Friday, October 11, 2013

Another Double Eyelid Disaster: Don't they ever Learn ?

I think I could easily fill this blog with pages and pages of eyelid disaster done by unlicensed personnel in saloon and sometimes even in hotels. I revised three or four such cases a month but I am pretty sure they are plenty more victims out there who don't know where to seek help or too embarrassed to seek second opinion.
This desperate housewife was referred to me by an ophthalmic colleague because of uneven double eyelids created by a beautician. She had dermatochalasis (droopy eyelids due to excess skin); the appropriate approach would be to remove the excess skin to create double eyelids of desired heights. Instead the beautician performed continuous suture technique in an attempt to create high skin creases (double eyelids). The patient was unhappy with the resultant double eyelids, not least because the height were markedly asymmetrical.
Inappropriate choice of technique and poor results.
Picture taken by the patient one day after suture technique by the beautician.
The beautician then attempted to remove the suture, she was successful with the right eye but for the left eye, the suture broke and desperate attempt was made to find the sutures using hooked needle and forceps. The patient was in severe pain as the saloon did not have the license to buy local anaesthesia (the double eyelids were performed using anaesthetic cream only) and severe abrasion and bruising occurred after half an hour of such manipulation. The beautician then asked the patient to seek medical help herself as she could do not more. The patient was left with severely asymmetrical skin creases (double eyelids)
High left double eyelid from retained suture and eyelid bruising
and abrasion from desperate attempt to remove the suture.
When I saw the patient, she was in tears and would not dare to venture outdoor without sunglasses. The asymmetrical skin creases were caused by retained suture in the left eyelid. I performed skin excision and removed the offending suture.
The excess skin was removed and the suture identified (arrows).

The retained suture was removed.

What is the lesson from this case? The case speaks for itself.


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