Next conservative uvulopalatoplasty was performed by

Next conservative uvulopalatoplasty was performed by exercising the uvula approximately 3
mm of the posterior edge of the palate. This defect was closed for approximately of upper 1/3
of the tonsillar fauces around over the palate and uvula defects across to the other tonsillar
fauces using chromic suture of running fashion. This completed the tonsillectomy UPPPT
portion of the case. See detailed dictation by Dr. Morphed and patient’s medical record.
The eyelids brow was then injected with lidocaine 1% and 1:100,000 epinephrine. The right
lower eyelid was addressed first. Canthotomy was performed with Wescott scissors follow by
cantholysis. Once the lower canthal tendon had been fully released, a subconjunctival plane
was developed just below the tarsus. After this has been developed, the Desmarres retractor
was inserted and the predisposing dissection was carried out down to the orbital rim.
Dissection just anterior to the orbital rim and just lateral to the infraorbital nerves. Expected
location revealed approximately 1cm or slightly smaller lobulated purplish mass. Brow
dissection around this mass delivered from the surrounding tissue without difficultly. No
bleeding was encountered during excision of the mass. The mass was passed off as a
permanent specimen.
Next the orbital septum was incised, and fat was removed from the nasal middle and temporal
compartment down to the level of the orbital rim. Bipolar cautery was used to obtain
meticulous hemostasis. A similar dissection and excision of fat was carried out on the left side
with the only difference being that there was no mass to be excised. A four vicryl suture
which was the utilized to reach the lateral canthal tendon to the periosteum of the lateral
orbital rim. Slight positioning was used to allow for slight relaxation in the post-operated.
These suspensions were performed bilaterally.
Next the preoperative replaced marking on the upper lids for skin excisions were addressed.
A 15 blades scalpel was utilized to one side down through the skin to the orbicularis oculi
muscle. The lower end of the incision was approximately at the superior edge of the tarsus,
and the upper end was approximately 8mm above the maximum dimension. Once the