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.
.
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

This highly engaging episode will give you a comprehensive look at the journey of ASOPRS and the luminaries whose contributions continue to shape the future of this field.

About the Guests:

• Dr. David B. Samimi, MD: An esteemed oculoplastic surgeon based in Los Angeles, Dr. Samimi is driven by his passion for the history and future of oculoplastic surgery. He has trained under many prominent figures in the field and brings a wealth of experience and insightful storytelling to the discussion.

• Dr. Steven C. Dresner, MD: A pioneer in orbital implants and aesthetic surgery, Dr. Dresner is a leading figure in oculoplastic surgery, teaching at USC and known for his captivating stories and deep knowledge of the field’s history. Sadly, Dr Dresner passed away 2 weeks after this recording. We are fortunate to have his animated story telling captured here.

• Dr. Jill A. Foster, MD: Operating out of Ohio, Dr. Foster is renowned for her expertise in both functional and aesthetic surgery. She trained with Bill Katowitz and works at the Ophthalmic Surgery Consultants of Ohio.

• Dr. Michael Hawes, MD: Based in Colorado, Dr. Hawes is celebrated for his innovations in eyelid reconstructive surgeries. He recently retired after a distinguished career, having worked with numerous people and served as a key figure in the field’s development.

• Dr. David M. Reifler, MD: An authority on the history of oculoplastic surgery, Dr. Reifler has documented the evolution of this field via his books. He trained in Manhattan and now enjoys retirement across Austin and Michigan.

Host Dr. David B. Samimi engages with prominent oculoplastic surgeons Drs. Steven C. Dresner, Jill A. Foster, Michael Hawes, and David M. Reifler. They delve into the fascinating history of oculoplastic surgery and its evolution, highlighting the contributions of the founding figures, the development of fellowship training, and the transformative events that have shaped the field today.

Listeners will gain insight into the establishment of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) and how its meetings foster collaboration and progress in this specialized area. The discussion covers both the noble beginnings from war and trauma care and the more personal anecdotes from early days, offering a captivating mix of technical evolution and personal stories within the profession.

Key Takeaways:

• Historical Origins: The roots of oculoplastic surgery tie back to trauma and war, with foundational figures such as Wendell Hughes and Byron Smith pushing the field forward.

• Fellowship Training: Evolution from informal observerships to structured fellowship programs marked significant progress in the specialized training of oculoplastic surgeons.

• Influential Figures: Notable mentors like Dr. Henry Baylis and Dr. Richard Dortzbach significantly contributed to oculoplastic surgery’s growth and modern practices.

• Gender Pioneers: Early female surgeons like Dr. Virginia Lubkin and Dr. Bernice Brown played crucial roles in breaking barriers within the specialty.

• Evolving Practices: The panel discusses the importance of maintaining excellence and mentorship while acknowledging shifts in practice dynamics towards aesthetics and broader surgical capabilities.

Resources:

• Dr. David B. Samimi’s Profile on ASOPRS: asoprs.org

• Dr. David M. Reifler’s Books: “ASOPRS: The First 25 Years” and “ASOPRS: The Next 50 Years” available on the ASOPRS website.

• Jeremiah Tao’s Chapter on Mentorship with the ASOPRS Family Tree: Available in the ASOPRS 50th Anniversary book on asoprs.org

About the Guest(s):

Dr. Richard Dortzbach: A pioneering figure in oculofacial surgery, Dr. Richard Dortzbach, affectionately known as “Dortz,” was the first fellowship-trained oculoplastic surgeon at the University of Wisconsin - Madison. Over his illustrious career, he trained 19 fellows and significantly influenced the field through his contributions to both clinical practice and education. Notably, Dr. Dortzbach held the Pa Noh professorship at UW-Madison and served in numerous leadership roles within the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), including President in 1995.

