Overview

Asians are predisposed to prominent epicanthal folds, which are skin folds covering the inner corner of the eyes. A lower nasal bridge may also bring attention to epicanthic folds.

Bambi surgery is used for eyes that require numerous procedures, such as Ptosis correction, Epicanthoplasty, Lateral Canthoplasty, and Lateral Hotz Canthoplasty.

All surgical operations to attain the required size and shape are performed on the top of the eye as well as up, down, left, and right. Take note of the eye's features and proceed through the procedure to balance the face. You can make enormous, lovely, and adorable Bambi eyes.

 

What are the Eyelid structures?

Eyelid, moveable tissue composed mostly of skin and muscle that shields the eyeball from mechanical harm while also contributing to the moist chamber required for appropriate conjunctiva and cornea function. The conjunctiva, like the cornea, is a mucous membrane that covers the visible region of the eyeball and borders the eyelid (the transparent part of the eyeball that covers the iris and the pupil). A fibrous plate known as a tarsus supports each eyelid, as do muscles that move the eyelids and meibomian (or tarsal) glands that release lubricating fluids.

The lids are skin-covered, mucous membrane-coated, and framed by a fringe of hairs, the eyelashes. The action of the orbicularis oculi, a circular lid-closing muscle, and the levator of the upper lid, a lid-raising muscle, causes the lids to move. The facial nerve (seventh cranial) sends closure impulses, whereas the oculomotor nerve (third cranial) sends opening impulses. The meibomian glands' oily fluid (called sebum) keeps the lid margins wet. This secretion is absorbed into the tear film and contributes to the reduction of evaporative tear loss.

 

What are Components of Bambi Eylid surgery?

• Ptosis Correction: Lifting and tightening of the levator muscles in the eyelid to open up the eye larger and wider for a more clear, beautiful eye opening.
• Epicanthoplasty: Removing the front Indian fold to create an effect that makes the eyes look bigger.
• Lateral Canthoplasty: Cutting the outer edge of the eye to broaden the widths. It creates a longer horizontal length of the eyes.
• Lateral Hotz Canthoplasty: Creating bigger eyes by adjusting the angle of the eyes and expanding the length of the eyes

 

What Makes Bambi Eyelid Surgery So Special?

First, increasing the size and contour of the eyes with ptosis correction to the double eyelid crease.

Second, make almond-shaped eyes with intricate designs: Rather than making artificial round eyes, create a pleasant almond-shaped eyes with details of variations in eye motions, pupil exposure, and face characteristics for naturalization.

Third, without having to worry about the knot unraveling, clear double eyelids: the knot is securely secured on multiple locations for double eyes. Furthermore, finishing a crisp crease line since it is meticulously crafted from beginning to conclusion.

Fourth, Bambi surgery without fear of reattachment: There have been several examples of reattachment performed by just cutting the skin. However, in Bambi surgery, doctors perform a thorough incision inward to the conjunctiva, remove the tissues cleanly, and reattach to the periosteum, so there is little risk of recurrence.

 

Advantages of Bambi Eye Surgery?

1. Big and defined eyes: Right, left, top and bottom eye surgery at the same time to improve the eye size.
2. Surgery made for your eye type: Customized surgery in consideration of the eye ratio and the location of the pupils.
3. Almost no risk for recurrence: Firmly fixed; Without a need to worry about reattachment nor released.
4. Minimized Scars: Minimized incision; Almost no scars.
5. Quick recovery: Faster recovery; Almost no bruising or swelling.

 

What is Epicanthoplasty?

 

Epicanthoplasty is a straightforward surgical procedure performed to remove these unsightly folds. Although a moderate expression of the epicanthal fold is a defining and appealing feature of the Asian eye, a more prominent expression of the epicanthal fold can lead the eyes to appear too widely apart, round, and small. In this instance, double eyelid surgery and Epicanthoplasty may be needed.

Epicanthoplasty involves rearranging the tissue between the lower eyelid and the inner eye, revealing the medial canthus and medial palpebral fornix and enlarging the palpebral fissure. Epicanthal fold surgery should be performed in a way that minimizes scarring in this important aesthetic region.

Epicanthoplasty is done in two ways:

This type of epicanthoplasty involves cutting into the skin fold in the inner corner of the eye (canthus) to enlarge the width of each eye and therefore close the gap between them. For medial Epicanthoplasty, the skin redraping method is preferred, which entails cutting the epicanthal fold and then separating and suturing the resulting flaps. The epicanthal fold is eventually rectified and erased, giving in a larger and more pleasing eye. This method reduces the risks of hypertrophic scarring and keloid formation, which are unpredictably prevalent in conventional therapies.

• Medial Epicanthoplasty: 

It can be performed on its own or in combination with upper blepharoplasty. It is performed under local anesthesia. The therapy lasts around 30-45 minutes. The sutures are removed after one week. During the one-week period, the patient will be given a special antibiotic cream and advised to reduce physical activity.

