Thank You Plastic Surgery
Hello everyone, I'm a board-certified plastic surgeon, Dr. Kim Hyung-seok
Hello, also a board-certified plastic surgeon, I am Dr. Hwang Soong-oh
Today we will talk about
A rather serious topic
There are cases of medical complication
Where people lose their eyesight after a plastic surgery
They're being reported every few years
Even a while ago...
(Heartbreaking news of losing eyesight) There was a news about losing eyesight on one eye after the eye surgery
And many of you are curious about this
So today we'll cover this
What happened that
It led to losing one's eyesight?
Is what we'll be covering today
Thank You Plastic Surgery
Dr. Hwang, looking at this photo
We see the stitches under the eyes
So we can assume that he had a lower blepharoplasty
What could be the complication here?
I say, most probably, retrobulbar hemorrhage
Leading to pressure on arteries around the retina
Could've caused the loss of sight
So the term is retrobulbar hemorrhage
So what is the mechanism?
Please give us more details
In order to do that
We need to learn the shape of the eye socket
It is a space where the eyeball is placed
The compartment syndrome* inside the eye socket (*dicreased capillaries perfusion due to increase in tissue pressure within a closed compartment)
Is the mechanism behind the retrobulbar hemorrhage
Let me break it down a little more
The eye socket is like a room for the eyes
There are blood vessels, nerves, muscles around the eye
And other important tissues
When the blood fills in the back of the eye, it increases pressure
Which presses on blood vessels or nerves
Which it may lead to blindness
What plastic surgery can lead to this retrobulbar hemorrhage?
Please, Dr. Hwang.
(For reconstruction) It is generally known that
It could happen during an orbital fracture repair
For plastic surgery; lower blepharoplasty
Or under eye fat repositioning
Could induce such conditions
So compared to double eyelid surgery, ptosis correction or infrabrow excision blepharoplasty
Which treat the upper eyelid
The under eyelid surgery, espeially lower blepharoplasty
Which treat a bigger area under the eyes
Could have a higher chance of
An accident happening
After lower blepharoplasty
Or lower eyelid fat repositioning
Q. From what kind of symptoms should we suspect retrobulbar hemorrhage?
Please explain the symptoms
The first symptom is pain
Which occurs from raised blood pressure behind the eye
Also with the pain and the pressure
The eyes might bulge out a little
Other than that, bruises could be found on the eyelid
Or chemosis (eye swelling) might occur
And negative effects to the vision might happen
For example, the field of vision could narrow
or the perception of light and objects could degenerate
If if gets worse, loss of vision
can occur as well
[Symptoms of retrobulbar hemorrhage] Severe pain, eye bulging, eye surface swelling
bruises on the eyelid, and probems with vision
If these symptoms appear
it's crucial to talk to your doctor ASAP
or visit the emergency room
and get your eyes checked and treated
Q. How common does the retrobulbar hemorrhage occur and how high is the risk of losing vision?
This question must be the one
which all patients who have surgery would want to know about
We’ve searched through some reports
The first report we will share analyzed
the frequency which loss of vision occured, not in plastic surgeries
but in orbital fracture surgeries
It says that 2 out of 1180 had the problem
The report here for orbital fracture
researched in more of a serious external damage
or circumstances that could
cause a lot of bleeding
So in other words, 1 out of 500 experiences
retrobulbar hemorrhage after
a big surgery like an orbital fracture
compared to minor plastic surgeries
Another research says
5 out of 400 patients experienced retrobulbar hemorrhage, right?
Yes. That research was published by ophthalmology specialists
It says 5 out of 426, that is about 1.2%
but it says those 5 had undergone emergency surgery
and recovered well without loss of vision
That’s right. After orbital fracture surgery,
patients are taken care at the hospital
and treated fast
which significantly lowers the risk of going blind
So, while it is best to avoid retrobulbar hemorrhage all together
but even if one experience it, if treated well and fast
(if treated fast) The risk of losing vision is very low
Q. What should be done when one suspects retrobulbar hemorrhage?
If symptoms show
lowering the eye pressure is the first thing to do
If symptoms show after lower blepharoplasty
or lower eyelid’s fat repositioning, we would cut open the surgery area again
and remove the blood, and find the damaged blood vessel
to try to stop the bleeding is one of the most important steps
That’s right. When bleeding occurs and coagulates
it causes increase in the pressure
So if there’s a hematoma, it needs to be removed
Or if there is a bleeding spot
stopping the bleeding is important
The best way is preventing retrobulbar hemorrhage in the first place
or finding it
as fast as possible
Q. How can we prevent from getting retrobulbar hemorrhage?
It's quite obvious
but it’s crucial to control bleeding during the surgery
and check well during the surgery
to see if there’s bleeding
But, even if there’s no sign of bleeding during surgery
bleeding might occur later
due to various reasons
So, patients should also avoid certain things to prevent future bleeding
For example,
[How to prevent bleeding] Apply an ice pack, do not raise pressure in the head, do not lie down flat
but instead keep the upper body slightly inclined
Even if doctors control bleeding well
if patients take certain types of medicine that could cause bleeding
or coughs hard, or suddenly lower the head
or move in a way that raises pressure in the face area
the risk could increase
Therefore, it’s very important for patients themselves
to prevent bleeding
after the surgery
It is true that plastic surgeries
are performed with a good reason
and to achieve
good results
But please remember
any kind of surgery can have side effects or complications
So when you make your decision
please be aware of these risks
and make a thoughtful decision
Since plastic surgery is very common these days
people tend to take it too lightly
While you shouldn’t be too scared
but also shouldn’t take it too lightly
So, today we learned a bit about retrobulbar hemorrhage
And in the next video, we will continue to talk about
the loss of vision that could occur
after fillers or fat repositioning
This was Dr. Kim Hyung-seok
and Dr. Hwang Soong-oh
Thank you very much
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