Re: Canthoplasty surgery questions

[Guest guest]

HI Charlotte, I probably cant be much help, as I dont know the Y and Z reference you make. Howeve I do know that scarring for me and my daughter has been not an issue, especially on my daughter who is now 14 and had ops 10 years ago, her skin healed really quickly.

Clare Teale

Herts UK

From: Charlotte <charlottenordstrom@...>Subject: blepharophimosis Canthoplasty surgery questionsblepharophimosis Date: Wednesday, 12 May, 2010, 6:33

Dear group,We are working on a plan for our 10 year old son to have a canthoplasty surgery. We have done research and know the most common techniques are double Z-plasty and Y to V or modified Y to V (I just don't know what the "modified" means...). I would very much appreciate hearing about your experience with these or other techniques and how you and your surgeon decided on which technique to use. I am concerned with scarring and so have understood that the Y to V might have less scarring, but the Z-plasty might have a larger opening result. I also wonder if there is always modification to the epicanthal tendons in these surgeries?Our surgeon is also suggesting he make eyelid folds by cutting a line on the eyelids and sew together in a way that it will make a crease. He is also proposing to do new silicon slings in the same surgery. Our son has had two previous sling operations, but no other surgeries.Any

experience or advice is welcome. Thank you in advance!Charlotte in Minnesota USA

[Guest guest]

Hi there,

I have to ask I was a bit confused, is your child having " canthoplasty " (lower

eyelids) or his " epicanthic folds " (inner corners) operated on?? you mention

both but also mention eye opening going to be bigger so i just wanted to clarify

if he was going for canthoplasty surgery or epicanthoplasty surgery

on the epicanthic folds surgery y-v and z-plasty ...I have an article that

explains the different techniques and why, its a bit heavy on the medical

terminology however it has pictures and great explanations for each procedure,

http://archopht.ama-assn.org/cgi/reprint/107/3/448.pdf

the other thing i Highly suggest is go back to the doctor and ask him to

explain to you in layman terms exactly which procedure he wants to do and why,

and get him to explain what they involve, it may make you feel better coming

from the source that will be doing the surgery...

My son is 12 and has had 8 surgeries and the last was when he was 10 yrs old, if

you look in the pictures Lynden you will see his surgery of his latest

epicanthoplasty done, (inner corners) usually when he has his inner corners

done they always re do the brow lift (sling)

Our doctor was able to create an " eyelid " of sorts when he did the very first

silicone sling and inserted the rods,

I hope i could answer some questions about epicanthic surgery, if your main

concern was the canthoplasty (lower lids) then I am sure someone here will give

you some great answers regarding their experience with that surgery (we have not

had to have it)

--- In blepharophimosis , " Charlotte " <charlottenordstrom@...>

wrote:

>

> Dear group,

>

> We are working on a plan for our 10 year old son to have a canthoplasty

surgery. We have done research and know the most common techniques are double

Z-plasty and Y to V or modified Y to V (I just don't know what the " modified "

means...). I would very much appreciate hearing about your experience with

these or other techniques and how you and your surgeon decided on which

technique to use.

>

> I am concerned with scarring and so have understood that the Y to V might have

less scarring, but the Z-plasty might have a larger opening result. I also

wonder if there is always modification to the epicanthal tendons in these

surgeries?

>

> Our surgeon is also suggesting he make eyelid folds by cutting a line on the

eyelids and sew together in a way that it will make a crease. He is also

proposing to do new silicon slings in the same surgery. Our son has had two

previous sling operations, but no other surgeries.

>

> Any experience or advice is welcome. Thank you in advance!

> Charlotte in Minnesota USA

>

[Guest guest]

Hi there

Thanks for your link to the article on epicanthic surgery, it certainly gives a

good idea of how the op can be done. My only concern is that the article is from

1989 and in medical circles that would be outdated. There may be other modified

techniques now, so when reading it please keep this in mind. But a good overview

of the surgery none the less.

