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So what exactly is blepharoplasty? Blepharoplasty is the name given to eyelid surgery. This procedure can be done for
both functional and cosmetic reasons, where the upper eyelid or lower eyelid is reshaped by removing and moving
extra tissue and reinforcing tendons and muscles. When an excessive amount of skin is present on the upper
eyelid, it can result in a loss of peripheral vision by hanging over the eyelashes. The areas most affected
by this condition are the upper and outer parts of the visual field. Surgery may also be done even if no
vision is lost, purely for cosmetic reasons. EzineArticles.com expert:Jennifer Simpson




 









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Cary Blepharoplasty Palm Beach FL | Eyelid Lift West Palm Beach Florida

Blepharoplasty > > > This article may require to meet Wikipedia's .
Gantous will ask if you have allergies and if so, how they affect your eyes.
I made it a point to follow them exactly.
The patient had no other facial procedures.
In Cary, The results are dramatic and apparent within days and patients report looking more natural and relaxed.
The pseudohernias are observed most commonly in largest volume in the medial and central compartments of the lower lids.
He is a Fellowship Director, so he teaches blepharoplasty at an advanced level to board certified surgeons who wish to specialize further in Facial Plastic Surgery.
In some cases, sections of the frontalis (the eyebrow raising muscle, and the same one that causes the cross-forehead creases) are also removed.
A logical choice for considering surgery around the eyes is an ophthalmic plastic surgeon.
Excess skin above the crease is then removed and the edges of the incision are brought together to close the surgical wound.
In Cary, Achieving aesthetic balance in the brow, eyelids, midface.

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Dermabrasion can help your skin look young and beautiful again.
The usual management for entropion involves tightening of the eyelid and its attachments to restore some of its elasticity and to reposition it normally.
In Cary, Hedden offers a variety of lip enhancement techniques to enhance the lips while retaining their soft and natural feel.
, a board certified plastic surgeon located at 360 San Miguel Drive, Suite 507 Newport Beach, California 92660 and 465 N.
In Cary, the patient should consider reconstruction of the lid crease (tarsal fixation).
The correct angle of suspension is somewhat different from case to case.
Operative techniques in Oculoplastic, Orbital and Reconstructive Surgery.
In Cary, Facelift As we age, the skin gradually loses its elasticity and begins to loosen and sag on the face and neck.
It's usually done on an outpatient basis; rarely does it require an inpatient stay.
In Cary, The results are beyond what I expected and I have people everyday asking me what special cream am I using in my eyes.

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You and your surgeon should discuss these and any other risks and decide if this is the right procedure for you.
INTRODUCTION Jump to Section ? ? Introduction ? ? ? ? ? ? Upper (eyelid) blepharoplasty is one of the most frequent eyelid procedures performed by facial plastic surgeons.
For the upper lids, an incision will be made across the top and bottom of the excess skin, and this skin will be removed.
On the upper eyelid, it is used to correct redundant (droopy) skin of the upper eyelid and forehead.
Many surgeons feel that eyelid lift surgery helps a person look more alert, attentive and fresher than any other surgical procedure.
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Upper eyelid blepharoplasty & Trans bleph endotine browlift 75 year old female with bilateral brow ptosis and upper eyelid dermatochalasia.
This procedure does not erase the beautiful Asian look, but enhances the Asian eyelid by leading to a more widely opened eye.
We offer a line of skin care products, including Obagi® System and Innovative Skin Care, that can protect your skin from environmental stresses and give you a fresh, clean feeling every day.
Surgeon: Plastic Surgery Center of the South This 53 year old woman came to our office wanting to learn more about facial rejuvenation plastic surgery in Atlanta.
In Cary, Facial Plast Surg 1994;10:6-17.
In Cary, Adams better assess your eyes and face to assist in planning your surgery.
Frontal view of patient requesting tip and minor “bump removal” shown before and after a “finesse” rhinoplasty.
This procedure does not alter true skin pigmentation changes, nor does it address sagging eyebrows.
In Cary, Patients who could not be contacted were excluded from the study.
Summers helps , , , and patients.
The peel, which, depending on the patient, includes one to four steps, involves the topical application of a glycolic acid solution that essentially removes the outer layers of the skin and exposes the undamaged layers underneath.
In Cary, It is OK to take medications with a sip of water.

