Nov 21, 2020

On rebuilding eyelids

This for all zero of you interested in how an eyelid is reconstructed. I only know the details because I had most of a lower one removed a few years back (skin cancer of the lid margin which I heard is more common than one would think; remind your kids to wear UV sunglasses...) . This post, of course, has nothing to do with retirement finance.

In brief, first you lose, in my case, a rectangle about 3/4 of an inch by maybe 1/8 but it felt like a square mile. This was done Mohs style so it was cut wait cut wait cut wait. This is very unpleasant and the feeling and visuals are gross. The fentanyl helped, though, and I now know why that med is a controlled substance and I bless my anesthesiologist still to this day (the guy taps it in and when it hits the blood stream: "ahhh, so that's why it's illegal"). To get to him, though, I had to be driven to a second location by a now ex gf that begrudged me her assistance and I do not bless her to this day. It was during the drive and the long wait in the waiting room where the initial anesthetic wore off and the prospect of synthetic heroin started to have some appeal. 

Then, one has a "gap" to fill. The gap is filled in two layers, front and back. The back comes from the back of the upper eyelid. A square is cut on three sides with the bottom left intact. That square, with the bloodflow still working is folded down and becomes the new back. The front comes from skin harvested from the flesh just below the other eyebrow (I was advised to never get plastic surgery so that I'd have that flesh in the future if I needed it). That becomes the new front.

Then the whole eye gets sewn shut for a month (I could sorta peer through a hole in the sutures but it scared the kids when I did not wear my pirate patch). When it is ready the oculoplastic surgeon, who did an artful job by the way (the trick is not just cosmetic, it is also the proper tension, neither too loose nor too tight), snips the flap in half and behold, a new lid.  Most people can't tell now even when I tell the story. The biggest problem still hanging around is that: a) I lost not quite half of the lubricating glands in the combined upper and lower lids, and b) I now have stray -- what used to be eyebrow -- hairs that grow back towards my cornea. ugh. 

Did I mention UV sunglasses for the kids yet?



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