Botox and Fillers

Botulinum toxin works by paralyzing the muscles. The good thing is it is temporary and there are no significant side effects. But when given for cosmetic purposes this has to be repeated every few months.

The dynamic wrinkles are removed by this, but the static wrinkles can only be removed by fillers. Both these do not last long.

As regards administration, these can be given easily and there is no pain or swelling. The patient can get back to work immediately after the injection.

Good medication for getting a fresh face, though expensive. Of course it can also be used for small squints and for double vision...

Life like artificial eyes

  

Losing an eye is a disaster and the person loses all self confidence and belief in one self.

I have known a child who stopped talking when her eye was lost following a glass bulb burst. Once I made an artificial eye and fitted it on her, she started to talk and became her cheerful self. There was one more child who refused to go out and meet anyone as he had lost an eye. It is important in these children to give  them an artificial eye to make them look good and help them regain their self confidence.

Modern techniques of making artificial eyes are so good that it becomes difficult to differentiate the normal eye from the artificial eye. I have many times gone very close to the face of the person to identify which is the artificial eye. Custom made artificial eyes in which no surgery is needed are the best method of rehabilitating a person who has lost an eye. 

Making on an average about 10 eyes in a month, I have gained immense satisfaction from seeing the smile on my patient's faces and knowing they are satisfied with my work...

 

Orbit and tumors

The orbit refers to the box made of bone in which the eye sits safely. This protects the eye from injury. Sometimes there can be tumours in this bony cavity. The most common of these in adults is the cavernous hemangioma. This is a vascular tumor - soft and non cancerous. This tumor usually sits behind the eyeball and can be removed safely by a small incision in the outer wall of the orbit.

The surgery is minimally invasive, cosmetically not bad and can be done easily and safely by a trained orbit surgeon. Having removed many such tumors I have devised my own ways of making sure, the tumor is safely removed with minimal damage to the eye.

The patient if fine can go home the same day after surgery. Recovery to normal does not take too long and the patient can be allowed to resume normal activities in a weeks time.

Blepharoplasty

Baggy lids affect many especially in the present age of stress and increasing work pressures. The constant worries and tensions create furrows and wrinkles on the face. The lids become loose and baggy and sag down. The upper lid may droop and cover the eyes which makes seeing the world especially when looking up. Reading may also be a problem especially as the lids feel heavy and cover most of the eyes.

The lower lid may also be affected and there may be fullness of the lower lid area. This creates a look of an aging face.

Blepharoplasty is the surgical removal and correction of this upper lid droop and bags under the lower lids. Surgery has excellent results and there are no scars of surgery. The incisions or cuts are made in an aesthetic and hidden fashion and yield beautiful outcomes. This may be accompanied by ptosis that is drooping of the upper lids. This is all a part of oculoplasty surgery .

Having operated many patients from around the world of different racial origins, I can safely say with lots of experience that this is one surgery which makes my patients very happy and me too.

Newer frontiers in oculoplasty and ptosis

Ptosis remains a problem for many. It robs one of his or her self esteem and results in the person worrying about their appearance all the time. The good news is that ptosis correction has become easier and simpler and obviously more successful.

The day care approach to ptosis surgery has made the results very predictable and comfortable for the patient. The patient is made to sit up at the end of surgery and the position of the upper lid is noted. Finalization of the lid height to look good and to match the other eye is performed and the patient is shown the correction achieved by clicking a photograph.

Oculoplasty surgery is advancing in leaps and bounds and more progress is expected in the years to come...

Thyroid eye disease

Thyroid eye disease is an under diagnosed condition. Many patients are not diagnosed till late in the disease, when there are serious problems due to the disease. The eyes are usually red and congested. There is persistent watering from the eyes. The lids start to behave abnormally with widely open eyes which gives an angry look to the patient. The movements of the eyes can also get limited when the patient starts getting double vision. Protrusion of the eyes occurs due to the increase in fat in the orbit and enlargement of the eye muscles. The vision may drop when there is compression of the optic nerve by the eye muscles.

The serious manifestations are loss of vision and double vision. The treatment in the initial stages when the eyes are red is giving oral steroids or intravenous steroids so that the patient can tide over the inflammation or redness in the eyes.

Control of the thyroid status is also essential for the eye disease to become stable. For the double vision one can give prisms or even injection of botulinum toxin in the acute stages. Orbital decompression is needed if there is sight threatening optic nerve compression or for cosmetic reduction of the proptosis. Squint surgery may be needed for the double vision especially as there may be vertical displacement of images and adjustable sutures are used while performing the squint surgery.

I routinely perform surgery and manage many patients with thyroid eye disease, with a good outcome.

OCULOPLASTY MEETING AMRITSAR

The highlight of this meeting was the wonderful place Amritsar apart from the well planned scientific programme. Amritsar is most famous for the Golden Temple. As I sat in the precincts of this temple, the peace and tranquility enveloped me and made be feel very relaxed. There is no bar on any one for entering this temple, except one has to cover one's head. The temple with its rich gold carvings stands out like the sun. There was no jostling or pushing as in other temples, people stood quietly in queue letting infants and mothers and the elderly pass. There was contentment and patience as people waited slowly for their turn to visit the sanctum sanctorum.

The Wagah border was great, could see Pakistan on the other side. Inspiring patriotism in the masses, there was a crowd of nearly 15000 people on the Indian side. With songs and dancing, the jubilant indian crowd enjoyed every moment of the parade.

Oculoplasty meeting was a great success, my lecture was like the meeting point of squint and oculoplasty and was well appreciated especially as I highlighted the strong relation between the two. The intricate details which need to be looked into especially the cosmetic changes on the face when we perform a lid or squint surgery was highlighted. Overall a great break....

GANESH CHATURTHI

There was no dampening of spirits in the Ganesha festival this year also. I happened to visit the Dagdu Sheth ganesh pandal today. The decoration was unparalleled. The God's idol was housed in a palace which was a replica of the Hawa mahal at Jaipur. 

Eventhough there is high inflation and people are feeling the pinch the festival was celebrated with great energy and expectation. Everyone hopes that the festival will usher good times.. 
Hope drives the world.

Even we do surgery with a lot of hopes - expecting good results all the time. Hoping miracles happen and we come up with a great cure and result...Praying to God gives us hope to face the next day.. Oculoplasty surgery is very demanding especially for good results and perfection... and still there is hope... there is light at the end of the tunnel