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Who is a good candidate for rhinoplasty surgery? Any person with realistic expectations and dissatisfaction with their nose is a good candidate for this procedure.
In these patient healing may take up to one week.
In Cary, People interested in blepharoplasty are usually over 35, but if you are interested in having this done earlier it is possible.
glasses and vision: After blepharoplasty, you will have ointment inside and on your eyelids.
This helps to improve Crow’s feet deformity.
In Cary, If this done under local anesthesia it must be done with gentleness.
Frequently special tape is used to support the lower eyelid area for a week after surgery.
Clevens perform cosmetic eyelid surgery often? Over 250 men and women each place their trust in Dr.
In Cary, The article details Dr.
A mild to moderate amount of excess eyelid skin results in a tired, sad appearance.
Then the incision is closed with stitches.

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In Cary, The procedure typically takes no more than two hours to complete, and results are long lasting.
In Cary, ) You'll be shown how to clean your eyes, which may be gummy for a week or so.
In Cary, Most importantly, surgical results have been extremely successful and patient satisfaction has been very high.
In Cary, The incision heals in a few weeks and scars are usually unnoticeable.
In Cary, These types of medications are known to increase the amount of bleeding a patient experiences.
Brow Lift Also known as a forehead lift, a brow lift  is a great option for patients who want their facial appearance to be more youthful and energetic but who do not need a facelift.

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In Cary, Where are the scars with eyelid surgery and are they noticeable? Typically, the incisions for the upper eyelid are made in the natural crease lines.
In Cary, Pousti and Staff: I met Dr.
In Cary, Asians who desire a double eyelid.
Azar can help you achieve your goals.
In Cary, Permanent Makeup Does your morning routine revolve around the time-consuming chore of putting on your makeup? Wouldn’t it be great to wake up every morning looking well rested, awake, and fresh without any effort? Permanent makeup – one of the easiest and safest cosmetic procedures available – can make this possible.
has been confirmed by the Device and Technology Assessment (DATA) Committee of the American Society of Plastic Surgeons.
If the eyebrows are at the appropriate level, but there is excess skin or fat in the upper lid, then an upper lid blepharoplasty is the procedure of choice.

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Disclaimer: The information provided on Bodysculptor.
In this procedure the incision is made inside your lower eyelid, leaving no visible scar.
By OnlineSurgery Staff Updated: October 30, 2008 Search by Zip Code Featured Facility Beverly Hills , CA Dr.
This is a normal expressive variant.
While a complete understanding of these more specific complications is imperative, each surgeon must develop a much broader perception of the post-operative blepharoplasty course to include all gradations of normal post-operative healing, post-operative problems, and true complications that deviate from the ideal result.
"Eyelid Surgery (Blepharoplasty).
In Cary, Younger people also have this procedure done to remove the puffiness around the eyes due to excess fatty tissue.
During the initial evaluation, depending on your needs, a browlift or a mid-facelift procedure might be recommended in combination with the blepharoplasty.

