Blepharoplasty using an attractive assistant

Abstract

Atraumatic stabilization of delicate eyelid skin for visualization and control in the removal of skin and fat is a critical factor in achieving goods results in blepharoplasty. This traditionally requires an experienced and attentive surgical assistant. Doing these procedures without assistance is easily achieved by the adaptation of devices in the Canica Design Inc, Canada, hand surgery system (CHESS) (1). This uses rare earth magnets that are adhered to steel discs taped on the patient’s forehead skin. The magnets hold well to the discs even when covered with a drape. The silicone elastomers cleated in the magnets are infinitely adjustable, and allow precise retraction of the upper lids using a variety of available microretractors to aid in removal of fat. They also provide the necessary traction of the upper lid when a transconjunctival blepharoplasty is carried out (Figure 1). A single finger microhook is shown stabbed through the upper lid skin for atraumatic adjustable fixation. Figure 1) The upper lid is retracted dynamically by a microhook cleated in a CHESS (Canica Design Inc, Canada) magnet fixed on a steel disc on the forehead These simple devices enhance the control of the eyelid in an absolutely precise yet adjustable way to facilitate the atraumatic contouring of fat pads. By simply rotating the magnet the tension on the silicone elastomer is adjusted to achieve visualization without distortion. For upper eyelid surgery it eliminates the need for an assistant. There is potential for similar adaptation of these devices in craniofacial surgery or head and neck surgery with the magnets applied to a fixed metal base plate placed strategically where needed to allow precise controlled retraction of structures.