Abstract Listings 2024 – European Society of Ophthalmic Plastic and Reconstructive Surgery

Festoons and Periocular lymphatic Edema: what results and complications can be expected after surgery? A Retrospective Study of 14 patients

Author: Pierre ESCALAS
Base Hospital / Institution: Institut Ophtalmologique Sourdille-Atlantique

ePoster presentation

Abstract ID: 24-121

Purpose

To evaluate the cosmetic results and the complication rates following direct skin resection of festoons with lymphatic edema

Methods

This retrospective case series includes 14 patients comprising 5 men and 9 women operated on by the same surgeon (Dr Escalas MD) between 2003 and 2022. Among those patients, 5 patients presented with rosacea, 2 had edema following a previous surgical procedure, 1 had edema after facial childhood radiotherapy, 5 patients appeared to be idiopathic. The procedure involved direct removal of the abnormal infiltrated skin without dissection of the orbicularis. Preoperative and postoperative photographs were taken with the same parameters (light, focal length), retraction, inflammation, induration and thickening were recorded. The follow-ups were conducted at 1, 2, 6 and 12 months postoperatively with the final telephone assessment in 2023 to check for recurrence, were all performed by the same physician.

Results

Complete and enduring results were achieved in 8 cases (57%), albeit with a postoperative edema persisting for an average of 5.6 months. Complete resorption with minimal scarring was obtained in 2 cases (14%). In 3 patients (21%) there was a consistent cosmetic improvement, however with residual edema. There was no result at all in 1 case (7%). Rosacea and edema occurring after previous surgery appear to be risk factors.

Conclusion

Although festoon removal itself is a straightforward procedure, postoperative management can be complicated. Patients should be informed of the potential for partial results as well as the extended edema resolution times.