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Sensory changes such as numbness and itching may occur during the healing process.
Notice how the cheek fat has descended creating a deep lower eyelid crease and a deep fold above the lips.
How Much Will Eyelid Surgery Cost? Cost is always a consideration in elective surgery.
In Cary, ) (Warning graphic photographs.
In Cary, Dermatalogy Associates of Atlanta -> Blepharoplasty Eyelid Surgery > > BLEPHAROPLASTY Blepharoplasty Eyelid Surgery The "Eyes" Have It They draw attention wherever you go.
Entropion is a "turning in" of the eyelid.
In Cary, This generally resolves over a period of several weeks to months, but can be repaired at a later date if necessary.
In Cary, Traditional blepharoplasty involves an incision in the eyelid and can result in significant visible scarring or uncomfortable scar tissue.
Lee-Wing Blepharoplasty Baggy eyelids (dermatochalasis) are caused by loose skin and fat, which produce a droopy and tired appearance.
Dry eyes prior to a blepharoplasty can be worsened after surgery.
No orbicularis muscle was excised (Figures 1, 2, 3, and 4).
Your stitches will most likely be removed a week after surgery.

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Just remember that in a few weeks you'll be looking like yourself again - only without the wrinkles and sagging skin! A facelift can make you look younger and fresher, and it can improve your self- confidence as well.
, Suite 108 Walnut Creek, California 94598 Phone: (925) 939-9200 To learn more about post-bariatric procedures such as breast lift and blepharoplasty, contact the San Francisco-area practice of Dr.
In Cary, Denton's fully accredited private operating facility in Vancouver, British Columbia.
Consider someone with descent of the forehead resulting in a low brow.
In Cary, It is then transposed onto the skin side, which will constitute the new lid crease position.
In Cary, In this consultation, Dr.
Liberty, Missouri 64068 Phone:866-832-8466 | | | | | | Facelift, rhinoplasty, blepharoplasty, BOTOX ® Cosmetic, Restylane®, and other procedures are used in Kansas City, Missouri, at Genesis Plastic Surgery to enhance your appearance.
Complications connected with brow and forehead lift are relatively few  and minor; however, there are certain inherent risks connected with every cosmetic and plastic surgery procedure which should be thoroughly discussed with the physician.
In Cary, There may also be some excess tears, and your eyes may itch and be irritated, which is helped with eyedrops.
In Cary, Call us at 415-445-9513, click to or us today to meet with him.
Case # 54781: Picture/Photo of mid-thirties female before Blepharoplasty/Eyelid Surgery Procedure.
Puffiness above and below the eyes can even make you look older than your age.

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In Cary, Custom LASIK Laser eye surgery, Milwaukee WI.
In Cary, The surgeons are all highly trained and experienced.
The incision in this case is made inside the lower eyelid, and excess fatty material is removed.
Blepharoplasty removes excess (drooping) skin and/or fat in the upper or lower eyelid, and prior to surgery an eye examination may be performed by an eye specialist.
The results will be a more refreshed appearance, with younger, firmer eyelids.
Nearly as important as the areas treated by this laser are the areas left untouched.
In other words, those who are hoping the eyelids can be brought into better harmony with who they are on the inside do very well with cosmetic eyelid surgery.
Lower blepharoplasty is usually done through an incision fairly close below the lower lid eyelashes.
In Cary, Called an ectropion, this, too, may require a second, corrective surgery.
Int Ophthalmol Clin 1997;37:205-216.
There are no scars on the lower lids.

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Only approaching the lower blepharoplasty in a transcutaneous fashion can reduce malar bags or festoons.
Ice water soaked compresses are applied to the eyelid area, every 10 minutes, for the first 48-72 hours following surgery.
When your upper lids are droopy or lower-lids are puffy, you appear fatigued, unhappy, and even angry.
In rare cases, corrective surgery is required.
In Cary, Correcting the bulge of the malar crescent will restore a youthful smooth contour.
In Cary, For 1 week, patients are instructed to maintain a semi-upright position when sleeping or resting.
In Cary, If you would like to meet with Dr.
The patient is usually pain free, but if mild discomfort is present it can be totally eliminated with a mild pain reliever.