Regards

Colchester (UK)

>

>

> Hi there,

>

> I have to ask I was a bit confused, is your child having " canthoplasty " (lower

eyelids) or his " epicanthic folds " (inner corners) operated on?? you mention

both but also mention eye opening going to be bigger so i just wanted to clarify

if he was going for canthoplasty surgery or epicanthoplasty surgery

>

> on the epicanthic folds surgery y-v and z-plasty ...I have an article that

explains the different techniques and why, its a bit heavy on the medical

terminology however it has pictures and great explanations for each procedure,

>

> http://archopht.ama-assn.org/cgi/reprint/107/3/448.pdf

>

> the other thing i Highly suggest is go back to the doctor and ask him to

explain to you in layman terms exactly which procedure he wants to do and why,

and get him to explain what they involve, it may make you feel better coming

from the source that will be doing the surgery...

>

> My son is 12 and has had 8 surgeries and the last was when he was 10 yrs old,

if you look in the pictures Lynden you will see his surgery of his latest

epicanthoplasty done, (inner corners) usually when he has his inner corners

done they always re do the brow lift (sling)

>

> Our doctor was able to create an " eyelid " of sorts when he did the very first

silicone sling and inserted the rods,

>

> I hope i could answer some questions about epicanthic surgery, if your main

concern was the canthoplasty (lower lids) then I am sure someone here will give

you some great answers regarding their experience with that surgery (we have not

had to have it)

>

>

> --- In blepharophimosis , " Charlotte " <charlottenordstrom@>

wrote:

> >

> > Dear group,

> >

> > We are working on a plan for our 10 year old son to have a canthoplasty

surgery. We have done research and know the most common techniques are double

Z-plasty and Y to V or modified Y to V (I just don't know what the " modified "

means...). I would very much appreciate hearing about your experience with

these or other techniques and how you and your surgeon decided on which

technique to use.

> >

> > I am concerned with scarring and so have understood that the Y to V might

have less scarring, but the Z-plasty might have a larger opening result. I also

wonder if there is always modification to the epicanthal tendons in these

surgeries?

> >

> > Our surgeon is also suggesting he make eyelid folds by cutting a line on the

eyelids and sew together in a way that it will make a crease. He is also

proposing to do new silicon slings in the same surgery. Our son has had two

previous sling operations, but no other surgeries.

> >

> > Any experience or advice is welcome. Thank you in advance!

> > Charlotte in Minnesota USA

> >

>

[Guest guest]

Sorry, he is having his epicanthic folds operated on, inner eye corners. Thanks!

>

>

> Hi there,

>

> I have to ask I was a bit confused, is your child having " canthoplasty " (lower

eyelids) or his " epicanthic folds " (inner corners) operated on?? you mention

both but also mention eye opening going to be bigger so i just wanted to clarify

if he was going for canthoplasty surgery or epicanthoplasty surgery

>

> on the epicanthic folds surgery y-v and z-plasty ...I have an article that

explains the different techniques and why, its a bit heavy on the medical

terminology however it has pictures and great explanations for each procedure,

>

> http://archopht.ama-assn.org/cgi/reprint/107/3/448.pdf

>

> the other thing i Highly suggest is go back to the doctor and ask him to

explain to you in layman terms exactly which procedure he wants to do and why,

and get him to explain what they involve, it may make you feel better coming

from the source that will be doing the surgery...

>

> My son is 12 and has had 8 surgeries and the last was when he was 10 yrs old,

if you look in the pictures Lynden you will see his surgery of his latest

epicanthoplasty done, (inner corners) usually when he has his inner corners

done they always re do the brow lift (sling)

>

> Our doctor was able to create an " eyelid " of sorts when he did the very first

silicone sling and inserted the rods,

>

> I hope i could answer some questions about epicanthic surgery, if your main

concern was the canthoplasty (lower lids) then I am sure someone here will give

you some great answers regarding their experience with that surgery (we have not

had to have it)

>

>

> --- In blepharophimosis , " Charlotte " <charlottenordstrom@>

wrote:

> >

> > Dear group,

> >

> > We are working on a plan for our 10 year old son to have a canthoplasty

surgery. We have done research and know the most common techniques are double

Z-plasty and Y to V or modified Y to V (I just don't know what the " modified "

means...). I would very much appreciate hearing about your experience with

these or other techniques and how you and your surgeon decided on which

technique to use.

> >

> > I am concerned with scarring and so have understood that the Y to V might

have less scarring, but the Z-plasty might have a larger opening result. I also

wonder if there is always modification to the epicanthal tendons in these

surgeries?

