If you're an ASOPRS Member, Surgeon or Trainee and are interesting in hosting a podcast episode, please submit your idea by visiting: asoprs.memberclicks.net/podcast

About the Guests:

Kelsey A. Roelofs, MD - An oculofacial plastic surgeon and Assistant Professor of Ophthalmology at the University of Alberta in Edmonton, Canada.

Catherine J. Hwang, MD - An oculofacial plastic surgeon at Cleveland Clinic Foundation Cole Eye Institute.

Marie B. Somogyi, MD - An oculofacial plastic and reconstructive surgeon in private practice in Austin, Texas at Eyelid and Facial Plastic Surgery, and an affiliate faculty member in Ophthalmology at the University of Texas Dell Medical School.

Jonathan Hoenig, MD - An oculofacial plastic surgeon and Aesoppers fellowship director in private practice in Beverly Hills, California, and an affiliate professor of ophthalmology at the University of California, Los Angeles.

Episode Summery

In this episode of the Oculofacial Podcast, host Dr. Kelsey Roelofs explores a series of insightful discussions with an expert panel on cutting-edge studies in the field of oculofacial plastic surgery, particularly focusing on topics including blepharoplasty complications, orbital implants, and hemorrhage following MMCR.

The conversation kicks off with Dr. Marie B. Somogyi summarizing a study on postoperative hemorrhage following Mueller's muscle conjunctival resection (MMCR). They analyze the implications, risk factors, and offer practical tips for managing such complications. Next, Dr. Catherine J. Hwang sheds light on a robust study from Moorfields Eye Hospital on the efficacy of one-stage orbital volume modification for exposed and non-exposed orbital implants, emphasizing single-stage procedures' advantages.

Continuing on, the discussion shifts to a review of two papers evaluating blepharoplasty complications, led by Dr. Jonathan Hoenig. These papers cover the risk of perforating and penetrating globe injuries during blepharoplasty, underscoring the diverse backgrounds of practitioners and the importance of procedural expertise.

Lastly, the episode delves into a large-scale study on the incidence of strabismus post-blepharoplasty from Massachusetts Eye and Ear, where they explore the potential mechanisms and prevention strategies for diplopia and strabismus following eyelid surgery.

Key Takeaways:

• Postoperative Hemorrhage after MMCR: Hemorrhage occurred on average 4 days postoperatively in around 3% of cases, typically resolving with conservative management without affecting final outcomes.

• Single-Stage Orbital Implant Surgery: Highlighted the success rate and benefits of single-stage surgeries for managing exposed and non-exposed implants and reducing the need for multiple interventions.

• Blepharoplasty Safety - Emphasizing safe practices including the potential complications arising from diverse practitioners performing eyelid surgeries and the necessity of meticulous preoperative planning and procedural caution.

• Strabismus Post-Blepharoplasty: Installation of protocols to identify and mitigate risks related to lower blepharoplasty and its potential impact on extraocular muscles.

• Patient Follow-Up: Importance of close postoperative monitoring to ensure early identification and management of complications, including detailed patient communication and safety briefings.

Produced by Dr. Lilangi Ediriwickrema
Moderator: Dr. Nicole Langelier

Expert Panel Members:
- Dr. Bobby Korn: Incorporating ChatBots into Your Oculofacial Practice
- Dr. Pete Setabutr: Virtual Reality and Surgical Planning
- Dr. Elizabeth Bradley: Facial Reanimation and Face Transplantation

Episode Summary:
Join host Dr. Nicole Langelier in an enlightening episode of the Oculofacial podcast, where leading experts delve into the transformative technologies reshaping oculoplastic surgery. Dr. Bobby Korn introduces the compelling world of large language models and chatbots, illustrating their seamless integration into clinical practice and administration. Dr. Pete Setabutr follows with a discussion on the current and potential applications of virtual and augmented reality in surgical planning and education, painting a futuristic view of surgical training and execution. Dr. Elizabeth Bradley wraps up the podcast by sharing groundbreaking advancements in facial reanimation and face transplantation, highlighting a multidisciplinary collaboration at Mayo Clinic.
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Key Takeaways:
- AI Integration in Clinical Practice: Dr. Bobby Korn highlights the significant role of AI and chatbots in assisting with
administrative duties and clinical care.
- Virtual Reality for Surgical Training: Dr. Pete Setabutr discusses the implementation of VR and AR technologies in enhancing anatomical understanding and surgical precision, with an emphasis on ophthalmology training and education.
- Facial Reanimation Innovations: Dr. Elizabeth Bradley shares advanced techniques such as using palmate longus tendon to support paralytic lower eyelid retraction and platysma muscle grafts with cross face nerve grafts for managing upper eyelid paralytic lagophthalmos. .Dr - Bradley also shares the role of technology and extensive collaboration among various specialties at Mayo Clinic in handling complex facial transplant cases.
- Future of Oculoplastic Surgery: The speakers collectively forecast significant advancements in personalized AI-assisted surgery, comprehensive virtual reality applications, and envisioning a tech-driven transformation in patient care and surgical education.

If you're an ASOPRS Member, Surgeon or Trainee and are interesting in hosting a podcast episode, please submit your idea by visiting: asoprs.memberclicks.net/podcast

If you're an ASOPRS Member, Surgeon or Trainee and are interesting in hosting a podcast episode, please submit your idea by visiting: asoprs.memberclicks.net/podcast

In the first of the TOP Surgical Battle Series, Dr. Natalie Homer (Stanford) moderates a debate between the frontalis sling (Dr. John Ng, OHSU) and frontalis muscle flap (Dr. Richard Allen, TOC Eye and Face) techniques for correction of myogenic ptosis.

In this episode, Dr. John Ng advocates for the frontalis sling procedure, emphasizing its straightforward nature, time-tested effectiveness, and adaptability. Dr. Ng discusses the various materials used, including silicone and fascia lata, and the procedure’s suitability for teaching and clinical practice. He addresses the potential for infection, material failure, and the cosmetic aspects of the procedure.

Dr. Richard Allen alternatively defends the frontalis muscle flap procedure, making a compelling case for its efficiency and durability. He details his comprehensive technique, incorporating elements such as levator resection. He shares his experience on patient outcomes, complications, and long-term results with this procedure.

Key Takeaways:

• The frontalis sling procedure is known for its straightforward approach and adaptability, particularly useful in teaching environments and varying patient anatomies.
• A variety of materials can be used in the frontalis sling procedure, including silicone and fascia lata. Each material has its pros and cons, such as durability and infection risks.
• The frontalis muscle flap procedure can avoid the use of foreign materials, offering a potentially longer-lasting solution. The technique includes levator resection for optimal eyelid contour and function.
• Post-operative care and complication management, including lagophthalmos and dry eye, are critical regardless of the technique used.
• Both procedures have unique indications and may be chosen based on individual patient needs, anatomical considerations, and potential for future adjustments.

Notable Quotes:

1. “The advantage of the [frontalis] sling is…for teaching at a teaching institute. The anatomy and the procedure is a lot easier to teach and has a...shallower learning curve.” - Dr. John Ng
2. “The beauty of a frontalis flap procedure is that you’re making a single incision across the eyelid, at the eyelid crease.” - Dr. Richard Allen
3. “I think that if you don’t do it,…they’re gonna find someone that does.”- Dr. Richard Allen
4. “It’s…representation of how the materials and techniques have evolved over time, balancing traditional methods with newer innovative practices.” (Regarding the frontalis muscle flap procedure) - Dr. John Ng