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But in another sense, the effects are permanent; years later, your face will continue to look better than if you had never had the procedure.
In Cary, Located in New York City serving Manhattan, Queens and Forest Hills.
In Cary, Boston, Massachusetts This entry was posted on Wednesday, March 7th, 2007 at 11:48 pm and is filed under .
In Cary, The excess skin is marked before the Blepharoplasty.
Q - What type of anesthesia is used for the eyelid lift? Upper eyelid lifts may be performed with just local anesthesia.
Depending on the genetics involved, it can begin at a disconcertingly young age, but usually somewhere in the early thirties people begin to notice changes (earlier with sun exposure).
The skin lateral to the orbital rim should be incorporated in the upper lid procedure.
It is now discussed that to take fat meringue out is unnecessary.

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Newman is able to remove unwanted or excess skin around the upper or lower eyelid, growths on the eyelid, and wrinkles on or around the eyelid with little, if any, bruising or swelling.
For this procedure, the surgeon makes incisions following the natural lines of your eyelids; in the creases of your upper lids, and just below the lashes in your lower lids.
Certain conditions affect the details of eyelid surgery and should be discussed with Dr.
This is a minimally invasive surgical procedure best suited if you have excess fatty tissue of the neck, but minimal excess neck skin.
In Cary, We supply the ice pack.
A subcutaneous tunnel is created to the midline.
Patients may request to be mildly sedated if anxiety is a concern.
Pre-operative (left) and one month post operative photos(right) are shown.
In Cary, Cleft Palate Surgery Cleft palate surgery, also offered at our practice in Melbourne, Australia, is more extensive than surgery for cleft lip, and for this reason, is typically performed when the child is about a year to a year-and-a-half old.
In Cary, The total fees can range from $2,000 to $5,000 or more, depending on the extent of the procedure.
In Cary, Cruise serves the following areas: Orange County, Irvine, Newport Beach, San Diego, Los Angeles, Beverly Hills, Southern California.

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Arizona Center for Aesthetic Plastic Surgery Steven H.
It will help but often a concurrent brow lift or temperal brow lift is necessary.
In Cary, Conversely, The lower eyelid has three fatty tissue pockets and are called the medial, central and lateral fat pockets.
In Cary, The forehead lift procedure begins with an incision starting near the ear and running across the top of your head either behind or at the hairline.
In Cary, They include thyroid problems such as hypothyroidism and Graves' disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes.
In Cary, It is often whiter than the preaponeurotic fat.

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OUT-OF-AREA GUESTS Frequently we have patients visiting us from overseas, Asia, Hawaii and other states along the East Coast of the United States.
In Cary, Reddy is also extremely skilled in laser treatments including laser resurfacing, laser lipo (SmartLipo and Cool Lipo) and Fraxel.
In Cary, If you have questions or concerns during your recovery, or need additional information at a later time, you should contact your surgeon.
This restores the natural shape and the tightness of the lower eyelid, and is usually performed in conjunction with the lower eyelid blepharoplasty, if needed.
In Cary, The procedure can be done on the upper and lower lids, at the same time or separately.
In Cary, In Beverly Hills, patients trust Dr.
In Cary, Most patients receive general anesthesia for this procedure, so that they sleep throughout the operation.

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In Cary, My Approach - The Formula? Less is More Over the 25+ years that I've been a plastic surgeon, no procedure has changed more dramatically than blepharoplasty.
In general, the Asian upper eyelid crease forms closer to the eyelashes, is shaped differently, and is sometimes incomplete or broken into multiple folds.
In Cary, Pain is minimal and recovery is rapid.
In Cary, Fat is youthful and must be removed only as needed.
There are several things that can be done to correct these problems.
Someone will need to drive you home after your eyelid lift surgery and stay with you that evening.
In Cary, Espinosa may consider having local or general anesthesia.
In Cary, No matter it sounds like it is impossible it is useful to think that the surgery is performed very close to the eyes and by very sharp gauges and there is always a risk even it is small.
This surgery, known technically as blepharoplasty, is one of the most popular cosmetic surgery procedures performed today.