> >

> > Our surgeon is also suggesting he make eyelid folds by cutting a line on the

eyelids and sew together in a way that it will make a crease. He is also

proposing to do new silicon slings in the same surgery. Our son has had two

previous sling operations, but no other surgeries.

> >

> > Any experience or advice is welcome. Thank you in advance!

> > Charlotte in Minnesota USA

> >

>

[Guest guest]

Do you have any photos of you or your daughter in the group site?

>

>

> From: Charlotte <charlottenordstrom@...>

> Subject: blepharophimosis Canthoplasty surgery questions

> blepharophimosis

> Date: Wednesday, 12 May, 2010, 6:33

>

>

>  

>

>

>

> Dear group,

>

> We are working on a plan for our 10 year old son to have a canthoplasty

surgery. We have done research and know the most common techniques are double

Z-plasty and Y to V or modified Y to V (I just don't know what the " modified "

means...). I would very much appreciate hearing about your experience with these

or other techniques and how you and your surgeon decided on which technique to

use.

>

> I am concerned with scarring and so have understood that the Y to V might have

less scarring, but the Z-plasty might have a larger opening result. I also

wonder if there is always modification to the epicanthal tendons in these

surgeries?

>

> Our surgeon is also suggesting he make eyelid folds by cutting a line on the

eyelids and sew together in a way that it will make a crease. He is also

proposing to do new silicon slings in the same surgery. Our son has had two

previous sling operations, but no other surgeries.

>

> Any experience or advice is welcome. Thank you in advance!

> Charlotte in Minnesota USA

>

[Guest guest]

A couple of people have asked now, I need to sort it out!

Will try to post photos soon.

Clare

Herts UK

From: Charlotte <charlottenordstrom@...>Subject: blepharophimosis Re: Canthoplasty surgery questionsblepharophimosis Date: Wednesday, 12 May, 2010, 15:09

Do you have any photos of you or your daughter in the group site?> > > From: Charlotte <charlottenordstrom @...>> Subject: blepharophimosis Canthoplasty surgery questions> blepharophimosis> Date: Wednesday, 12 May, 2010, 6:33> > > Â > > > > Dear group,> > We are working on a plan for our 10 year old son to have a canthoplasty surgery. We have done research and know the most common techniques are double Z-plasty and Y to V or modified Y to V (I just don't know what the "modified" means...). I would very much appreciate hearing about your experience with these or other techniques and how you and your surgeon decided on which technique to use. > > I am concerned with scarring and so have understood that the Y to V might have less scarring, but the Z-plasty might have a larger opening result. I also wonder if there is always modification to the

epicanthal tendons in these surgeries?> > Our surgeon is also suggesting he make eyelid folds by cutting a line on the eyelids and sew together in a way that it will make a crease. He is also proposing to do new silicon slings in the same surgery. Our son has had two previous sling operations, but no other surgeries.> > Any experience or advice is welcome. Thank you in advance!> Charlotte in Minnesota USA>

[Guest guest]

Hi Charlotte,

My son has had a few surgeries. He had one when he was 3, and we were very unhappy with the surgery and surgeon. I was just looking at the article that someone had sent. Im not sure of all the terminology or the names of the surgeries cause its been awhile. But the one that they did on the inside corners is like a zigzag, that is the one the first surgeon did and it does not heal well. He is still scared pretty good and he is 11 now.

The surgeons did not have any experience with this eye condition and they seemed like they were working from a text book and had no idea what they were doing. My opinion is that you need to find an opthalmology surgeon that has had experience in this surgery and ask for pictures of other children that they have done the surgery on. Ask lots of questions. The surgeon that we found that has lots of experience is in Philadelphia, Pennsylvania at the childrens hospital.

Tessa,

from Albany, NY

Live in NC n Wed, 12/5/10, Charlotte <charlottenordstrom@...> wrote:

From: Charlotte <charlottenordstrom@...>Subject: blepharophimosis Re: Canthoplasty surgery questionsblepharophimosis Date: Wednesday, 12 May, 2010, 9:42 AM

