By Zhou Jianren
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This Festschrift is a tribute to an eminent student, scientist and engineer, Professor Richard Kounai Chang, on his retirement from Yale collage on June 12, 2008. in the course of nearly 1/2 a century of clinical and technological exploration, Professor Chang contributed to the improvement of linear and nonlinear optics, novel photonic gentle localization units, floor moment harmonic iteration, surface-enhanced Raman scattering, and novel optical tools for detecting airborne aerosol pathogens.
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Location and size of fat pads and degree of prolapse is assessed in both upper and lower lids, simply by gentle pressure on the globe itself. , upward movement of globe on eyelid closure. As absence of Bell’s will increase the risk of corneal exposure post-op, particularly if there is any degree of lagophthalmos. AIM: By the end of the exam 1. Identified any previous unknown eyelid pathology which may require investigation/treatment 2. Determined from ophthalmology report the pre-op status of visual fields and visual acuity 3.
Determined lower lid laxity and lateral canthal tension 6. Confirmed presence of Bell’s phenomenon 7. Have decided on most appropriate technique/combination of techniques 8. Have an idea of any problem areas patient wishes to address 9. Awareness of patients expectations about outcome 14 R. Caulfield Investigations • Opthalmologist assessment of visual fields and visual acuity • If GA: Routine bloods: FBC, U + E’s, Coagulation screen • If GA and depending on co-morbidities, may also need chest X-ray, ECG etc.
Mastopexy alone techniques: All based on same approach taken to reduction cases. , most tend to be grade 1 or 2 ptosis • Wise pattern: Tend to need in most cases, as the self-selecting patient population are older, poor skin quality, often smokers/ex-smokers, and anyone with grade 3 ptosis Chapter 5. Ptotic Breasts/Mastopexy 39 Breast tissue re-modelling: Use a dermoglandular pedicle (as with reduction cases), which can be inferior, superomedial or central superior depending on surgeon’s preference and experience.