Patel Plastic Surgery Salt Lake City and St. George
  • 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

Enucleation and Evisceration

What is Enucleation?

Enucleation is the removal of the whole eye, including the contents (lens, uvea, etc) as well as the lining (sclera, cornea). The muscles are detached from the eye before the eye is removed.
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Normal orbit and contents

Results

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Appearance of a left prosthetic eye after a left enucleation and placement of an orbital implant, which is usually covered with sclera and the muscles are attached to the sclera.

Enucleation

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Normal eye.
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Phthysical eye where the eye “shrinks”
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After removal of the eye with enucleation and placement of an orbital implant.
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The prosthetic eye is measured to fit into the conjunctival fornices.
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Placement of the prosthetic eye in front of the implant.
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Cross-section of the orbits showing the orbital implant and the prosthetic eye.
"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

Evisceration

Evisceration is the removal of the contents of the eye whilst leaving the scleral lining with the muscle attached intact:
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Inflamed eye prior to evisceration
Picture
the corneal button is removed
Picture
removal of the cornea
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Incision of the conjunctiva and Tenon’s lining
Picture
the Tenon’s and conjunctiva are undermined up to the equator to allow the tissues to be mobilized forwards.
Picture
the corneal button is removed, followed by dissection within the sclera to remove the intraocular contents which include the lens, the choroid, the retina, etc.
Picture
Posterior dissection behind the sclera.
Picture
dissection posteriorly to remove the intraocular contents
Picture
Evisceration being completed with removal of the attachments at the optic nerve head
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the sclera is “scrubbed” to ensure that no uveal tissue is left behind.
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Cleaning the sclera, followed by relaxing incisions of the sclera to allow the placement of the correctly-sized implant
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Placement of the implant which may be made of hydroxyapatite or polyethylene
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The positioning of the implant is helped by performing relaxing incisions in the posterior sclera
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Layered closure of the Tenon’s fascia and the conjunctiva
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Closure is performed without tension
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Temporary tarsorrhaphy sutures are placed
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a conformer is placed in the fornices
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a patch is placed on the eye

What types of implants are placed in the orbit?

Historically, implants have been made of many materials: magnets, gold, silver, glass, silicone, cartilage, bone, fat, cork, titanium mesh, acrylics, wool, rubber, catgut, peat, agar, polyethylene, hydroxyapatite.


The modern options include the following:

MEDPOR®

MEDPOR® is comprised of a lightweight, porous form of high-density polyethylene, a material with a long history of medical applications. Its unique, highly porous texture allows vessels to incorporate into the enhancement shape, integrating MEDPOR® 
into a patient's tissues. The shape and size can be customized by your surgeon to fit your individual needs. MEDPOR® eliminates the need for grafts or silicone implants.
​

MEDPOR® Orbital Spheres
Picture
​We select from sphere implant diameters of 18 mm to 22 mm.

​A resterilizable sizer set is available for selecting the appropriate implant diameter at the time of surgery.

Hydroxyapatite:
Picture
  • The Bio-eye hydroxyapatite (HA) ocular implant is a spherical (ball-shaped) implant composed of natural coralline HA.
  • It is used to replace the volume of the orbit when the eye is surgically removed, or as a replacement implant in patients with a poorly functioning, pre-existing implant.
  • Historically, the use of nonporous synthetic ocular implants has led to complications such as exposure, extrusion, migration, infection, poor motility, and poor cosmesis

Dermis-fat graft

  1. is composed of subcutaneous fat and overlying dermis.
  2. Its advantages include the fact that it is an autologous graft and, thus, lacks concerns for bio-compatibility in disease transmission. However, there is a certain degree of fat atrophy which might possibly occur leading to somewhat unpredictive and result of volume.
  3. Dermis fat graft might possibly be used as a primary procedure following primary reconstruction for orbital exenteration, as a low cost means to provide an orbital implant and in instances in which enucleation is performed early in childhood since the fat might possibly grow and provide stimulus for orbital growth.
  4. Dermis fat graft can also be used in numerous secondary procedures such as a replacement of an extruded orbital implant and correction of deep superior sulcus deformity.
  5.  The surgeon might possibly choose one of several donor sites including the lower abdominal quadrant and the outer ​
  6. quadrant of the buttock.
  7. Typically a graft is measured approximately 25 mm in diameter. The epidermis might possibly be abraded with the derma-brader or with a #15 blade.
  8. ​The graft is harvested with an attempt to minimize mechanical manipulation of the graft and to quickly insert the graft into the previously prepared recipient bed.
  9. Often the dermis has slight surgical modifications in order to create a dome shape to it which often provides better motility for the prosthetic implant.

Picture
Picture
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Porous implants of various types are used, including porous polyethylene implants
Picture
Hydroxyapatite implant

What is the prosthetic eye made of?

Prosthetic artificial eye after an enucleation or evisceration by Dr. Bhupendra C. K. Patel MD of Patel Plastic Surgery
Prosthetic eyes used to be made of glass. Because of the incidence of breakage, most modern prosthetic eyes are made of polymethylmethacrylate. The prostheses are polished every six months or so by the prosthetician.

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"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
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Find Us

Locations: 
​Dr. BCK Patel MD, FRCS
​65 Mario Capecchi Drive
Salt Lake City, Utah, US
(801) 585-6641

Dr. BCK Patel MD, FRCS
617 E Riverside Dr Suite 101
​Saint George, UT 84790
(435) 215-0014

Let Us answer your questions

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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

WEBOFSCIENCE

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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