Patel Plastic Surgery Salt Lake City and St. George
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    • Plastic Surgery Salt Lake City
    • Plastic Surgery St. George
  • Conditions
    • Aging Of The Face
    • Aging of Lower Eyelids
    • Aging of the Forehead and Brows
    • Aging of Upper Eyelids
    • Aging of the Cheeks
    • Aging of the Neck
    • Aging of the Lips
    • Aging of the Mouth
    • Aging of the Chin
    • Aging of Eyelashes
    • Aging of the Hands
    • Aging Of Skin Colour
    • Aging Of Hair
    • Aging of the Jowls
    • Aging of Men
    • Aging of the Skin
    • Aging of Veins and Vessels
    • Scars
  • Cosmetic
    • Facelift
    • Browlifts
    • Lower Blepharoplasty
    • Upper Blepharoplasty
    • Midface Lift/Hammock Lift
    • Necklift
    • Cosmetic Surgery for Men
    • Lip Lines
    • Lips
    • Mouth
    • Neck Liposuction
    • Fat Transfer
    • Skin Resurfacing
    • Cheeks
    • J-PLASMA SKIN RESURFACING
    • J-PLAZTY FACE
    • Removal of Moles, Lesions, Tags, Cysts and Blemishes
    • Facial Implants
    • Otoplasty, Ear Pinning, or Bat-Ear Repair
    • Complications?
  • Reconstruction
    • Acquired Ptosis and Dermatochalasis
    • Congenital Ptosis
    • Ptosis in Myasthenia Gravis
    • Blepharophimosis Syndrome
    • Entropion
    • Ectropion
    • Thyroid Eye Disease
    • Nasolacrimal Duct Obstruction
    • Skin Tumors
    • Orbital Tumors
    • Blepharospasm
    • Pterygium
    • Anophthalmos and Microphthalmos
    • Enucleation and Evisceration
    • Exenteration
    • Symblepharon
    • Congenital Anomalies - Lid Disorders
    • Acne Rosacea
    • Trauma
    • Infections
  • Non Invasive
    • Photorejuvenation
    • Aerolase Laser
    • Botox
    • Radiesse
    • Restylane
    • Juvederm
    • Fractional Carbon Dioxide CO2 Laser
    • Fractional Resurfacing Lasers: Erbium lasers
    • Laser Hair Removal
    • Kybella
    • Chemical Peels
    • XEOMIN ®
    • Voluma
    • LATISSE EYELASH TREATMENT
    • Leg Veins and Spider Vein Treatment
    • Sculptra
    • Neck and Chest Cosmetic Concerns
    • Dysport
    • Accent Radiofrequency
    • Microdermabrasion and Light Chemical Peels
    • Melasma
    • Laser Tattoo Removal
    • Color and Texture Issues – Brown Spots on Face, Redness
    • Scars and Acne
    • Permanent Cosmetic Makeup
  • Resources
    • Patient Forms & Downloads
    • Out Of State and Overseas Patients
    • Reviews
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Anophthalmos  and Microphthalmos

What is Anophthalmos and Microphthalmos?

Anophthalmia is a medical term used to represent the absence of the globe and ocular tissue from the orbit. It may be congenital, where a child may be born with no eye or associated structures, or it may be acquired, when
​an eye is lost to trauma or surgery.
Picture
Normal orbit and contents
"Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love..."  D. Rock  63 Yrs Old with Fat Droopy Eyes - Salt Lake City, UT
Picture
Anophthalmis with no globe present. Some vestigial structures suggesting rudimentary extraocular muscles are present.
Microphthalmia is where a child is born with a rudimentary eye. There are vestigial tissues, albeit of great importance to the body. The presence of even the smallest of rudimentary eyes allows the surrounding tissues to grow and should always be preserved. ​

ANOPHTHALMIA
Anophthalmia ( A medical term used to represent the absence of the globe and ocular tissue from the orbit ) can be congenital (present at birth) or acquired later in life. Congenital anophthalmia can occur alone or along with other birth defects. Cases of Anophthalmia could result from inherited genetic mutations, sporadic genetic mutations, chromosome abnormalities, prenatal environmental insult or unknown.

​True or primary anophthalmos is very rare. Only when there is complete absence of the ocular tissue within the orbit can the diagnosis of true anophthalmos be made. Extreme microphthalmos is seen more commonly. In this condition, a very small globe is present within the orbital soft tissue, which is not visible on initial examination.
Anophthalmia and microphthalmia could occur secondary to the arrest of development of the eye at various stages of growth of the optic vesicle. It is important to recognize microphthalmia because the development of the orbital region, as well as the lids and fornices, is dependent on the presence of a normal-sized eye in utero. Anophthalmia is may be a clinical characteristic of Trisomy 13 which is a Gross Chromosomal Abnormality.