Dr. Mark Lucarelli: Dr. Mark Lucarelli is an esteemed colleague of Dr. Dortzbach and his final fellow. He has continued the tradition of excellence in oculofacial surgery as a distinguished member of the UW-Madison faculty. Dr. Lucarelli is highly respected for his contributions to both patient care and the education of future oculoplastic surgeons. He has been an ASOPRS fellowship program director since 2005 and served as President in 2020.

Dr. Suzanne van Landingham: Dr. Suzanne van Landingham is an assistant professor of oculofacial surgery at UW-Madison and a former fellow of Dr. Lucarelli. She plays a vital role in ongoing educational efforts and upholding the high standards set by her predecessors.

Episode Summary:

In this insightful episode of TOP (The Oculofacial Plastic Surgery podcast), Dr. Mark Lucarelli and Dr. Suzanne van Landingham sit down with Dr. Richard Dortzbach, a towering figure in oculofacial surgery. They delve into Dr. Dortzbach’s impactful career, exploring his journey as the first fellowship-trained oculoplastic surgeon at the University of Wisconsin - Madison and his extraordinary dedication to teaching and patient care.

From pioneering procedures dating back to the times of Hammurabi to the modern-day complexities of oculoplastic surgery, Dr. Dortzbach discusses the evolution of the specialty. The conversation highlights key milestones such as the establishment and growth of ASOPRS and the invaluable legacy left through his fellowship program. The episode offers a wealth of insights into educational excellence, mentorship, and the profound impact of Dr. Dortzbach’s work on numerous generations of surgeons.

Key Takeaways:

• Evolution of Oculoplastic Surgery: Dr. Dortzbach shares compelling anecdotes about the specialty’s origins,

• including significant contributions from early pioneers and the formalization of ASOPRS.

• The Importance of Fellowship and Mentorship: Emphasizing continuous learning and teaching, Dr. Dortzbach underlines the value of fellowship training and how it has shaped the landscape of oculofacial surgery.

• Scientific Contributions and Publications: Dortz discusses his most impactful research and educational materials, including his seminal textbook and the prestigious White Coat Society.

• Lessons and Aphorisms: Dr. Dortzbach’s pearls of wisdom, such as the necessity of patient-centered care and his distinctive mottos that continue to influence his trainees.

• Balancing Professional and Personal Life: Insights into maintaining a work-life balance and the importance of family and personal milestones in a demanding medical career.

Notable Quotes:

1. Dr. Richard Dortzbach: “The most important thing is to always focus on the patient.”

2. Dr. Mark Lucarelli: “Dortz, you really established the concept of “fellowship family”.”

3. Dr. Richard Dortzbach: “Commitment only, no lip service.”

4. Dr. Suzanne van Landingham: “You’ve also done a lot to foster community in your fellowship graduates.”

5. Dr. Richard Dortzbach: “Education in all aspects is really the key for trainees.”

Resources:

• ASOPRS Website

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 this insightful episode of The Oculofacial Podcast, Dr. Christy Nelson sits down with Dr. Sara Wester and Dr. Parag Gandhi to discuss the exciting and rewarding world of global outreach in oculoplastic surgery. This episode delves into personal narratives from their international experiences, the impact of their work, and the comprehensive efforts led by the ASOPRS Global Opportunities Committee in making oculoplastic care accessible worldwide.

Listeners will discover how Dr. Wester and Dr. Gandhi first got involved in global health initiatives and the profound personal and professional impacts of these experiences. From overcoming logistical challenges to the joy of teaching and learning in diverse cultural settings, the episode is packed with rich, first-hand insights and practical advice. They also discuss current projects, partnerships like the Honduras fellowship with ACE Global, and provide actionable tips for those interested in starting their own global outreach work.

Key Takeaways:

• Getting Started in Global Outreach: Dr. Wester and Dr. Gandhi stress the benefits of starting on a smaller manageable scale and leveraging existing connections and organizations for initial trips.
• Impact of International Work: Personal stories highlight how global outreach can be both humbling and empowering, offering unique opportunities to learn and teach.
• Specific Challenges: Overcoming hurdles such as varying medical equipment availability, cultural differences, and adapting to different surgical environments.
• Sustainable Programs: Both doctors emphasize the importance of education and creating sustainable programs that continue to benefit communities long-term.
• Global Opportunities Committee: The committee’s efforts in providing resources, networking opportunities, and structured programs for ASOPRS members interested in international outreach.