• Lateral Epicanthoplasty:

Lateral Epicanthoplasty, on the other hand, lengthens the eye by modifying the slant of the eye by cutting into the outer canthus. This results in a more harmonious look and is recommended for patients who have an undesired upward tilt in the outside eye corner or insufficient sclera visibility (white of the eye).

Like medial Epicanthoplasty, this procedure can be performed alone or in combination with an upper blepharoplasty. The sutures are also removed after one week.

 

What is Ptosis Correction?

Ptosis is the sagging or drooping of a specific area of the body, most notably the eyelid. Ptosis of the eyelids can arise and affect one or both eyelids. It is characterized by the upper eyelid sagging such that it partially conceals the pupil. As a result, you will seem lethargic and fatigued, and your vision will be impaired. In most circumstances, a corrective operation is required to repair the problem and improve eyesight.

A ptosis correction is often advised in this condition. It tries to tighten the sagging eyelid(s) to give you a brighter and young appearance. The treatment is often performed by ophthalmologists who specialize in eyelid surgery. Apart from extensive experience, this type of surgery requires proper care when planning and executing the operation.

 

Eyelid Ptosis Correction

It seeks to raise the top eyelid, which causes blurred vision and an asymmetrical look. This often improves both the vision field and the aesthetic elements. The specialists employ a variety of surgical techniques to elevate the eyelid. The particular approach you adopt is determined on the underlying etiology of ptosis.

To precisely calculate the height of the upper eyelid, maximum calmness and cooperation are required. As a result, the treatment is typically conducted under local anesthetics delivered through the eye. Following the administration of anesthetic eye drops, local anaesthetic is administered directly into the eyelid. This numbs the area where the treatment will be performed.

When it comes to performing the procedure, the physician can opt for either levator muscle advancement or brow suspension surgical approaches. 

• Levator muscle advancement:

This is the most common type of ptosis surgery. It entails making an incision in the natural upper eyelid skin fold. The levator muscle, which raises the eyelid, will be identified by the doctor through the incision. To reinforce it, it is rejoined or pushed forward, and dissolving stitches are employed to protect it. The skin incision in the eyelid crease is sutured with dissolving sutures, which usually come out on their own within a few weeks. You may need to return to the hospital at times to have them removed.

• Brow suspension surgery: 

When a patient's levator muscle is excessively thin or weak, this procedure is used. Some children are born with the disease, while others might develop it as they grow. The top eyelid is attached to the forehead with a plastic substance, such as a non-dissolving suture. The doctor can also take tissue from the upper thigh to use as a sling. The eyelid will then be elevated with the help of the muscles in the forehead. Two incisions on the top lid, two incisions slightly above the brow, and one minor cut on the forehead are required for the surgery.

 

What is Canthoplasty?

Canthoplasty is a treatment that elevates the muscles in the lower lids' outside corners, much like lifting one end of a hammock. Canthoplasty can also be used to change the curve of the eye's outer corner if necessary. To correct the lid laxity, a new lower-lid tendon must be fashioned, which is a more complicated procedure.

Bick popularized the technique of tightening the lower eyelid at the lateral canthus (as opposed to shrinking the eyelid via mid-lid excision) in 1966. Since then, different strategies for reconstructing the lateral canthus have been documented, with variable degrees of success. Unsatisfactory postoperative outcomes have fueled the growth of surgical procedures.

Canthoplasty is a procedure that is done at the eye's outer corner (the canthus), at the area where the lower and upper eyelids meet, also called as the lateral canthus. This meeting place should be near our nostrils, just above the medial canthus, which connects the lower and upper eyelids. This frequently results in a "upward" canthal tilt or slope, resulting in an almond-shaped eye.

 

How You Prepare?

Before scheduling blepharoplasty, you will meet with a plastic surgeon and an eye specialist (ophthalmologist) or a plastic surgeon who specializes in eye treatments (oculoplastic surgeon) to discuss:

• Your medical history. Your surgeon will ask about previous procedures as well as any current or former conditions such as dry eyes, glaucoma, allergies, circulatory disorders, thyroid issues, and diabetes. Your doctor will also ask about any medicines, vitamins, herbal supplements, alcohol, cigarettes, or drugs you are currently using.
• Your expectations. An open talk about your expectations and why you are having surgery can help provide the groundwork for a good outcome. Your surgeon will tell you whether or not the procedure is likely to be effective for you. 

Before your eyelid surgery, you'll undergo:

• A physical examination is required. Your surgeon will undertake a physical examination, which may include measuring portions of your eyelids and analyzing your tear production.
• An eyesight test. Your eye doctor will examine your eyes and evaluate your vision, especially your peripheral vision. This is needed to back up an insurance claim.
• Eyelid photography. Your eyes will be photographed from numerous perspectives. These images help in the operation's planning, analysis of its immediate and long-term consequences, and development of an insurance claim.

And you'll be asked to:

• Warfarin (Coumadin, Jantoven), aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, others), naproxen (Naprosyn), and any other medicine or herbal supplement associated to increased bleeding should be avoided.
• Consult your doctor about how long you should wait before stopping these drugs. Take just the medications advised by your surgeon.
• Stop smoking at least a few weeks before your operation. Smoking may impede your ability to recover after surgery.
• Make plans for someone to drive you to and from your outpatient operation. Make arrangements for someone to stay with you the first night after surgery.