 (Anophthalmia is very rare but the exact incidence is unknown. One report from a prospective study of 50,000 newborns found an incidence of microphthalmia of 0.22 per 1,000 live births)
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Acquired Anophthalmos

Acquired anophthalmos is where an eye is lost (removed) secondary to:
  1. trauma
  2. infection
  3. tumor (such as retinoblastoma, choroidal malignant melanoma)
  4. advanced ocular disease (corneal disease, advanced resistant glaucoma)
"I had a excellent eye lift done by Dr. Patel. He knows what he is doing and is very pleasant. Dr.Patel was easy to get an appointment and he works with you. The office staff was very pleasant and made you feel calm."  D. Gull Highly recommended for eye lift surgery - Salt Lake City, UT

How is Anophthalmos Managed?

When there is true anophthalmos (no eye and no rudimentary eye), it is important to encourage growth of bones as well as soft tissues. In the presence of true anophthalmos, there may be rudimentary eyelids and eyelid structures. An orbital expanding implant is inserted with sequential expansion of this implant to allow pressure to be exerted on the surrounding orbital bones and thereby encourage growth. Similarly, soft tissue expansion is encouraged with an anterior conformer.


Together with colleagues in Germany, we have developed the following sequence of managing patients with anophthalmos:
​
  1. At about 3 months of age, expansion of the conjunctival lining is commenced by inserting an osmotic expander of hemispheric shape. At birth, a normal eyeball would have a volume of 2.5 ml. Therefore, we try to get that degree of volume in the socket to simulate a normal tissue volume.
  2. At about one year of age, an expanding or expandable orbital implant is placed inside the orbit and expanded sequentially. The aim is to provide pressure on the bony surfaces and expand them. Furthermore, an increasing sized conjunctival conformer is placed with the help of our ocularist.
The eye and the orbit grow the fastest during the first year of life: seventy percent of the increase of the globe’s volume occurs by 4 years of age and 90 percent by age 7 years. The growth of the eye ends at age 14. The growth of orbits ends at age 11 in females and at age 15 in males. ​
Picture
Soft tissue expanders placed to expand the conjunctiva
In some instances, hydrophilic, spheric osmotic expanders are inserted behind the conjunctiva.

​In some instances, bony osteotomies are performed with repositioning of the bone, sometimes with interpositional bone grafts. It is now known that this should not be done until the child in in the mid-teens.

How is Microphthalmos Managed?

It is imperative NOT to remove even a vestigial eye. No matter how small an eye, it is responsible for allowing and encouraging orbital bony as well as soft tissue growth. There has been a tendency in the United States to remove these microphthalmic eye and replace them with solid orbital implants: this is a MISTAKE and should be discouraged.
​

We expand the anterior part of the socket, namely the conjunctival lining and eyelids with appropriate tissue expansion anteriorly. These expanders are sequentially exchanged. Socket reconstruction is only undertaken when maximal growth has occurred, usually by the age of about 15 years. ​
Picture
3-D CT scans allow measurement of bony expansion using expansion techniques.
Picture
Hydrophilic spherical expanders are sometimes combined with injectable “pellet” expanders ((Osmed GmbH, Ilmenau, Germany).

Before & Years After

Picture
Orbital expansion with osmotic orbital expanders and fitting of an artificial eye.

Results!

With appropriate soft tissue expansion in microphthalmos, the appearance can be excellent.

​This young lady was treated with serial expansion for her left microphthalmic eye and socket.
Picture

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Locations: 
​Dr. BCK Patel MD, FRCS
​1025E 3300S
Salt Lake City, Utah 84106, USA

(801) 413-3599 (phone/text)
E: [email protected]
bckpatel.info

Dr. BCK Patel MD, FRCS
617 E Riverside Dr Suite 101
​Saint George, UT 84790, USA
(435) 215-0014
​E: [email protected]
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Conditions

Aging Of The Face
Aging of Lower Eyelids
Aging of the Forehead and Brows
Aging of Eyelashes
Aging of the Cheeks
Aging of the Neck
Aging of the Lips
Aging of the Mouth
Aging of the Chin
Aging of Eyelashes
Aging of the Hands
Aging Of Skin Colour
Aging Of Hair
​Aging of the Jowls
Aging of Men
Aging of the Skin
Aging of Veins and Vessels
Scars

Cosmetic

Facelift
Browlifts
Lower Blepharoplasty/Hammock Lift
Upper Blepharoplasty
Midface Lift/Hammock Lift
Necklift
Lips
Mouth
Neck Liposuction
Fat Transfer
Skin Resurfacing
Cheeks
J-PLASMA SKIN RESURFACING
J-PLAZTY FACE
Removal of Moles, Lesions, Tags, Cysts and Blemishes
Facial Implants
Otoplasty, Ear Pinning, or Bat-Ear Repair
​Complications?

