyediseaselateraltarsorrhaphymalaysia.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">Before surgery, the amount of lid closure was determined by closing </span></i></div>
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<i><span style="font-size: x-small;">the upper and lower lid laterally.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHlhtLWw29t1CGe2WKYtQ2DbFNvhXeq4Mo6E7EUPse6T10LDmo0f0yA0Vp9mwU8rKYuykpfroF8oEURy9cukxSOPB3TuCeSAOGP9TKbz6z5Gef19ByvoiS-I8igJv4A31BePZVXnu5MGo7/s1600/lateraltarsorrhaphymalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="455" data-original-width="750" height="242" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHlhtLWw29t1CGe2WKYtQ2DbFNvhXeq4Mo6E7EUPse6T10LDmo0f0yA0Vp9mwU8rKYuykpfroF8oEURy9cukxSOPB3TuCeSAOGP9TKbz6z5Gef19ByvoiS-I8igJv4A31BePZVXnu5MGo7/s400/lateraltarsorrhaphymalaysia.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">The amount of tissue needed to be removed was marked.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjcwPadPsfWwFppK-g03VZOl-nuL5jsXHhQ_c0mmcwZ2u7r6_aX-eb4BnGnjkHictNx4NdKqDn-de2GcOghXckcHzAptOc8jDhK550NX7Qm8TTHzb2RCdTC1O-kY2fOjZQ37bHfzNydKxOg/s1600/lateraltarsorrhaphymalaysia2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="455" data-original-width="750" height="242" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjcwPadPsfWwFppK-g03VZOl-nuL5jsXHhQ_c0mmcwZ2u7r6_aX-eb4BnGnjkHictNx4NdKqDn-de2GcOghXckcHzAptOc8jDhK550NX7Qm8TTHzb2RCdTC1O-kY2fOjZQ37bHfzNydKxOg/s400/lateraltarsorrhaphymalaysia2.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">The amount of marked tissue was incised.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj72Mab90sg0CR24LuDKooDBZbc4FQbAuC6hC1OwQqukQIukJ-GD0-X8bXO0eyrV_1XnCjFcigEuHJeu8stIKaDvHuTM9Z9ozuZQWCUUJTwoooKhitgu0mR150aExlnZwAS8EeCWWsUog5g/s1600/thyroideyediseasemalaysia2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="455" data-original-width="750" height="242" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj72Mab90sg0CR24LuDKooDBZbc4FQbAuC6hC1OwQqukQIukJ-GD0-X8bXO0eyrV_1XnCjFcigEuHJeu8stIKaDvHuTM9Z9ozuZQWCUUJTwoooKhitgu0mR150aExlnZwAS8EeCWWsUog5g/s400/thyroideyediseasemalaysia2.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">The anterior lamella of the eyelid was split to take out the anterior lamella.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj0yrxCtm8S1eoEtzG7tQiSmRQud2pdfWJt_F0h7VRDV2bCIiYHlBoXJ5PNgf8hjVw5IG7GTJRdtTKJMp_oJRAWdrzmB9owU8mYbr8nLqvcu2O2wFWuS73TnjeFU39gnSuP2d9_HB8r0hq6/s1600/eyelidsurgery.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="457" data-original-width="750" height="242" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj0yrxCtm8S1eoEtzG7tQiSmRQud2pdfWJt_F0h7VRDV2bCIiYHlBoXJ5PNgf8hjVw5IG7GTJRdtTKJMp_oJRAWdrzmB9owU8mYbr8nLqvcu2O2wFWuS73TnjeFU39gnSuP2d9_HB8r0hq6/s400/eyelidsurgery.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">The picture showed the tissue removed with the lateral anterior lamella.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdBdF9kHJEADjBKFRQDIL0uVFF8dqTCATvzuyfUf68evKEfIFG7L2a5aZluWCWNSiwgUQ12lM4KHhPk58CtnrkWKYsbZCg9pHCAW6iSPU4nL2a3yFdWufN06vbcdTqWvs7TL32ECDT7pLm/s1600/eyelidsurgery2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="457" data-original-width="750" height="242" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdBdF9kHJEADjBKFRQDIL0uVFF8dqTCATvzuyfUf68evKEfIFG7L2a5aZluWCWNSiwgUQ12lM4KHhPk58CtnrkWKYsbZCg9pHCAW6iSPU4nL2a3yFdWufN06vbcdTqWvs7TL32ECDT7pLm/s400/eyelidsurgery2.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">The angle of the eyelid was formed with 6/0 vicryl.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVQwsSyKZv4F9FhAoNBCnyEoeKkEzOZT6m1L7LYySuTHGWeHdhh_nnFJ4hHmx5UcJmrwwlwNZD1uiyW5k-TVOlNZtvjSuLogi9hvwNsQKV80-T4Zlpnbt54KKaWw3UvAbTScutep7-bHXc/s1600/eyelidsurgerykualalumpur.