Sorry, he is having his epicanthic folds operated on, inner eye corners. Thanks!> >> > Dear group,> > > > We are working on a plan for our 10 year old son to have a canthoplasty surgery. We have done research and know the most common techniques are double Z-plasty and Y to V or modified Y to V (I just don't know what the "modified" means...). I would very much appreciate hearing about your experience with these or other techniques and how you and your surgeon decided on which technique to use. > > > > I am

concerned with scarring and so have understood that the Y to V might have less scarring, but the Z-plasty might have a larger opening result. I also wonder if there is always modification to the epicanthal tendons in these surgeries?> > > > Our surgeon is also suggesting he make eyelid folds by cutting a line on the eyelids and sew together in a way that it will make a crease. He is also proposing to do new silicon slings in the same surgery. Our son has had two previous sling operations, but no other surgeries.> > > > Any experience or advice is welcome. Thank you in advance!> > Charlotte in Minnesota USA> >>

[Guest guest]

The Dr in PA is Dr. Katowitz. There is also Dr. in Salt Lake

City who is supposed to be very good.

I and my sister had the z-plasty when we were children and I am considering the

Y to V technique for my son. I am not sure if we want to have the surgeon make

a eyelid fold. He says he can do it, but wants us to decide since it is really

more cosmetic and our choice.

Charlotte

> > >

> > > Dear group,

> > >

> > > We are working on a plan for our 10 year old son to have a canthoplasty

surgery. We have done research and know the most common techniques are double

Z-plasty and Y to V or modified Y to V (I just don't know what the " modified "

means...). I would very much appreciate hearing about your experience with these

or other techniques and how you and your surgeon decided on which technique to

use.

> > >

> > > I am concerned with scarring and so have understood that the Y to V might

have less scarring, but the Z-plasty might have a larger opening result. I also

wonder if there is always modification to the epicanthal tendons in these

surgeries?

> > >

> > > Our surgeon is also suggesting he make eyelid folds by cutting a line on

the eyelids and sew together in a way that it will make a crease. He is also

proposing to do new silicon slings in the same surgery. Our son has had two

previous sling operations, but no other surgeries.

> > >

> > > Any experience or advice is welcome. Thank you in advance!

> > > Charlotte in Minnesota USA

> > >

> >

>

[Guest guest]

As it happens, I was talking to my current ophthalmic surgeon just on

Monday, who was trained by the bloke who did my surgeries in the

mid-late 1960s. According to him, the basic techniques of BPES repair

haven't changed since then. So don't be too sure that a 1989 article is

necessarily 'out of date'; I have a (possible the same) 1989 journal

article, and also surgical articles and manual extracts from as far back

as 1956 and 1963/1964 and the 1970s, and they're not much different.

What might have improved since 1989 (and 1956!) is the finer details

such as wound management (suture materials, dressings, etc.),

anaesthetics, positioning/cut-angles, etc., which would give better

results even with the same techniques.

But, as others have said, one should grill one's surgeons without mercy

with as long a list of questions as one can think of; they're the

experts -- or will be exposed through interrogation as not being

experts, as the case may be.

Rob W

Oz

On 12/05/2010 9:01 PM, parsonsfamily108 wrote:

> Hi there

>

> Thanks for your link to the article on epicanthic surgery, it

> certainly gives a good idea of how the op can be done. My only

> concern is that the article is from 1989 and in medical circles that

> would be outdated. There may be other modified techniques now, so

> when reading it please keep this in mind. But a good overview of the

> surgery none the less.

[Guest guest]

Yes , Dr. Katowitz, thats who did his surgeries. I havent heard about the other one. Im still not really sure what the y to v and z are. My son had the eyelid fold and I think it came out really good, there was no scaring because they are adding new skin from leg and making a fold.

Tessa

From: Charlotte <charlottenordstrom@...>Subject: blepharophimosis Re: Canthoplasty surgery questionsblepharophimosis Date: Thursday, 13 May, 2010, 1:31 AM

The Dr in PA is Dr. Katowitz. There is also Dr. in Salt Lake City who is supposed to be very good.I and my sister had the z-plasty when we were children and I am considering the Y to V technique for my son. I am not sure if we want to have the surgeon make a eyelid fold. He says he can do it, but wants us to decide since it is really more cosmetic and our choice.Charlotte> > >> > > Dear group,> > > > > > We are working on a plan for our 10 year old son to have a canthoplasty surgery. We have done research and know the most common techniques are double Z-plasty and Y to V or modified Y to V (I just don't know what the "modified" means...). I would very much appreciate hearing about your experience with these or other techniques and

how you and your surgeon decided on which technique to use. > > > > > > I am concerned with scarring and so have understood that the Y to V might have less scarring, but the Z-plasty might have a larger opening result. I also wonder if there is always modification to the epicanthal tendons in these surgeries?> > > > > > Our surgeon is also suggesting he make eyelid folds by cutting a line on the eyelids and sew together in a way that it will make a crease. He is also proposing to do new silicon slings in the same surgery. Our son has had two previous sling operations, but no other surgeries.> > > > > > Any experience or advice is welcome. Thank you in advance!> > > Charlotte in Minnesota USA> > >> >>

[Guest guest]

Do you have any photos on the group site? I am curious about the making of the

eyelid fold. thanks.