Notable Quotes:

• “I’ve always kind of loved feeling a little bit out of my comfort zone and these opportunities push me in unique ways.” - Dr. Sara Wester
• “Outreach doesn’t always have to be overseas. One can work locally with nonprofits like Lions International to develop programs for the underserved in state.” - Dr. Parag Gandhi
• “ I’ve also seen gratitude in these experiences that is truly unique” - Dr. Sara Wester
• “One should note there are many reasons to get interested in international work. It’s really kind of a very individual driver.” - Dr. Parag Gandhi
• “You have to adapt to different surgical environments, different equipment, and different team structures.” - Dr. Sara Wester

Resources:

• Virtue Foundation: Website
• Orbis International: Website
• Seva Foundation: Website
• Ace Global: Website

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

Podcast Guests:

Dr. Evan Kalin-Hajdu - Assistant Professor of Ophthalmology at the University of Montreal. Dr. Kalin-Hajdu is the host of the current "Oculofacial Podcast Journal Club".

Dr. Bryan J. Winn - Professor of Ophthalmology and Vice Chair and Division Director for Oculofacial Plastic Surgery at UCSF. He also serves as the Chief of Ophthalmology at the San Francisco VA Healthcare System.

Dr. Davin Ashraf - Assistant Professor of Ophthalmology at Oregon Health & Science University (OHSU).

Dr. Kyle J. Godfrey - Assistant Professor of Ophthalmology at Weill Cornell Medicine and the New York Presbyterian Hospital. He is also the Director of the Ophthalmology Residency Program and a member of the Departments of Ophthalmology and Neurological Surgery.

Episode Summary:

Dr. Evan Kalin-Hajdu is joined by Dr. Bryan J. Winn, Dr. Davin Ashraf, and Dr. Kyle J. Godfrey to discuss three key articles from the May-June 2024 issue of the Ophthalmic Plastic and Reconstructive Surgery (OPRS) journal. Their discussions center on short-term versus long-term results of teprotumumab, a more tailored approach to the management of thyroid eye disease, and the nuances of increasingly popular transorbital surgery.

Dr. Winn begins by summarizing an article on teprotumumab for recalcitrant thyroid eye disease. The panelists then discuss the strengths and weaknesses of the paper, highlighting the medication’s short-term effectiveness but raising concerns about its long-term durability. Dr. Ashraf then provides insights into a study that compared teprotumumab versus orbital decompression for thyroid eye disease, highlighting the likely additive effects of these combined treatments, but also raising compelling points about regression of proptosis that was only observed in the teprotumumab group. Dr. Godfrey then wraps up with an in-depth look at a novel transorbital endoscopic approach to the foramen rotundum for infraorbital nerve stripping, emphasizing the technique's potential utility, risks, and anatomical considerations.

Key Takeaways:

• Teprotumumab demonstrates significant short-term (3 weeks post treatment) efficacy in reducing proptosis and clinical activity scores in recalcitrant thyroid eye disease. However, data on long-term durability in this cohort remains unknown.
• Combining teprotumumab with orbital decompression may provide additive benefits for proptosis reduction. Surgical decompression provides the greatest proptosis reduction and does not appear to regress in time. However, patients treated solely with teprotumumab appear to regress within months of therapy.
• The participants discuss a more evidence-based approach to the management of thyroid eye disease, shifting away from the “one size fits all” model. The approach involves an effective short-term disease modulator, such as teprotumumab, followed by a more effective long-term disease modifier, such as tocilizumab or radiation therapy.
• Introducing a transorbital endoscopic approach for infraorbital nerve stripping could expand the surgical arsenal for managing complex orbital and perineural pathologies.