There is more or less edema following the operation, associated with or without discoloration, which disappears usually without treatment in forty-eight hours. It is advisable to administer a saline laxative each morning following the operation for several days. Small doses of magnesium sulphate answer the purpose very well.
The sutures are withdrawn in from twenty-four to forty-eight hours after having been carefully softened with warm boric-acid solution, or a ten-per-cent peroxid-of-hydrogen aqueous solution. The early removal of the sutures prevents stitch cicatrices. The part is again powdered as before and covered with the adhesive silk plaster, which answers both purposes of protection and splinting.
The resulting cicatrization is so surprisingly little as to be almost invisible in the great majority of cases. In patients of blond complexion the redness of the scar disappears as early as three weeks, but is more prolonged in persons of darker type. It is not advisable to do both upper and lower eyelids in one operation to avoid the discomfort of the edema which usually follows.
In rare instances there appears a hypertrophy of the scar line, which is best treated with strips of thiosinamin plaster mull, twenty per cent, applied nightly and removed the next morning. If irritation results the plasters should be discontinued for a day or two.
XANTHELASMA PALPEBRARUM
A yellow discoloration of irregular patchlike formation in the skin of the lids, usually about the region of the inner canthus.
The condition may involve both upper and lower lids symmetrically. The patches are generally slightly elevated and vary in size. They make their appearance usually late in life, and are due to the infiltration of the deeper layers of the skin with groups of cells overburdened with fat.
They are best removed by excision, following the method of the preceding operation. There may or may not be a recurrence of the disease at an indefinite period, when the tissue must again be removed.
Remarks
All of the above operations in blepharoplasty can be done under local anesthesia, using either the two- or three-per-cent cocain or, preferably, Beta-eucain solutions.