Do you want to read a detailed post about eyelid surgery? Here it is. With photos.
I find this sort of thing fascinating. I looked for detailed info before my own surgery because I like to know what I’m getting into. If you’re grossed out by surgical/medical descriptions or photos, skip this one. So I had this spot — like a pimple or small wart — appear under my right eye years ago. 2017, 2018? Sometime in there. It was very small, directly under/partially on the lash line near the inside corner of my right eye. Not really noticeable, didn’t hurt or itch or grow or change so I didn’t worry about it 1 . Anyway over the last year it got a bit bigger, so I had it checked out. My dermatologist did a biopsy. Result: basal cell carcinoma. So I needed to have the spot removed. Due to its location, it was likely the lid margin 2 would be affected. So after the removal, I’d need eyelid reconstruction surgery by an ophthalmic surgeon. Here’s how they do it: They schedule the Mohs surgeries 3 in the morning. They schedule the reconstruction surgeries the same afternoon. They do this because Mohs surgeries can take… hours. They don’t know till they’re doing it. The surgeon takes off the cancerous area and a layer of the skin around it, then examines it under a microscope. If they still see carcinoma cells 4 , they take off another layer. Inspect the removed layer. Repeat until there are no carcinoma cells visible in the removed layer. The removal is quick. The inspection takes longer. So each “layer” (removal + inspection) can be over an hour. Once that’s done, they either sew you up there or send you off for reconstruction surgery. I was at the hospital from 7am to 5pm. Most of that time was spent waiting. The Mohs surgery required two layers removed. I was done there around 9:30. They bandaged my eye and sent me off for reconstruction which was scheduled for…. 2:30pm. So, yeah, lots of waiting. Mohs surgery Local anesthetic (needle in the cheek below the right eyelid). They lean you back in a chair and tuck surgical drapes around the area. Assisting docs hold the head still and hold the eyelid open or closed or whatever it needs to be. It’s pretty surreal to see a scalpel coming directly toward your eyeball. But the most surreal part was hearing the snip-snip-snip of scissors knowing it’s my skin that’s being snipped off my face . Pain: none. They gave me another shot of anesthetic right before they patched me up which was nice. Hungry (no eating allowed before the reconstruction surgery). Did some Christmas shopping. Pirate impressions. Thought about food. Went to the bathroom a couple of times to peek under the bandage and make sure my eye was still there. Then the anesthetic wore off so I didn’t need to do that anymore. Contemplated the hierarchy of snacks. Assured 4 different nurses that there is zero possibility of pregnancy, no really, I promise, I do not have a uterus . Speaking of the beast (not) in me: Watched a couple of episodes of The Beast In Me . Looked at the entire Internet. Thought about food some more. Napped a little. Eyelid reconstruction Sedation (via IV) plus local anesthetic. I was very relaxed and full of warm happy thoughts. This part was fascinating: The removal took about half the width of my eyelid rim above the area of removed tissue. They took skin from my left eyelid and grafted it on. To do that, they cut right along the crease of my left eyelid, removed some skin, and sutured the eyelid back together. Then they sewed those two strips of skin (I think it was two, I was a little drowsy) below my right eye, creating a new portion of eyelid rim and filling the hole. Amazing that we can do this stuff. The surgery itself took about an hour. Recovery was quick. I was home eating a giant Chipotle bowl very soon after. It was delicious. Pain: minimal. Took Tylenol that first night and following day, then didn’t need it again. Antiobiotic ointment applied 3x a day. This is annoying as fuck because I have to make sure I get a lot of ointment on that lid margin (very important to keep it moisturized) which means some ointment always gets in my eye so vision is blurred for an hour+ every time I apply. Swelling: yes. Bruising: some. Not as much as I anticipated. Itchy and irritated: YES. OMG. I get the dressing & sutures off tomorrow morning and I CANNOT WAIT. Here’s how it looks today (six days post-op): Oh, what’s that? You were hoping for an EYELID SURGERY RECOVERY MONTAGE of POOR QUALITY PHOTOS documenting the healing process from DAY 1 TO DAY 6 POST-OP? I’ve got that right here for you. Also I did not have health insurance at the time so even if I had been worried about it I probably wouldn’t have done anything. Say you're in the U.S. without saying you’re in the U.S. The eyelid margin is the “edge” of the eyelid. Also known as the mucocutaneous margin. Eyelashes grow from the margin & there are glands that produce oil to help keep the eye moisturized. Detailed explanation of Mohs Micrographic Surgery . Molecular imaging of different skin cancer cells vs normal skin cells. Local anesthetic (needle in the cheek below the right eyelid). They lean you back in a chair and tuck surgical drapes around the area. Assisting docs hold the head still and hold the eyelid open or closed or whatever it needs to be. It’s pretty surreal to see a scalpel coming directly toward your eyeball. But the most surreal part was hearing the snip-snip-snip of scissors knowing it’s my skin that’s being snipped off my face . Pain: none. They gave me another shot of anesthetic right before they patched me up which was nice. Hungry (no eating allowed before the reconstruction surgery). Did some Christmas shopping. Pirate impressions. Thought about food. Went to the bathroom a couple of times to peek under the bandage and make sure my eye was still there. Then the anesthetic wore off so I didn’t need to do that anymore. Contemplated the hierarchy of snacks. Assured 4 different nurses that there is zero possibility of pregnancy, no really, I promise, I do not have a uterus . Speaking of the beast (not) in me: Watched a couple of episodes of The Beast In Me . Looked at the entire Internet. Thought about food some more. Napped a little. Sedation (via IV) plus local anesthetic. I was very relaxed and full of warm happy thoughts. This part was fascinating: The removal took about half the width of my eyelid rim above the area of removed tissue. They took skin from my left eyelid and grafted it on. To do that, they cut right along the crease of my left eyelid, removed some skin, and sutured the eyelid back together. Then they sewed those two strips of skin (I think it was two, I was a little drowsy) below my right eye, creating a new portion of eyelid rim and filling the hole. Amazing that we can do this stuff. The surgery itself took about an hour. Recovery was quick. I was home eating a giant Chipotle bowl very soon after. It was delicious. Pain: minimal. Took Tylenol that first night and following day, then didn’t need it again. Antiobiotic ointment applied 3x a day. This is annoying as fuck because I have to make sure I get a lot of ointment on that lid margin (very important to keep it moisturized) which means some ointment always gets in my eye so vision is blurred for an hour+ every time I apply. Swelling: yes. Bruising: some. Not as much as I anticipated. Itchy and irritated: YES. OMG. I get the dressing & sutures off tomorrow morning and I CANNOT WAIT. Also I did not have health insurance at the time so even if I had been worried about it I probably wouldn’t have done anything. Say you're in the U.S. without saying you’re in the U.S. The eyelid margin is the “edge” of the eyelid. Also known as the mucocutaneous margin. Eyelashes grow from the margin & there are glands that produce oil to help keep the eye moisturized. Detailed explanation of Mohs Micrographic Surgery . Molecular imaging of different skin cancer cells vs normal skin cells.