 

Bambi Eyelid Procedure

An eyelid surgery procedure includes the following steps:

Step 1 – Anesthesia:

During the surgical process, you will be given medications to help you relax. There are two options: intravenous sedation or general anesthesia. Your doctor will advise you on the best option for you.

Step 2 – The incision:

The incision lines for eyelid surgery are meant to disguise the resulting scars within the natural structures of the eyelid area.

An incision within the natural crease of the eyelid might be used to fix the upper eyelid. This enables fat deposits to be removed or repositioned, muscles to be tightened, and superfluous skin to be removed.

Lower eyelid conditions can be treated by an incision just below the lower lash line. Excess skin in the lower eyelid is removed using this incision. Excess fat might be relocated or removed once again.

A transconjunctival incision on the inner of the lower eyelid is another option for correcting lower eyelid problems and redistributing or removing extra fat. No skin is removed with this method.

Step 3 – Closing the incisions:

Sutures or skin glue are commonly used to seal eyelid incisions. Sutures are removed after a week.

To minimize discoloration of the lower eyelids, your surgeon may also recommend a laser or chemical peel.

Step 4 – See the results:

As swelling and bruises lessen, the effects of eyelid surgery will show a smoother, better-defined eyelid and surrounding region, as well as a more alert and rejuvenated look. 

 

What Happens After Bambi Eyelid Surgery?

Following the treatment, your eyes are covered with a temporary protective covering. When you remove your protective eye shields after your procedure, you will notice that your vision has become blurred. This is because an antibiotic ointment is used to protect your eyes from drying up during surgery. To avoid infection, you'll be given this ointment and instructed to put it inside your eye and on your incision many times every day.

You will be instructed to bring someone to surgery who will drive you home. It is advised that you have someone stay with you for the first day or two after surgery since you will be most comfortable with your eyes closed and protected by eye shields.

Recovery from a Bambi surgery is comparable to that of other eyelid surgeries, it usually takes two to three weeks. Most patients report edema and bruising, which go away within two weeks but may take many more weeks to completely recover. After a few months, the complete results will be seen

It is critical to follow your doctor's post-op instructions at this time to avoid complications and harm to the fragile soft tissue surrounding your eyes. To avoid infection, you may be prescribed ointments or eye drops in addition to artificial tears. Steroid drops may be necessary to treat ocular edema.

Recovery may be uncomfortable at first. Your doctor can prescribe pain medication if it is necessary. You can take paracetamol tablets for pain relief. A small amount of blood ooze is normal within the first 24 hours following surgery.

No bending, lifting heavy, or strenuous exercise for 10 days. Swelling is natural and ranges from mild to severe. During the first two days, a cold compress should be used often. Fill a clean dish halfway with cold water, then soak and squeeze a clean facecloth in it. A facecloth should be used to cover the incision. Rinse the cloth in cold water again when it is no longer cool. A cool compress will reduce swelling and pain.

You should avoid taking showers, splashing your face, and wiping your eyes for at least one month after surgery. Strenuous activities should be avoided for at least two weeks, or until your doctor verifies that it is safe to do so. Makeup is usually permitted after two weeks.

Pain, bruising, and swelling are common after eye surgery, but they should subside in 7-14 days. Initially, keep your head up and get as much rest as you can. Patients should avoid from exercising, rubbing their eyes, or applying make-up for two weeks.

People's vision may shift under certain conditions, but this should only be temporary, with normal vision returning without medical intervention. Patients should avoid placing strain on their eyes after surgery by not looking at their phones, reading, or watching TV. Contact lenses should be avoided for many weeks after surgery.

Full recovery typically takes 2-4 weeks, during which time it is vital to follow your surgeon's post-operative instructions and attend any scheduled follow-up appointments. A skilled surgeon would strive to conceal the scar with the natural crease of the eye.

 

Risks & Complications

Of course, any surgery has some risk, although serious problems from a canthoplasty are uncommon. Swelling and bruises are common in the first few weeks following surgery and typically resolve within two to three weeks. You may also have dry eyes, excessive tears, and blurred vision in the weeks following surgery.

During your pre-operative appointment, your surgeon will thoroughly discuss all of the potential risks and complications of your surgical procedure. This information will also be provided in writing to you as part of the consent procedure so that you may review it.

 

Conclusion

Bambi surgery is for eyes that require multiple surgeries including Ptosis correction, Epicanthoplasty, Lateral Canthoplasty and Lateral hotz Canthoplasty.

Bambi procedure include the following steps: 1)An adequate consultation with doctor in order to accurately identify the preoperative status, 2)Designing the area for surgery based on the test results and consultation, 3)Able to open the eyes properly by pulling the  tied eye muscles and tarsal plate, 4)Completion of larger and charming and eyes like Bambi.

After the surgery, you will be given soothing eye drops, antibiotics and medication to reduce pain and swelling. Stitches are removed after a week and you may experience swelling for 1-2 weeks. Social downtime is around 1-2 weeks.