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="457" data-original-width="750" height="242" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVQwsSyKZv4F9FhAoNBCnyEoeKkEzOZT6m1L7LYySuTHGWeHdhh_nnFJ4hHmx5UcJmrwwlwNZD1uiyW5k-TVOlNZtvjSuLogi9hvwNsQKV80-T4Zlpnbt54KKaWw3UvAbTScutep7-bHXc/s400/eyelidsurgerykualalumpur.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">The posterior lamella was closed with 6/0 vicryl.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjSBxwZrOkEJO4L_wRwdY_LrTcu8bAi0jpMgz2gjPnep9DOKeg6NvD11sWEX_cUZ-QAI7DpClTZJVsEXiLassE50WQ-aeBAKlp1jNcvNwXvGEEPdsxeKh51YAE2CRT0OO77Pp84Dtt463H9/s1600/eyelidsurgerymalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="457" data-original-width="750" height="242" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjSBxwZrOkEJO4L_wRwdY_LrTcu8bAi0jpMgz2gjPnep9DOKeg6NvD11sWEX_cUZ-QAI7DpClTZJVsEXiLassE50WQ-aeBAKlp1jNcvNwXvGEEPdsxeKh51YAE2CRT0OO77Pp84Dtt463H9/s400/eyelidsurgerymalaysia.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">The orbicularis muscle was closed with 6/0 vicryl before the skin </span></i></div>
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<i><span style="font-size: x-small;">also with 6/0 vicryl.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBsUMLwB89SkL_QoJgnBND_OQgRkfsJdCo7Pdoqj_OdkH3Ni6gS1HhwhYe8v8eOAlh_j-EIizmmmLN9G5sh3q8XcLoI9EzI-zX_Q0F7t-ueAjpnuDPkRSvzp3TOtXB8bSfkudRWGtfQS5U/s1600/eyelidsurgerythyroideyedisease.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="292" data-original-width="750" height="155" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBsUMLwB89SkL_QoJgnBND_OQgRkfsJdCo7Pdoqj_OdkH3Ni6gS1HhwhYe8v8eOAlh_j-EIizmmmLN9G5sh3q8XcLoI9EzI-zX_Q0F7t-ueAjpnuDPkRSvzp3TOtXB8bSfkudRWGtfQS5U/s400/eyelidsurgerythyroideyedisease.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">Immediately after the procedure.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhpIO5H7e5eGEs1BwW0z2G5nj6RBjhXFs4pH16Y-YszOdSjX8tsQm0EJJuFQC66JaF2R9Hjl3C3guM18clOp5xt10H0YA2ajioPo27rdLz7ApDkQ6sTahfDADhrZkDYaj7EaZyyB49tWclF/s1600/thyroideyediseasemalaysia1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="289" data-original-width="750" height="153" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhpIO5H7e5eGEs1BwW0z2G5nj6RBjhXFs4pH16Y-YszOdSjX8tsQm0EJJuFQC66JaF2R9Hjl3C3guM18clOp5xt10H0YA2ajioPo27rdLz7ApDkQ6sTahfDADhrZkDYaj7EaZyyB49tWclF/s400/thyroideyediseasemalaysia1.jpg" width="400" /></span></i></a></div>
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<i><span style="font-size: x-small;">At two weeks postoperative. The exposure was reduced.</span></i></div>
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Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com7tag:blogger.com,1999:blog-282224171793732169.post-787770097630763802017-07-29T21:58:00.001+08:002017-07-29T21:58:19.186+08:00A Patient with Upper Lid Swelling from Unknown Filler Injection<div style="text-align: justify;">
This man had had injection to his upper lid in a beauty saloon with an <a href="http://eyelidsurgerymalaysia.blogspot.my/2010/11/shxx-my-discounted-sheep-placenta.html">unknown filler</a> resulting in upper eyelid swellings and occlusion of his visual fields. Examination revealed severe puffiness and hardness of the skin. Hyalase (enzyme to dissolve hyaluronic acid) was injected but the swelling failed to resolve suggesting some sort of permanent filler such as silicone might have been given. </div>
