Recent publication out regarding the finding of a new but rare type of orbital tumor we discovered.

I was part of a team of New York Oculoplastic Surgeons who identified a rare type of orbital tumor (located next to the eyeball but within the orbit itself) and the clinical findings and treatment were described in this month's Ophthalmic Plastic and Reconstructive Surgery Journal.  "A rare variant of adenoid cystic carcinoma is the dedifferentiated sarcomatoid form, which has previously been reported in the hard and soft palate, maxillary sinus, submandibular glands, and nasal cavity. The authors report the first case of a dedifferentiated sarcomatoid adenoid cystic carcinoma occurring in the lacrimal gland, that of a 52-year-old man. The patient presented with a 4-month history of diplopia, decreased vision, and right upper eyelid swelling. Radiographic imaging showed a soft tissue mass in the extraconal compartment superolateral to the right eye. The patient subsequently underwent surgical debulking. Histologic examination of the tissue revealed classic cribiform adenoid cystic carcinoma and a sarcomatous component consisting of malignant spindle cells and fusiform cells arranged in whorls. Dedifferentiation is a well-established phenomenon in salivary gland tumors that is associated with aggressive behavior and poor prognosis; however, the exact nature of such dedifferentiated neoplasms remains unclear." 

See Abstract Text in Pubmed.gov.

It's not just females who had an increase in plastic surgery last year, but also men.

More and more men are seeing plastic surgeons for either non invasive procedures (such as Botox and subdermal fillers such as juvederm, restylane, fat injections) or surgical procedures such as blepharoplasties (eyelid lifts) and face lifts.   The baby boomers are now at the age of noticing their aging changes and want them addressed, male or female.  Believe it or not, up to 20% of my Facial Aesthetic practice is males in their 30's to 50s that come in for Botox and fillers (juvederm and restylane).  The most common reason I see males is for Botox to their forehead and eyelid crows feet wrinkles.  In general, males end up needing more Botox for a particular area than woman do.  But at the end of the day, the feedback is that the males enjoy looking "less-tired" at work and have less of the "frowning" appearance.  All of these surely equates to better performance at work!

Read more here

Learning to See the Strike Zone With One Eye

A very inspiring story of an college athelete who lost his eye from an injury while playing baseball.  Despite the thought that he would never play baseball again, he is and playing at the level if not better than before his injury. Read more in NY Times.

Orbital fractures are commonly seen in trauma

I am often involved in the repair of orbital fractures, which occur from trauma such as car accidents, falls, and assaults.  The orbit is a series of bones that comprise the wall (or socket) that contains the eyeball and other important contents that allow us to see and move our eye in all directions. Parts of the orbit are more prone for injury (such as the floor, which has a paper thin bone that can often break with force that usually doesn't break other bones in the rest of the body. Such fractures may need to repaired when they result in double vision, difficulty seeing, or deformity of the socket or eye.  The surgery involves exploration of the fracture and reparing it. I use various materials to repair the fracture depending on its size and patient factors. Implant materials range from titanium mesh, Medpor implants, and calvarial bone graft (bone graft taken from the calvarium or skull). 

Figure 1. CT scan showing a large orbit floor fracture

Figure 3.  Intraoperative photo taken showing the repair of the orbital fracture. In this case, the fracture was so large that a titanium mesh with bone graft was used to repair the fracture.

The arrow indicates the mesh being placed into the orbit.

Medical tourism--it's cheap but beware of the risks!

More and more Americans are going to Asia for cosmetic surgery, where surgical procedures such as rhinoplasty or Asian eyelid surgery are the cost of what they are here in the States. There are serious risks to having surgical procedures overseas--it's not so much the risk for the surgery but more so the complications that can occur when the patient returns back home.   Read more in the LA Times.

Selphyl Injections---the modern Vampire Face-Lift???

More and more physicians are offering Selphyl injections in their office to patients as an alternative to other fillers (such as as fat injections, Juvederm, Restylane, and Sculptra). It is a filler that is composed of your own blood cells after it is spun down using a centrifuge and reinjected into the face to help stimulate collagen.  It appears safe but the question is whether it is really effective for long term rejuvenation??? Studies are currently being conducted to evalute its long term effects. Read more in the NY Times.