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About the Guests: 

Kelsey A. Roelofs, MD - An oculofacial plastic surgeon and Assistant Professor of Ophthalmology at the University of Alberta in Edmonton, Canada.

Catherine J. Hwang, MD - An oculofacial plastic surgeon at Cleveland Clinic Foundation Cole Eye Institute.

Marie B. Somogyi, MD - An oculofacial plastic and reconstructive surgeon in private practice in Austin, Texas at Eyelid and Facial Plastic Surgery, and an affiliate faculty member in Ophthalmology at the University of Texas Dell Medical School.

Jonathan Hoenig, MD - An oculofacial plastic surgeon and Aesoppers fellowship director in private practice in Beverly Hills, California, and an affiliate professor of ophthalmology at the University of California, Los Angeles. 

Episode Summery

In this episode of the Oculofacial Podcast, host Dr. Kelsey Roelofs explores a series of insightful discussions with an expert panel on cutting-edge studies in the field of oculofacial plastic surgery, particularly focusing on topics including blepharoplasty complications, orbital implants, and hemorrhage following MMCR. 

The conversation kicks off with Dr. Marie B. Somogyi summarizing a study on postoperative hemorrhage following Mueller's muscle conjunctival resection (MMCR). They analyze the implications, risk factors, and offer practical tips for managing such complications. Next, Dr. Catherine J. Hwang sheds light on a robust study from Moorfields Eye Hospital on the efficacy of one-stage orbital volume modification for exposed and non-exposed orbital implants, emphasizing single-stage procedures' advantages. 

Continuing on, the discussion shifts to a review of two papers evaluating blepharoplasty complications, led by Dr. Jonathan Hoenig. These papers cover the risk of perforating and penetrating globe injuries during blepharoplasty, underscoring the diverse backgrounds of practitioners and the importance of procedural expertise.

Lastly, the episode delves into a large-scale study on the incidence of strabismus post-blepharoplasty from Massachusetts Eye and Ear, where they explore the potential mechanisms and prevention strategies for diplopia and strabismus following eyelid surgery. 

Key Takeaways:

• Postoperative Hemorrhage after MMCR: Hemorrhage occurred on average 4 days postoperatively in around 3% of cases, typically resolving with conservative management without affecting final outcomes. 

• Single-Stage Orbital Implant Surgery: Highlighted the success rate and benefits of single-stage surgeries for managing exposed and non-exposed implants and reducing the need for multiple interventions. 

• Blepharoplasty Safety -  Emphasizing safe practices including the potential complications arising from diverse practitioners performing eyelid surgeries and the necessity of meticulous preoperative planning and procedural caution. 

• Strabismus Post-Blepharoplasty: Installation of protocols to identify and mitigate risks related to lower blepharoplasty and its potential impact on extraocular muscles.

• Patient Follow-Up: Importance of close postoperative monitoring to ensure early identification and management of complications, including detailed patient communication and safety briefings.