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He underwent upper blepharoplasty with removal of the skin, fat and repositioning of the lacrimal glands.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh2e19ev0di7LSHOvo-lhZa2AAGRrJeOg58aEivheS0EgnufoiglTUVr3OctG6No2exGr9rFLsEHcx9OSLVkWx1kmqUrCEREOsKLLr0FuNabVtOJQV61qrhwLfAZSGUD4WtluzYTh3TTXYC/s1600/puffyeyelidsmalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="284" data-original-width="747" height="121" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh2e19ev0di7LSHOvo-lhZa2AAGRrJeOg58aEivheS0EgnufoiglTUVr3OctG6No2exGr9rFLsEHcx9OSLVkWx1kmqUrCEREOsKLLr0FuNabVtOJQV61qrhwLfAZSGUD4WtluzYTh3TTXYC/s320/puffyeyelidsmalaysia.jpg" width="320" /></a></div>
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<i><span style="font-size: x-small;">Severe upper eyelid swelling after filler injection, </span></i></div>
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<i><span style="font-size: x-small;">right lid more puffy than the left.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0mc_oTxs0wqMQuJp-CVDZrfN4Q52A2Cw8ZQUsq_n-E_RNZFnqU6nHIO2Y4Qz2-4KL4Whd8SmRjpTL2r-ru_MUU2Pcr6-cwB90_B7sGywTOUUL9anGHgOR7cgnHKAtKmD-4TV8Pt3htq7q/s1600/lacrimalglandprolapse.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="334" data-original-width="750" height="142" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0mc_oTxs0wqMQuJp-CVDZrfN4Q52A2Cw8ZQUsq_n-E_RNZFnqU6nHIO2Y4Qz2-4KL4Whd8SmRjpTL2r-ru_MUU2Pcr6-cwB90_B7sGywTOUUL9anGHgOR7cgnHKAtKmD-4TV8Pt3htq7q/s320/lacrimalglandprolapse.jpg" width="320" /></a></div>
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<i><span style="font-size: x-small;">Proposed height of the skin crease was shown to the patient. </span></i></div>
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<i><span style="font-size: x-small;">Black arrows shows prominent puffiness of the lateral upper </span></i></div>
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<i><span style="font-size: x-small;">eyelids </span></i><i><span style="font-size: x-small;">indicating there may also be lacrimal gland prolapse.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNHeE-bjrhGHF513qYQhikXkr8Bg4F9NoGUfFtsk8dDPg3jdnrN4B0y2H2jOqHxjdd_Gbvrckyq0WXmLQX8wLC-UmgUzXnng9h-Ud2qyQGDdk0LCR-RBsFpngnB13lmPHwn_0SRWdWUxHp/s1600/correctionofpuffyeyelids.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="285" data-original-width="750" height="121" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNHeE-bjrhGHF513qYQhikXkr8Bg4F9NoGUfFtsk8dDPg3jdnrN4B0y2H2jOqHxjdd_Gbvrckyq0WXmLQX8wLC-UmgUzXnng9h-Ud2qyQGDdk0LCR-RBsFpngnB13lmPHwn_0SRWdWUxHp/s320/correctionofpuffyeyelids.jpg" width="320" /></a></div>
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<i><span style="font-size: x-small;">The skin to be excised was marked and the skin crease was set </span></i></div>
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<i><span style="font-size: x-small;">at 5.5mm </span></i><i><span style="font-size: x-small;">(Note: <a href="http://eyelidsurgerymalaysia.blogspot.my/2011/06/do-you-create-double-eyelids.html">in male, the desired skin crease should be </a></span></i></div>
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<i><span style="font-size: x-small;"><a href="http://eyelidsurgerymalaysia.blogspot.my/2011/06/do-you-create-double-eyelids.html">not more than </a></span></i><i><span style="font-size: x-small;"><a href="http://eyelidsurgerymalaysia.blogspot.my/2011/06/do-you-create-double-eyelids.html">6 mm to avoid feminization of the eyes</a>)</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg79tMXjx2kuvhSXHoi1WPM7XHJan0y2PVcj4f8baLXlTej1GGjoVsGrK6oraSxY90f16y3VtAPqUbXramuQO-yKyfCtMsjsIkdL74oYzxrDDC6-gYt7L87BT-TDcfmgY5-wrMwRm_9PeJl/s1600/excisionofeyelidskinmalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><i><span style="font-size: x-small;"><img border="0" data-original-height="489" data-original-width="750" height="208" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg79tMXjx2kuvhSXHoi1WPM7XHJan0y2PVcj4f8baLXlTej1GGjoVsGrK6oraSxY90f16y3VtAPqUbXramuQO-yKyfCtMsjsIkdL74oYzxrDDC6-gYt7L87BT-TDcfmgY5-wrMwRm_9PeJl/s320/excisionofeyelidskinmalaysia.jpg" width="320" /></span></i></a></div>
