Fig. 112. Fig. 113.
Blepharoplasties, Author’s Method.
The superior line of incision in operations of the lower lid should be made as close to the tarsal line as is practical, so as to show as little of the resulting scar as possible. The best distance is about an eighth of an inch below the tarsal cartilage fold. Accuracy in making the superior line of the incision is furthered by outlining the flap to be removed with a very fine bistoury.
In operations about the upper lid a somewhat widened elliptical piece of skin is excised with its inferior margin about one fourth to one half inch above the tarsal line, so as to allow the line of union to lie above it and within the curved fold when the eye is open.
Fig. 114.—Curved Eye Scissors.
For the excision it will be found best to use a fine pair of curved eye scissors, beginning the incision by raising the skin at the outer canthus with a fixation forceps or tenaculum.
Another guide to outline the necessary amount of tissue to be removed is to mark the area, prior to operation, with India ink or an indelible pencil. The parts can then be snipped away readily without fear of causing ectropion. There is usually very little bleeding, and in most cases the tissue is exceedingly thin.
The margins of the wound are brought together with very fine twisted silk, using the continuous suture preferably on account of the ease with which it can be removed.
The wound is then powdered with a suitable antiseptic powder and covered with antiseptic adhesive silk plaster moistened with an antiseptic. The form of the plaster should be of suitable shape, not too wide, and nicked so as to permit of proper application.