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