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<i>The marked area was incised. </i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhUTukQomF0ddy-sF7u9BUTtEULcseX-ch5Is7y3XO_21b0F46ZhvWyuCZAwDaJ6xh1MmyWHtvwICW9Gu76unX7i1QZg8oRy-DSt2Gb44-HMj7y7kxvJUc_RPXBRysT6fKirVKguKTNXm27/s1600/uppereyelidskinremovalmalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="483" data-original-width="738" height="209" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhUTukQomF0ddy-sF7u9BUTtEULcseX-ch5Is7y3XO_21b0F46ZhvWyuCZAwDaJ6xh1MmyWHtvwICW9Gu76unX7i1QZg8oRy-DSt2Gb44-HMj7y7kxvJUc_RPXBRysT6fKirVKguKTNXm27/s320/uppereyelidskinremovalmalaysia.jpg" width="320" /></a></div>
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<i><span style="font-size: x-small;">The under surface of the excised eyelid showed the filler </span></i></div>
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<i><span style="font-size: x-small;">as shinny </span></i><i><span style="font-size: x-small;">substances (arrowed).</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjO4iYZcngFE0j3WCXhckydkYuaBlpS6XLE3dv8KXkrZ0gltJ_NuOP4S9lMsQVcgCi-H9B7pS6ybHtxUpN0vXl7UtMT91jWWuL60l19Ew-2bhyphenhyphenDW9w_SFcZdRsARdHIUW5FETuoijDF5Afp/s1600/removaloforbitalseptummalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="483" data-original-width="738" height="209" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjO4iYZcngFE0j3WCXhckydkYuaBlpS6XLE3dv8KXkrZ0gltJ_NuOP4S9lMsQVcgCi-H9B7pS6ybHtxUpN0vXl7UtMT91jWWuL60l19Ew-2bhyphenhyphenDW9w_SFcZdRsARdHIUW5FETuoijDF5Afp/s320/removaloforbitalseptummalaysia.jpg" width="320" /></a></div>
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<i><span style="font-size: x-small;">The orbital septum was removed to show the fat.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi6j38eCZHtsw_D2iZo9uQX6BhNTer9ovYczDO_EoCUUkD1Bs_vKfPYHPXeqE7rv2ZEFGgoPMTPwHzC18AcX48Z7na3E9BJrzy8we6Y5n_GLefB7Y39tiNzHCm3SxmXLCbn-P2ZBEV95sd2/s1600/fatprolapsemalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="575" data-original-width="750" height="245" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi6j38eCZHtsw_D2iZo9uQX6BhNTer9ovYczDO_EoCUUkD1Bs_vKfPYHPXeqE7rv2ZEFGgoPMTPwHzC18AcX48Z7na3E9BJrzy8we6Y5n_GLefB7Y39tiNzHCm3SxmXLCbn-P2ZBEV95sd2/s320/fatprolapsemalaysia.jpg" width="320" /></a></div>
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<i><span style="font-size: x-small;">The lacrimal gland (1) and levator aponeurosis (muscle that </span></i></div>
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<i><span style="font-size: x-small;">open </span></i><i><span style="font-size: x-small;">the eye, 2) </span></i><i><span style="font-size: x-small;">were found below the fatty tissue.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj06pdjxC-Zm4jSTecLOW21PdgkwjwQfy5zYMR8EIF_srleIDASD2NfaGYpqLV06uH8t4-WF7lpoOjMxWO8kc1nChrFAqiB7iI8JrNLf3_CVdR4sBqsRe6ifu1iTsfGZd5j9Nuet5w1VXsj/s1600/fatexcisionmalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="483" data-original-width="738" height="209" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj06pdjxC-Zm4jSTecLOW21PdgkwjwQfy5zYMR8EIF_srleIDASD2NfaGYpqLV06uH8t4-WF7lpoOjMxWO8kc1nChrFAqiB7iI8JrNLf3_CVdR4sBqsRe6ifu1iTsfGZd5j9Nuet5w1VXsj/s320/fatexcisionmalaysia.jpg" width="320" /></a></div>
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<i><span style="font-size: x-small;">The fat that formed part of the upper lid swelling was excised.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjEsIl-P82kdKQzQfV2H1iRnmoEjLEiD2CpChuOrL0BCTAMgv6Aal_pUOQCm1S5HohwvujPmtF8rPOIAQSGcJmP_Z_GGId8Jmpws7pIn0DWi5frAB1VLoKVrJIU2-_-glambeUeEJ3ouP_E/s1600/lacrimalglandprolapsemalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="483" data-original-width="738" height="209" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjEsIl-P82kdKQzQfV2H1iRnmoEjLEiD2CpChuOrL0BCTAMgv6Aal_pUOQCm1S5HohwvujPmtF8rPOIAQSGcJmP_Z_GGId8Jmpws7pIn0DWi5frAB1VLoKVrJIU2-_-glambeUeEJ3ouP_E/s320/lacrimalglandprolapsemalaysia.jpg" width="320" /></a></div>
