Laissez-Faire Tutorial

Step by step description of how to choose laissez-faire as a reconstructive technique from Mr Richard Caesar and www.oculoplastics.info

[@esrasanli2613]

What a terrific tutorial! I was discussing this technique with a registrar just today and was so pleased to find this video had been uploaded recently. I will definitely be doing a few of these this year. Thank you!

[@riccaesar]

Esra - So lovely to hear from you! Hope you're settled into your new life in the sunshine. Stay in touch! Best wishes Ric

[@oculoplastica1104]

Brilliant as always Dr. Caesar.

[@lendzubow]

Tremendously helpful and appreciated series of videos. Would you consider producing video instruction for the non- Oculoplastic surgeon such as Mohs surgeons for reconstructive tips and pitfalls regarding both lower and upper eyelid repairs? Thanks.

[@snellen87]

In some reviews they suggest the benefit of laissez faire in concave b areas and problems in convex areas. This ties in with what you described

[@Fotograf110]

Very useful video with clear explanation, thank you so much. Do you biopsy these lesions first to confirm histology? When you are measuring the excision margin do you stretch the skin and mark the line of incision? Thank you once again. Mark

[@riccaesar]

Hi. We should always offer the patient the options of: no surgery, biopsy only or full excision biopsy. If the lesion is a classic BCC then most opt for direct excision biopsy with margin. I set a 4mm margin as my default. The skin is pulled flat, but not stretched. For an equivocal lesion, or one where the excision will cause damage to the lacrimal apparatus I often do a punch biopsy first to see if full wide excision is warranted. Best wishes, Ric

[@burcake.5580]

Dear Dr. Caesar, thank you for this video. I wanted to ask: Which method do you prefer for large medial or total lower lid defects closure/ reconstruction?

[@riccaesar]

Hi I try to use flaps ahead of grafts, so like the V to Y sliding forehead flap and Rhomboid flap for lesions above the medial canthus. Large loss below the canthus can be nicely filled with the paramedian forehead flap, but this is a 2 stage flap with a cosmetically embarrassing first stage and best kept for younger patients with long term gain. Lesions below the canthus take a graft well and the scar can be well hidden with spectacles. Suturing 2 upper lid blepharoplasty skin excisions together to create a large graft has proven to be a win. Total lower lid loss requires a maximal Hughes with either heteropalbebral flap or cheek rotation. 2 stage but very effective. Ultimately the chosen technique is based on the best fit for that patient, taking their skin, age, face, and needs into account. Best wishes. Ric

[@burcake.5580]

Thank you very much for your quick and extensive answer. I wish you a nice holiday season and a happy new year.

[@pawelponiatowski3759]

Grate. Thank you for your lessons. Big fan;)

[@albertochierigo8462]

Thank you for this video. You mention that it is quite important to give patients an estimate of how long the healing process is going to take. How long does it usually take for the wounds shown in this video to heal? Thank you in advance.

[@riccaesar]

Hi Alberto. 2 months to heal over. 6 months to look good. If not looking good at 6 months then all reconstructive options remain open. Best wishes. Ric

[@mohamedmetwally7806]

the absolute elegance

[@elcinkalali5]

Can you ever thınk about a 5-fu treatment for these scars ? after the healıng process or begin about 2 weeks after ? very good video .thank you Sir

[@bodyby2894]

Very nice sir and very useful thank you, I have questions when you this procedure , do you prefer to apply on the wound an ointment or antiseptic or nothing . What is your post operative care.

[@riccaesar]

Hi Mad bob. I usually ask the patient to apply Chloramphenicol ointment 4 times a day for 4 weeks. Some patients prefer to cover the wound while in the wet phase with a dressing. Some patients are allergic to the Chloramphenicol, but can use other moisturisers. At 6 weeks, if the scar is angry, I recommend using Dermatix at night with active massage. Best wishes Ric

[@bodyby2894]

@@riccaesar hi sir Ric , very nice is clear thank you for your answer

[@bhavyavejendla8127]

Thank you so much sir

[@arwam9404]

Thanks a lot for sharing this idea, it is a nice option that we can add to our armamentarium.

[@anasalrawi3156]

Please sir tell us about your opinion about nonsurgical blepharoplasty...many thanks

[@XxDeanPxX]

What do you think of the Zitteli areas of healing in the face? Can they be applied in reconstructional problems near the eyes?

[@riccaesar]

Hi K S, yes. All the principles of healing apply. Especially that concave areas heal better by LF than convex. Best wishes. Ric

[@hiso1981]

Amaizing! Thanks a lot!

[@Mosaferian]

Great presentation👌👌👍👍🤠🤠

[@salwaa.a574]

Please could you show how lift the out corner of eyes .circular shape is happen after surgery for lower eyelid .before surgery my eyes almond has shape..thank you

[@riccaesar]

Hi. The most important thing to avoid rounding is not to take too much lower lid skin. Then it is essential to tighten the lower lid. A canthopexy or full lateral tarsal strip work well. Both are on my channel. Best wishes. Ric

[@salwaa.a574]

@@riccaesar thank you for your interested really I hope to visit your office .I will feel confidence under your hands

[@MrHassaanjd]

Lovely

[@anasalrawi3156]

Thank you sir

[@zorekhala3084]

Patient at 6:30 he looks that he doesn't have latral canthus ? The results were suprising really 😶

[@ttatian]

Cuanto vale la cirujia

[@ttatian]

Hola yo quiero tener los ojos mas grandes y almendrados