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In Cary, However, informed consent documents should not be considered all inclusive in defining other methods of care and risks encountered.
Tape and other devices are sometimes used to permit wearing glasses without stressing the area where surgery was performed.
In Cary, In general, however, the benefits are much greater than the risks for these procedures.
The incision is made below the eyelash on the lower eyelid.
However, on occasion, the lobe is just too large.
Testing the lower lid to determine tone will determine the vulnerability of the lower lid to postoperative scleral show, lateral hound dogging, or ectropion.

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In Cary, Blepharoplasty (Eyelid surgery) is a procedure that can make your eyes and aging face fresh.
Contact for more information What are the risks associated with this surgery? As with any surgery, there are risks such as infection, bleeding, and scarring.
Be sure to inform your surgeon of any previous diseases and allergies.
Symptoms of ptosis include a decreased ability to keep your eyes open, eye strain and eyebrow fatigue from the increased effort needed to raise your eyelids, especially when reading.
Blepharoplasty corrects these problems and also removes puffiness and bags under the eyes that make you look worn and tired.
Fat from both eye-sockets is excised and compared for symmetry.
It will usually not address "crow's feet" or other facial wrinkles.
2080 Century Park East, Suite 710, Los Angeles, CA 90067 Copyright © 2005 Century Aesthetics®, All rights reserved.

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This is appeared as lividness in the eye and it may be encountered in almost all the eyelid surgeries.
Recovery from a Blepharoplasty Post-operative discomfort is fairly mild and well-tolerated, and bruising may be present for up to a week more following the procedure.
In Cary, What’s New is powered by.
Photos courtesy of , board certified plastic surgeons located at 1400 East Bert Kouns Suite 106, Shreveport, Louisiana 71105.
Reddy passes onto his patients.
Procedure day: On the day of surgery, arrive early to get checked in and settled.
The above surgeries are designed to restore function, aesthetics, and comfort.
In Cary, The asymmetry will always more exaggerated following surgery.

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The skin becomes thicker and more sebaceous laterally.
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The muscles on the neck can slacken, too, causing you to look years older than your real age.
In Cary, Patients who are subject to dryness of the eyes should notify us of this problem.
In Cary, This patient underwent upper and lower lid blepharoplasty, and had a small mole removed from her lower lid.
It may slant down or flare up at either canthal angle.

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In Cary, Patients may also experience some temporary itching, dryness, burning, tearing, blurred or double vision, or sensitivity to light.
Nevertheless, there is always a possibility of complications, including infection or a reaction to the anesthesia.
The surgery: The surgery is usually done on an out patient basis and does not require an in patient stay.
" Procedure Spotlight: Dr.
There are both risks and benefits involved with this type of eyelid surgery.
If you do, you may want to wear sunglasses whenever you are in the presence of bright light.
Not only can ptosis negatively affect appearance, but it can also cause dangerous obstruction, blocking vision and seriously limiting activities.
Ear surgery, or otoplasty, is a permanent solution to this problem.
Postoperative pain is usually mild and easily controlled with the medication provided.
Be sure to identify any problems you may have had with anesthesia.
Whether you are having upper, lower, or both lids done, the procedure generally follows this format: Making the incision.

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They are renowned as some of the most experienced , , eyelid surgery and specialists.
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In the lateral lower lid the suspension suture (described below) effaces the orbital rim - lateral orbital septum junction.
As your eyes convey a world of emotion, you normally would not want to include tiredness or sleepiness to other people's impression of you.
Any skin lesion such as keratosis, nevus, syringoma, trichoepithelioma, or xanthoma should be discussed as to the possibility of excision and the anticipated result.
A few medical conditions make blepharoplasty more risky.
A formal visual field test may be helpful in this situation.
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On the lower lid, the incision is made along the lash line toward the temples and is hidden by lashes when healed.
In Cary, Stevens in People Magazine about his surgery on Sharon Osbourne.