Reconstruction

​Entropion
Acquired Ptosis
Ectropion
Congenital Ptosis
Blepharospasm
Anophthalmos and Microphthalmos
Thyroid Eye Disease
Enucleation and Evisceration
Nasolacrimal Duct Obstruction
Symblepharon
Congenital Anomalies - Lid Disorders
Acne Rosacea
Trauma
Infections
Skin Tumors
Orbital Tumors

Non- Invasive

 Photorejuvenation
Aerolase Laser
Botox
Laser Hair Removal
Kybella
Juvederm
Chemical Peels
Fractional Carbon Dioxide CO2 Laser
XEOMIN ®
Voluma
Latisse Eyelash Treatment
Leg Veins and Spider Vein Treatment
Sculptra
Neck and Chest Cosmetic Concerns
Restylane
Dysport
Accent Radiofrequency
Microdermabrasion and Light Chemical Peels
Melasma
Fractional Resurfacing Lasers: Erbium lasers
Color and Texture Issues – Brown Spots on Face, Redness
Laser Tattoo Removal
Radiesse
Acne
​Permanent Cosmetic Makeup

VIDEOS

links
​
www.hammocklift.com

WWW.PATELFACELIFT.COM

www.englishsurgeon.com

www.drbhupendrapatel.com
​
bckpatel.info

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Patel Plastic Surgery  .  Copyright 2022 . All Rights Reserved
  • Home
  • Locations
    • Plastic Surgery Salt Lake City
    • Plastic Surgery St. George
  • Conditions
    • Aging Of The Face
    • Aging of Lower Eyelids
    • Aging of the Forehead and Brows
    • Aging of Upper Eyelids
    • Aging of the Cheeks
    • Aging of the Neck
    • Aging of the Lips
    • Aging of the Mouth
    • Aging of the Chin
    • Aging of Eyelashes
    • Aging of the Hands
    • Aging Of Skin Colour
    • Aging Of Hair
    • Aging of the Jowls
    • Aging of Men
    • Aging of the Skin
    • Aging of Veins and Vessels
    • Scars
  • Cosmetic
    • Facelift
    • Browlifts
    • Lower Blepharoplasty
    • Upper Blepharoplasty
    • Midface Lift/Hammock Lift
    • Necklift
    • Cosmetic Surgery for Men
    • Lip Lines
    • Lips
    • Mouth
    • Neck Liposuction
    • Fat Transfer
    • Skin Resurfacing
    • Cheeks
    • J-PLASMA SKIN RESURFACING
    • J-PLAZTY FACE
    • Removal of Moles, Lesions, Tags, Cysts and Blemishes
    • Facial Implants
    • Otoplasty, Ear Pinning, or Bat-Ear Repair
    • Complications?
  • Reconstruction
    • Acquired Ptosis and Dermatochalasis
    • Congenital Ptosis
    • Ptosis in Myasthenia Gravis
    • Blepharophimosis Syndrome
    • Entropion
    • Ectropion
    • Thyroid Eye Disease
    • Nasolacrimal Duct Obstruction
    • Skin Tumors
    • Orbital Tumors
    • Blepharospasm
    • Pterygium
    • Anophthalmos and Microphthalmos
    • Enucleation and Evisceration
    • Exenteration
    • Symblepharon
    • Congenital Anomalies - Lid Disorders
    • Acne Rosacea
    • Trauma
    • Infections
  • Non Invasive
    • Photorejuvenation
    • Aerolase Laser
    • Botox
    • Radiesse
    • Restylane
    • Juvederm
    • Fractional Carbon Dioxide CO2 Laser
    • Fractional Resurfacing Lasers: Erbium lasers
    • Laser Hair Removal
    • Kybella
    • Chemical Peels
    • XEOMIN ®
    • Voluma
    • LATISSE EYELASH TREATMENT
    • Leg Veins and Spider Vein Treatment
    • Sculptra
    • Neck and Chest Cosmetic Concerns
    • Dysport
    • Accent Radiofrequency
    • Microdermabrasion and Light Chemical Peels
    • Melasma
    • Laser Tattoo Removal
    • Color and Texture Issues – Brown Spots on Face, Redness
    • Scars and Acne
    • Permanent Cosmetic Makeup
  • Resources
    • Patient Forms & Downloads
    • Out Of State and Overseas Patients
    • Reviews
    • VIDEOS Patel Plastic Surgery
  • About
  • Blog
  • Contact