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<i><span style="font-size: x-small;">The lacrimal gland contributed to the lateral puffiness. Removal </span></i></div>
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<i><span style="font-size: x-small;">is not recommended as this may cause dry eye.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgkHBaYXCM4fK_EHJKBV87r6fVDCzcKNtc4JRuaMLWIf9l3uRFxrbV2szCSmGe-ZNJc6Uff1rqpGFXWfbEayi_3FAg6t9ZD4ruetoq7gWG1tDJI_XiEkWJA2icsOkWBLoVfXHK-vYgNmyKF/s1600/lacrimalglandrepositioning1malaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="483" data-original-width="738" height="209" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgkHBaYXCM4fK_EHJKBV87r6fVDCzcKNtc4JRuaMLWIf9l3uRFxrbV2szCSmGe-ZNJc6Uff1rqpGFXWfbEayi_3FAg6t9ZD4ruetoq7gWG1tDJI_XiEkWJA2icsOkWBLoVfXHK-vYgNmyKF/s320/lacrimalglandrepositioning1malaysia.jpg" width="320" /></a></div>
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<i><span style="font-size: x-small;">Instead the lacrimal gland is repositioned using 5/0 ethilon </span></i></div>
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<i><span style="font-size: x-small;">to the orbital roof.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjYmsCpfyVCcJU1A0E1Xp_MS6O2Yz93VXQDsXInsIknSlyCq8IThGzkNrVW72AEqdrrwu4_NKPenh2I74vOI03av53JLaznkRno_uz6sMg000vZDGVotxVqE1MxR4VFDM6Q03V4yO6QLZxr/s1600/lacrimalglandrepositioning.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="483" data-original-width="738" height="209" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjYmsCpfyVCcJU1A0E1Xp_MS6O2Yz93VXQDsXInsIknSlyCq8IThGzkNrVW72AEqdrrwu4_NKPenh2I74vOI03av53JLaznkRno_uz6sMg000vZDGVotxVqE1MxR4VFDM6Q03V4yO6QLZxr/s320/lacrimalglandrepositioning.jpg" width="320" /></a></div>
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<i><span style="font-size: x-small;">The lateral puffiness was abolished after lacrimal repositioning.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnnaxvFFWUhtFVg-VzYEgSZXN0GLVWiEJQWtqkEcs8P35nTX2-MevQr8OePbUe60fRmfYly_vlvto6WL1a84ES6Ha7gAJEdJ0uJjdMy-EXCggLTtmCDtfzIMMzaLFy6rcLeGTFHBWzEWNu/s1600/postblepharoplasty.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="259" data-original-width="750" height="110" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnnaxvFFWUhtFVg-VzYEgSZXN0GLVWiEJQWtqkEcs8P35nTX2-MevQr8OePbUe60fRmfYly_vlvto6WL1a84ES6Ha7gAJEdJ0uJjdMy-EXCggLTtmCDtfzIMMzaLFy6rcLeGTFHBWzEWNu/s320/postblepharoplasty.jpg" width="320" /></a></div>
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<i><span style="font-size: x-small;">At the end of the surgery.</span></i></div>
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Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-90680347953877940352017-07-13T11:07:00.002+08:002017-07-13T11:07:12.256+08:00A Patient with Headache and Blurred Vision.This patient who had had cataract surgery 5 years ago complained of increasing blurriness of vision and headache. Examination did not show any opacities of the posterior capsule or any retina diseases, however, refraction showed high astigmatism of 2.00 D. In addition, she had excessively high eyebrows. The symptoms were attributable to droopy eyelids: astigmatism can occur when the droopy eyelids press on the globe and the headache due to constant use of the forehead muscle to elevate the eyebrows in an attempt to open the eyes.<br />
