Inserting branemark implants into eye orbit

So after a bit of a wait from my last surgery to fill the hole in my head with skin and muscle from my back I am back to have a procedure carried out to re attach the Branemark implants into my eye orbit.

To recap

It’s just over a year since I started writing this blog and I am pleased to say that it has helped many people in various ways, especially the few that have undergone the same treatment.
This operation (which I consider a walk in the park in whole scheme of things) is still a major consideration if you find yourself in my position. Why do it, why put yourself through another operation?

Forgive me as I have already covered this earlier on in my treatment story (I had previously had the implants fitted, but they were removed during the last surgery) the reason why I cover it again is because the circumstances and specifics are different this time, and maybe more useful as I now represent a more “typical” case.

I now have a skin flap neatly and securely in pace where my eye orbit once was, and again if you have seen the previous pictures here, or indeed seen me on tv then you will know I had a cavernous hole where the original attempt to cover the void from the removal of my eye orbit failed.

The Branemark implants are named after the surgeon that invented them. Made from titanium they come in 3 parts: the housing which screws into your bone. The shaft which is then attached to the housing, this can be slightly different lengths to suit, and then interchangeable heads which may have a clip, but typically a magnetised tip. Titanium is accepted by the body so bone fuses to the housing, and skin will grow (once healed) healthily around it.
For the purposes of a full orbital prosthesis it is typical to have 3 separated implants to give a kind of tripod support for the prosthesis.

It is my understanding that a lot of people needing similar surgery to me have the void left by the removal of the eye and socket replaced by skin and muscle from the thigh within the same operation.
Mine was different and had it of worked I know I would have preferred my procedure, but as it never worked out there is a lot to say for doing the safest thing first time.

Now I do have skin and muscle in place, it sits relatively flat in my face which is not ideal.
To those that won’t know, we are not talking a “glass” eye which sits under your eyelids, it is everything in and around the eye too, including eyebrows! For the best result the prosthetic must sit into the orbit to appear the same depth as the good eye (something that can’t be achieved with a flat piece of skin) and so a recess needs to be formed, and to do this means making an incision around the grafted skin to get underneath an “debulk” it. How they do this I don’t know, and I won’t ask, but the result should be that the skin sits further back, and the insertion of the implants will hold the skin down so it rebinds to the inner tissues.

As operations go it should be fairly short. I’m guessing an hour in this case as I already have the housings in place.

This section is written post surgery.

image
A week after the Branemark implants were fitted

This is a week after surgery and you can see that I’ve only two implants fitted. This is because the surgeon couldn’t reach the other side from the incision he made, due to the vein which supplies the new skin and muscle  is in the way. So it means another operation but I can say it is quite painless despite the bruising.

The implants have their white healing caps on and the bloody looking stuff around is a kind of binding that keeps the skin back. This will be removed in another week when the stitching is taken out.

If you want to find out about how an orbital prosthesis is formed then read the blog entry here. The next operation to fit the third implant and debulk the other side hasn’t been booked yet, but I guess this pretty much covers it. I will post a picture once I have my new eye in a few months time!

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