who present with pruritus during the healing phase, an antihistaminic drug should be prescribed to avoid scratching.

18.7.5 Eyelid Skin Infection

The author’s experience has seen one case of a localized infection to the eyelid skin. This case was treated with Ciprofloxacin for 1 week. The healing process was delayed beyond the normal 8 days, though without permanent complications. At the time that the bismuth layer was removed, an eyelash was found below the infected lid, and described as the inciting event.

18.8 Discussion

Today, more than ever, the public cares about appearing healthy and attractive. Eyes play an important role in the overall expression of the face. Eyes display feelings and emotions, and may be considered the window to the sole. Aging of the region surrounding the eyes may make a patient appear either sad or tired. In the distant past, eyelid surgery was performed in order to remove lesions, though the last 60 years saw aesthetic surgical blepharoplasty blossom. Eyelid rejuvenation surgery has many indications and when properly done brings excellent results. There are, however, some features of the eyelids and periorbital area that surgery cannot solve, such as dark circles and crow’s feet. In terms of surgical blepharoplasty, the upper eyelids often show a better result than the lower ones. Chemical

blepharoplasty is a new and unique tool that may be complementary to surgical facial or eyelid rejuvenation, as well as the sole option in selected cases. It is important to state that when chemical blepharoplasty is going to be complimentary to facial or eyelid surgery, there must be a delay of 3 months between procedures.

18.9 Conclusion

Periorbital and eyelid rejuvenation can be performed as a single intervention using the unique dermatologic approach described above, or in combination with surgery. The advantage of this combination technique, in selected cases, is to promote a complete and deep rejuvenation of aging, both clinically and histologically [12]. Plastic or cosmetic surgery, in combination with dermatological techniques, can enhance the results of each other, increase patients’ satisfaction, and avoid certain complications. For example, a patient may be dissatisfied when facial or eyelid surgery was technically well done, but the skin still does not display beauty and a healthy shine. In this case, a dermatologic approach is also required in order to remove the remaining signs of aging such as fine wrinkles or blemishes.

References

1.Baker TJ. Chemical face peeling and rhytidectomy. A combined approach for facial rejuvenation. Plast Reconstr Surg. 1962;29:199–207.

2.Baker TJ, Gordon HL. The ablation of rhytids by chemical means: a preliminary report. J Fla Med Assoc. 1961; 48:451–4.

3.Fintsi Y. Exoderm – a novel phenol-based peeling method resulting in improved safety. Am J Cosmet Surg. 1997; 14:49–54.

4.Hetter GP. An examination of the phenol-croton oil peel. Part I: Dissecting the formula. Plast Reconstr Surg. 2000;105(1):227–39.

5.Hetter GP. An examination of the phenol-croton oil peel: Part II. The lay peelers and their croton oil formulas. Plast Reconstr Surg. 2000;105(1):240–8.

6.Hetter GP. An examination of the phenol-croton oil peel: Part III: The plastic surgeons’ role. Plast Reconstr Surg. 2000;105(2):752–63.

7.Hetter GP. An examination of the phenol-croton oil peel: Part IV: Face peel results with different concentrations of

phenol and croton oil. Plast Reconstr Surg. 2000;105(3): 1061–3.

8.Gatti JE. Eyelid phenol peel: an important adjunct to blepharoplasty. Ann Plast Surg. 2008;60(1):14–8.

9.Epstein JS. Management of infraorbital dark circles. A significant cosmetic concern. Arch Facial Plast Surg. 1999; 1(4):303–7.

10.Truppman ES, Ellenberry JD. Major electrocardiographic changes during chemical face peeling. Plast Reconstr Surg. 1979;63(1):44–8.

11.Rullan PP. The 2-day light phenol chemabrasion for deep wrinkles and acne scars: a presentation of face and neck peels. Am J Cosmet Surg. 2004;21:199–209.

12.Kligman AM, Baker TJ, Gordon HL. Long-term histologic follow-up of phenol face peels. Plast Reconstr Surg. 1985;75(5):652–9.