After consultation, bilateral ptosis (droopy eyelid) surgery was done using the posterior approach. After the operation, her vision improved due to reduction of the astigmatism to -0.75 and the headache disappeared when the eyebrows returned to normal height.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgC3_V7wpy1k4lYoPD_cmtaEFuydxNIJ-8hnKEkpMczYPiM_TjW-iMvG6ICkECIB4ueCcKjLr2sX2RDuhCgnIiYV0e9TXtqu7Na6NbvEGn1Cxev7TKslcWVsprQzV7_tcNHQ2zRUxwiHwTK/s1600/Malaysiadroopyeyelids.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="474" data-original-width="750" height="202" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgC3_V7wpy1k4lYoPD_cmtaEFuydxNIJ-8hnKEkpMczYPiM_TjW-iMvG6ICkECIB4ueCcKjLr2sX2RDuhCgnIiYV0e9TXtqu7Na6NbvEGn1Cxev7TKslcWVsprQzV7_tcNHQ2zRUxwiHwTK/s320/Malaysiadroopyeyelids.jpg" width="320" /></a></div>
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<i><span style="font-size: x-small;">Headache due to constant excessive use of forehead </span></i></div>
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<i><span style="font-size: x-small;">muscle to open the eyes.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvTn1VlIjgaudf4EXVqh81DJwgQl78BE2Y3_b7twuUH6l0BP440Va9IM6vzehVeesO-s1Ub0Va76zRT9-NpzZRDsKh-r58IpKZ_QREIlXoKjQfZ6LPMasJ9zCm8WZDxgDxYtTcZXu5U_rB/s1600/droopyeyelidmalaysia.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><br /></a>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvTn1VlIjgaudf4EXVqh81DJwgQl78BE2Y3_b7twuUH6l0BP440Va9IM6vzehVeesO-s1Ub0Va76zRT9-NpzZRDsKh-r58IpKZ_QREIlXoKjQfZ6LPMasJ9zCm8WZDxgDxYtTcZXu5U_rB/s1600/droopyeyelidmalaysia.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: 1em; text-align: center;"><img border="0" data-original-height="474" data-original-width="749" height="202" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvTn1VlIjgaudf4EXVqh81DJwgQl78BE2Y3_b7twuUH6l0BP440Va9IM6vzehVeesO-s1Ub0Va76zRT9-NpzZRDsKh-r58IpKZ_QREIlXoKjQfZ6LPMasJ9zCm8WZDxgDxYtTcZXu5U_rB/s320/droopyeyelidmalaysia.jpg" width="320" /></a></div>
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<i><span style="font-size: x-small;">One day after ptosis (droopy eyelid) operations.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhDQWVhBgxd6J5GUAJi7Am22mKldTOiLAwrQ_rWzQzJYuQ8GsbmAJg2B1SsN2veJGFwPUuADvCiwa10dwbEvApBLSGdywuYt87u4kPkV7JYQ_kobDqcHG0Or29FaUEL0tdJYB2BjOUVVyEl/s1600/Malaysiadroopyeyelids2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="474" data-original-width="749" height="202" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhDQWVhBgxd6J5GUAJi7Am22mKldTOiLAwrQ_rWzQzJYuQ8GsbmAJg2B1SsN2veJGFwPUuADvCiwa10dwbEvApBLSGdywuYt87u4kPkV7JYQ_kobDqcHG0Or29FaUEL0tdJYB2BjOUVVyEl/s320/Malaysiadroopyeyelids2.jpg" width="320" /></a></div>
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<i><span style="font-size: x-small;">Normal eye opening two weeks after droopy eyelid surgery.</span></i></div>
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Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com3tag:blogger.com,1999:blog-282224171793732169.post-76802552169236076572017-02-25T19:33:00.004+08:002017-02-25T19:34:30.015+08:00Oculoplastic Workship 18th-19th March 2017.<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxVCGxn7sJH5uDyacL5j3IehqEP2ngaq3FbTitzkqw3CRdM5EudSXq3NNt6nFn_Wff0tQzt4-LsKodbFtrmMa2n8NCB-_g3bJ05djVhDmzEoQKHLno-6PDp3jCOmgfwmeKghdRQ0DPlPRu/s1600/Oculoplasticworkshipprofchua1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxVCGxn7sJH5uDyacL5j3IehqEP2ngaq3FbTitzkqw3CRdM5EudSXq3NNt6nFn_Wff0tQzt4-LsKodbFtrmMa2n8NCB-_g3bJ05djVhDmzEoQKHLno-6PDp3jCOmgfwmeKghdRQ0DPlPRu/s640/Oculoplasticworkshipprofchua1.jpg" width="425" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgkr0DQ8VAWtaWvO_7XB-kW3AxLtCfFKjtmW38_LTPU04k37OEHpJIolpRuNK0ZbQzhTGkcyV8cPKNRMeO_-PjYo_31kF3ED_G0K5zr3kUl0cF9v8VjphOArYXypuheZCJcLGWiTmz4Vcfd/s1600/Oculoplasticworkshipprofchua2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgkr0DQ8VAWtaWvO_7XB-kW3AxLtCfFKjtmW38_LTPU04k37OEHpJIolpRuNK0ZbQzhTGkcyV8cPKNRMeO_-PjYo_31kF3ED_G0K5zr3kUl0cF9v8VjphOArYXypuheZCJcLGWiTmz4Vcfd/s640/Oculoplasticworkshipprofchua2.jpg" width="394" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiV7Pa31V3P4Xp7x4ep4NYTrjgl2UxALsJzW0YddRiYpIbWKsI5kpSu7d-l3t9hJ1T2p27dOpsNSOSsiEhfDcKfUthfLvtEpF4DwmmLNKR1zbW1BzzeLSJxjjSp82856qpdamchY2kxUrz8/s1600/Oculoplasticworkshipprofchua3.