> > > >

> > > > Dear group,

> > > >

> > > > We are working on a plan for our 10 year old son to have a canthoplasty

surgery. We have done research and know the most common techniques are double

Z-plasty and Y to V or modified Y to V (I just don't know what the " modified "

means...). I would very much appreciate hearing about your experience with these

or other techniques and how you and your surgeon decided on which technique to

use.

> > > >

> > > > I am concerned with scarring and so have understood that the Y to V

might have less scarring, but the Z-plasty might have a larger opening result. I

also wonder if there is always modification to the epicanthal tendons in these

surgeries?

> > > >

> > > > Our surgeon is also suggesting he make eyelid folds by cutting a line on

the eyelids and sew together in a way that it will make a crease. He is also

proposing to do new silicon slings in the same surgery. Our son has had two

previous sling operations, but no other surgeries.

> > > >

> > > > Any experience or advice is welcome. Thank you in advance!

> > > > Charlotte in Minnesota USA

> > > >

> > >

> >

>

[Guest guest]

I dont have any yet on there, im going to work on getting some up now. I will email back when I get them on.

Tessa

From: Charlotte <charlottenordstrom@...>Subject: blepharophimosis Re: Canthoplasty surgery questionsblepharophimosis Date: Friday, 14 May, 2010, 12:22 AM

Do you have any photos on the group site? I am curious about the making of the eyelid fold. thanks.> > > >> > > > Dear group,> > > > > > > > We are working on a plan for our 10 year old son to have a canthoplasty surgery. We have done research and know the most common techniques are double Z-plasty and Y to V or modified Y to V (I just don't know what the "modified" means...). I would very much appreciate hearing about your experience with these or other techniques and how you and your surgeon decided on which technique to use. > > > > > > > > I am concerned with scarring and so have understood that the Y to V might have less scarring, but the Z-plasty might have a larger opening result. I also wonder if there is always modification to the epicanthal tendons in these surgeries?> > > > >

> > > Our surgeon is also suggesting he make eyelid folds by cutting a line on the eyelids and sew together in a way that it will make a crease. He is also proposing to do new silicon slings in the same surgery. Our son has had two previous sling operations, but no other surgeries.> > > > > > > > Any experience or advice is welcome. Thank you in advance!> > > > Charlotte in Minnesota USA> > > >> > >> >>

[Guest guest]

Hi, I just finally got some pics on there! they are under , he has a red shirt on in the pics and there are a couple of baby pics that I scanned, but you can still see his eyes in it.

Tessa

From: Charlotte <charlottenordstrom@...>Subject: blepharophimosis Re: Canthoplasty surgery questionsblepharophimosis Date: Friday, 14 May, 2010, 12:22 AM

Do you have any photos on the group site? I am curious about the making of the eyelid fold. thanks.> > > >> > > > Dear group,> > > > > > > > We are working on a plan for our 10 year old son to have a canthoplasty surgery. We have done research and know the most common techniques are double Z-plasty and Y to V or modified Y to V (I just don't know what the "modified" means...). I would very much appreciate hearing about your experience with these or other techniques and how you and your surgeon decided on which technique to use. > > > > > > > > I am concerned with scarring and so have understood that the Y to V might have less scarring, but the Z-plasty might have a larger opening result. I also wonder if there is always modification to the epicanthal tendons in these surgeries?> > > > >

> > > Our surgeon is also suggesting he make eyelid folds by cutting a line on the eyelids and sew together in a way that it will make a crease. He is also proposing to do new silicon slings in the same surgery. Our son has had two previous sling operations, but no other surgeries.> > > > > > > > Any experience or advice is welcome. Thank you in advance!> > > > Charlotte in Minnesota USA> > > >> > >> >>