Xanthelasma Removal in London
Treating your eyelid cholesterol deposits
Xanthelasma palpebrarum are yellowish papules and plaques that can appear on the eyelids and lower eyelids due to cholesterol deposits in foam cells and lipid-laden histiocytes in the reticular dermis of the skin.
These lesions are not harmful and are painless, though they can have an impact on the individual’s appearance and may affect their confidence. Although there is little evidence to suggest that Xanthelasma palpebrarum is associated with high levels of cholesterol in the blood, it is still recommended to do a simple blood test to check total cholesterol and lipid levels.
Usually, the lipid metabolism is normal. Blood glucose levels should also be checked to rule out diabetes mellitus. If the Xanthelasma progresses to form nodules, this may be termed a Xanthoma.
Xanthelasma lesions may also be classified as a Xanthoma subtype. Xanthelasma is diagnosed following an assessment from a doctor who is familiar with the condition.
Other rare cases and inflammatory skin disorders that may appear similar include Sebaceous Cysts and, less commonly, Sarcoidosis, Necrobiotic Xanthogranuloma, Syringoma, Sebaceous Hyperplasia, Erdheim Chester, Lipoid Proteinosis, and adult-onset Asthma with Peri-ocular Xanthogranuloma Syndrome.
Treatment options for the yellowish plaques associated with Xanthelasma palpebrarum are available and multiple options may be discussed with a doctor.
How Xanthelasma are removed?
Xanthelasma palpebrarum can be left untreated if they are not causing any discomfort. However, they may increase in size over time and can be treated with various methods.
Chemical peels using topical Trichloroacetic acid can be applied to the affected area, or surgical excision may be performed. Laser treatments such as Carbon dioxide or CO2 laser, YAG laser, and liquid nitrogen cryotherapy are other non-surgical treatments, although they can cause scarring.
Some doctors may offer laser or cryotherapy treatments, but this is less common. Mr. Ahmad Aziz prefers chemical peels or surgical excision, and performs these procedures in Eyes Defined clinic located in London.
Why is a chemical peel done?
If you’re looking for an alternative to surgery to remove xanthelasma, you might consider a trichloroacetic acid chemical peel. This treatment works by applying the peel to the affected area, which can cause the xanthelasma to lighten in color and the surrounding skin to become slightly inflamed.
Over a period of several weeks, the yellowish plaques may reduce in size. This treatment is most effective when the area is small and not too close to the eyeball. You may need to repeat the treatment a few times to completely remove the xanthelasma.
How you prepare?
Before xanthelasma is surgically removed, you will meet with an eye plastic surgeon who specializes in xanthelasma to discuss:
Before undergoing Xanthelasma surgery, it is important to stop taking any medications that can increase the risk of bleeding, such as aspirin, ibuprofen, warfarin, apixaban, and other similar medications.
Your doctor will go over these medications with you to make sure it is safe to stop taking them prior to surgery. In addition, it is also recommended to quit smoking several weeks before the surgery, as this can help improve the healing process after the procedure.
Finally, you should also make sure to arrange for someone to drive you home after the surgery and stay with you for the first night after the operation.
What are the risks?
To understand your individual risks for Xanthelasma and decide if surgery is the best option for you, it is important to talk to your doctor. Your doctor will discuss your medical history and may order blood tests to check for high cholesterol, triglyceride levels, and other lipid disorders.
They will also assess your risk for diabetes, nephrotic syndrome, and atherosclerosis, as well as other cardiovascular risk factors that may increase your risk of myocardial infarction or ischemic heart disease. With this information, you and your doctor can decide together if Xanthelasma surgery is the right option for you.
Why is surgery done for Xanthelasma?
Xanthelasma removal surgery may be a viable option if:
- You have excess skin in the upper eyelids around the Xanthelasma
- The Xanthelasma is very close to the eye making a Tricholoracetic acid peel difficult
- Tricholoracetic acid peel has been tried and has not been successful in removing the Xanthelasma entirely,
- Need an instant removal of the Xanthelasma.
Insurance coverage for Xanthelasma removal surgery may depend on your policy, as it is usually done for cosmetic reasons and cannot be used to improve vision.
What you can expect before the procedure?
Xanthelasma removal surgery is usually performed as an outpatient procedure, meaning you can go home the same day. Before the procedure begins, your surgeon will inject local anesthetic into the eyelids to numb the area, and you may be given medication through an IV to help you relax. You can see previous cases before and after
What you can expect during the procedure?
Your surgeon will make an incision along the Xanthelasma-affected eyelid, removing any excess skin and fat. The resulting scar is carefully placed in the natural eyelid crease in order to minimize its visibility.
Depending on the location of the Xanthelasma, it may not be possible to completely hide the scar in the crease, particularly if the lower lid is affected. However, the scar should heal to become a fine line that is less noticeable than the Xanthelasma. In more severe cases, reconstructive surgery may be necessary.
What you can expect after the procedure?
After the surgery, you will be closely monitored for any possible complications. Once it is determined that you are safe to leave, you will be allowed to go home to rest and begin the healing process.
After surgery you may temporarily experience:
Your doctor will likely suggest you take the following steps after surgery:
What are the results of surgery?
Many patients are satisfied with the results of Xanthelasma surgery and benefit from a more youthful appearance and increased self-confidence due to the removal of the Xanthelasma. The effects of the surgery can last a lifetime, although in some cases the Xanthelasma may recur with time.
Bruising and swelling settle within two weeks, resulting in a more natural look and increased confidence in going out in public. Subtler swelling can take two months to fully resolve in most cases.
The scars from the surgery may take several months to fully fade, but they should be hidden in the skin crease if possible. It is important to protect your eyelids from too much sun exposure, as you should do for the rest of your skin.