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiV7Pa31V3P4Xp7x4ep4NYTrjgl2UxALsJzW0YddRiYpIbWKsI5kpSu7d-l3t9hJ1T2p27dOpsNSOSsiEhfDcKfUthfLvtEpF4DwmmLNKR1zbW1BzzeLSJxjjSp82856qpdamchY2kxUrz8/s640/Oculoplasticworkshipprofchua3.jpg" width="370" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh8tRH6ESepAEyT5AhFYsNlrgdnmpHq2FXsmc8ghOs1O5FKo5EkKfC4yJpR_PSrGnPTJat5niNvkR5K-Rw1WNokbbEa5IhOoTU912Do2lRgYF8TfmyiaUivd-OmcS7GCpcnA8bx0bhCJ1Sd/s1600/Oculoplasticworkshipprofchua4.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="258" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh8tRH6ESepAEyT5AhFYsNlrgdnmpHq2FXsmc8ghOs1O5FKo5EkKfC4yJpR_PSrGnPTJat5niNvkR5K-Rw1WNokbbEa5IhOoTU912Do2lRgYF8TfmyiaUivd-OmcS7GCpcnA8bx0bhCJ1Sd/s400/Oculoplasticworkshipprofchua4.jpg" width="400" /></a></div>
<br />Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com0tag:blogger.com,1999:blog-282224171793732169.post-26919739855529900902016-11-10T18:48:00.002+08:002016-11-10T18:48:52.781+08:00Doc, can you do something about my sausage lip?<div style="text-align: justify;">
Having a full lip can make a person more sensuous and attractive. However, an artificial pump-up lips which are not proportional to one's face can make one an object of ridicule.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQug6nqc99k3QpBYHiS1rGdn5iSPEpqGKpxRcuJskC54qfBdGk4fDthyphenhyphenjiX8EHHMIHOF4Y3NGHwCaQahXoVuCsgvsIIYjTuo3oJbBmcy2Ice81ttjy05Uu_ebHk7h-UGSS7Eb1uaowyxPM/s1600/naturalversusunnaturallips.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="181" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQug6nqc99k3QpBYHiS1rGdn5iSPEpqGKpxRcuJskC54qfBdGk4fDthyphenhyphenjiX8EHHMIHOF4Y3NGHwCaQahXoVuCsgvsIIYjTuo3oJbBmcy2Ice81ttjy05Uu_ebHk7h-UGSS7Eb1uaowyxPM/s400/naturalversusunnaturallips.jpg" width="400" /></a></div>
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<i><span style="font-size: x-small;">Natural versus unnatural lips.</span></i></div>
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This woman had lip injection in a beauty saloon two years ago to give her a better pout. She was told the injection consisted of hyaluronic acid. Two years later, the lips remained swollen and the upper lip had poor contour with the left side bigger than the right. She was depressed as people ridiculed her for having "sausage lips". </div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwQTjmV_51KH_SfXdAtt_zBOinUWDJ5GHv_0zrkIPoN5CQ9V8_OB73CWOUIG-a2z6_o1pTJsdDIL-KZm-X3kzzc7xFY6yr_QY9NFEUALbZ-uOtl6K36PMLpbi8G6V0B62R6flIHYT7Yude/s1600/Lipgranulomafromunknownfillerinjection.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="255" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwQTjmV_51KH_SfXdAtt_zBOinUWDJ5GHv_0zrkIPoN5CQ9V8_OB73CWOUIG-a2z6_o1pTJsdDIL-KZm-X3kzzc7xFY6yr_QY9NFEUALbZ-uOtl6K36PMLpbi8G6V0B62R6flIHYT7Yude/s400/Lipgranulomafromunknownfillerinjection.jpg" width="400" /></a></div>
