Gather a fold of lid skin between a couple of fingers, or raise it up with a hook, and lay the fold between two small wooden bars or rods as long as the lid and as broad as a lancet. Bind their ends very tight together. The skin between these small pieces of wood, deprived of nutrient, dies in about ten days, the enclosed skin falls off, leaving no scar.
The Tadhkirat of Ali ibn Isa of Baghdad
Cosmetic eyelid surgery today has the benefit of 2000 years of development and refinement of surgical techniques and instruments. Ali ibn Isa (AD 940-1010) described the procedure just quoted more than 1000 years ago (Fig. 1-1), at a time when his medical treatment for 'oedema of the lids' was 'letting blood from the head, and treating the eye with a preparation of celandine, sancilewood, and endives. . . .'
Figure 1-1 Early technique of excision of excess skin of the upper eyelid.
Aulus Cornelius Celsus, a Roman encyclopedist and philosopher in the first century, was probably the first to comment on the excision of skin of the upper eyelids when he described the treatment of 'relaxed eyelid' in his De re Medica (AD 25—35).2 De re Medica was not published until 147cS, following its rediscovery by Pope Nicholas V.
Even before Celsus, the Hindus were known to have referred to cosmetic and reconstructive surgery about the face. The accepted form of corporal punishment in India 2000 years ago was amputation of the nose. The surgeons of this time became so skilled in reattaching this appendage that officials began to throw the amputated nose into the fire to ensure their goal of disfigurement. It is interesting that the skilled surgeons who were able to reattach the nose successfully were actually members of the lowly tile makers' caste.3
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