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<i><span style="font-size: x-small;">Swollen upper lip with asymmetrical contour.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjORCBjreP6IK3ojTAK-Z7_2vBw-CLBZprTjADbxNUG4K4OafnFIv2OB7L3XpK-pooa940nC3lfAgGS92UqODLVlvzQWLcTHqQ66UY5QStHgP5ySYLHBiAKf0fi3WlT0ReKj7Vl2ZnH5rTR/s1600/Sideviewofthegranulomashowingexcessiveupperlidpouting.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="196" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjORCBjreP6IK3ojTAK-Z7_2vBw-CLBZprTjADbxNUG4K4OafnFIv2OB7L3XpK-pooa940nC3lfAgGS92UqODLVlvzQWLcTHqQ66UY5QStHgP5ySYLHBiAKf0fi3WlT0ReKj7Vl2ZnH5rTR/s400/Sideviewofthegranulomashowingexcessiveupperlidpouting.jpg" width="400" /></a></div>
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<i><span style="font-size: x-small;">Side view of the lips</span></i></div>
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She consulted a few aesthetic physicians and had injections including steroid and hyalurodinase to reduce the swelling but to no avail. Examination showed the lips to be thickened and hard to touch, it was likely that she was injected with silicone rather than hyaluronic acid. The only treatment of choice is to surgically remove the granuloma. </div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhjXg2fegU-ZQCRNIYI6WBRV8sX6FqUw2ZSJf1txYLvAFsVr6xSb03_n_ekU0RAULv23ftomLf1wjLL9iqmtriN_SylDseebv1Nb-YZS2oR1I0JJJ-fArx3zfS8CA_PwOwkRhyA8svdpwYP/s1600/lipreductionkualalumpur8.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhjXg2fegU-ZQCRNIYI6WBRV8sX6FqUw2ZSJf1txYLvAFsVr6xSb03_n_ekU0RAULv23ftomLf1wjLL9iqmtriN_SylDseebv1Nb-YZS2oR1I0JJJ-fArx3zfS8CA_PwOwkRhyA8svdpwYP/s400/lipreductionkualalumpur8.jpg" width="361" /></a></div>
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<i><span style="font-size: x-small;">Surgical removal of the granuloma and to reshape the contour </span></i></div>
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<i><span style="font-size: x-small;">of the upper lip.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFV2N4IQ7e2zeqduSRuB4RXqVvCJsVD2odY3OKeBoAnlfOE6H_ETE-Yfm5u63NJn9OSZhNdD6DyAHYE-_PgrWq1yjdYpcyLacnA8Vdpo2yG5udSi_24cHg7wWcZ1IjonR-02wsu6d1BH3Z/s1600/Excisedtissuesshowinggranuloma.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="243" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFV2N4IQ7e2zeqduSRuB4RXqVvCJsVD2odY3OKeBoAnlfOE6H_ETE-Yfm5u63NJn9OSZhNdD6DyAHYE-_PgrWq1yjdYpcyLacnA8Vdpo2yG5udSi_24cHg7wWcZ1IjonR-02wsu6d1BH3Z/s400/Excisedtissuesshowinggranuloma.jpg" width="400" /></a></div>
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<i><span style="font-size: x-small;">Excised lip tissue showing granuloma.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfi4ueITOL5-nrtDa4XqGoqI90hr9BAxxhCa5VWgTG4M9NVyjywnM7uYUH3SRMEWQUVWpCoFVvrumH7a5yNpuZuUBAl8Sc4uc5f2_dIeVgyQaL9LlT2xYu2diqJOJYwQCNoV3omMtTQ_UB/s1600/postlipreduction.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="260" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfi4ueITOL5-nrtDa4XqGoqI90hr9BAxxhCa5VWgTG4M9NVyjywnM7uYUH3SRMEWQUVWpCoFVvrumH7a5yNpuZuUBAl8Sc4uc5f2_dIeVgyQaL9LlT2xYu2diqJOJYwQCNoV3omMtTQ_UB/s400/postlipreduction.jpg" width="400" /></a></div>
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<i><span style="font-size: x-small;">Post lip reduction with good contour.</span></i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhguSYj5JNaRdB0MF-c-70obGKK4Y5VqV7h_PBCsRH4lsKAJuzLisoGshHR6hJjARGbcgjznEydEWEuyPdrNcOaE4VQNjTI9f9psx_gr40Emk3-Mvp1jUE223ZG_bC1XWCkO4zHCBTz5cxp/s1600/lipreductionmalaysia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="183" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhguSYj5JNaRdB0MF-c-70obGKK4Y5VqV7h_PBCsRH4lsKAJuzLisoGshHR6hJjARGbcgjznEydEWEuyPdrNcOaE4VQNjTI9f9psx_gr40Emk3-Mvp1jUE223ZG_bC1XWCkO4zHCBTz5cxp/s400/lipreductionmalaysia.jpg" width="400" /></a></div>
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<i><span style="font-size: x-small;">Side view of the upper lip post lip reduction.</span></i></div>
<br />Chua Chung Nenhttp://www.blogger.com/profile/15039077925677773325noreply@blogger.com1