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quickContactForm);" > Request Free Information Newsletter Signup Blepharoplasty Surgery Cosmetic Facial Plastic Surgery Blepharoplasty Surgery Procedure Blepharoplasty Surgery is the most common form of cosmetic eyelid surgery, and is performed to remove excess fat and skin from around the eyelids.
In Cary, Lower eyelid surgery is a similar procedure, involving the removal of excess fat and, sometimes, muscle.
In Cary, Meronk Solutions for upper and lower eyelid hollowness Before and after upper and lower blepharoplasty Pictures and diagrams of lid and facial anatomy Unsatisfactory results after cosmetic eye surgery Compare and contrast procedure pros and cons Cosmetic blepharoplasty shown start to finish Articles on eyelid care and maintenance Submit a no-cost secure inquiry online © Copyright 2000-2009 Frank Meronk, Jr.
can restore a youthful appearance to your eyes.
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What can go wrong? Blepharoplasty itself is a safe procedure.
Procedures To Enhance Your Face and Lift Your Spirits – Thousand Oaks, Simi Valley, Westlake Village and Agoura Hills Face Lift Exposure to sun, weight gain or loss, and the natural aging process all take their toll on skin, causing it to loosen, slacken, or sag, especially on the face.
The duration of the procedure will depend on the extent of the work involved.

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The advantages of wedges compared to pillows are that they are sturdy, you do not have to worry about slipping off as you would with pillows, you have far less tension and stress on your body, and you do not have to periodically rearrange the wedge as you would with pillows that shift around and fall.
In transconjunctival blepharoplasty the small incision for a blepharoplasty is made with a laser through the conjunctiva on the inside of the lower eyelid and avoids damage to the supporting muscle.
The blepharoplasty procedure by itself (without a forehead lift) does not improve droopy eyebrows.
Maryland Plastic Surgeon, Dr.
Nirenberg will instruct you to keep your head elevated for several days, and to use cold compresses to reduce swelling and bruising.
In Cary, No orbicularis muscle was excised (Figures 1, 2, 3, and 4).
In Cary, Fred Thompson at Genesis Plastic Surgery in Kansas City, Missouri, to create the look you envision.
In Cary, Rhinoplasty can make a nose smaller or larger, more symmetrical, or more in balance with the rest of the face.
(1700’s) Fuch, in 1892 documented in the literature “ptosis adiposa” (”excessive accumulation of fat in the covering fold”).

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However, an Endoscopic Forehead Lift can eliminate or minimize the amount of skin that needs to be removed by lifting the brow.
In Cary, Anderson's technique for a browlift.
In Cary, Fechner performs a brow-release that can be achieved through the standard blepharoplasty incision.
In Cary, Some vision blurring is normal.
The sutures are usually removed in about 4-5 days, and the swelling and discoloration around your eyes will gradually subside over the first week.
Side effects such as dry eye and sensitivity to light occur in some patients, but fade within about 10 days.
In Cary, During your initial consultation, you will be asked to give information about your medical history, prior procedures, medications, allergies, and your motivations for seeking plastic surgery.
In Cary, As in upper eyelid surgery, placement of the incision in natural crease lines allows for the scar to usually heal in an inconspicuous fashion.
What medications should I avoid? You should avoid or be off all diet or over the counter weight medications.
Eyelid Surgery | Facelift | Bergen County | Englewood Dr.
In Cary, , a board certified plastic surgeon located at 1009 Missouri Street, Houston, Texas 77006.

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In Cary, Site Categories Links More About Miami Plastic Surgery Articles - Blepharoplasty Eyelid Surgery Information, costs, and side effects Basic procedures and techniques Anesthesia: General, local or sedation Location: Hospital, surgical center or office Surgery time: 1-3 hours During the operation, the surgeon makes incisions above and below the eye tissue.
In Cary, Here is a partial list of to be avoided prior to surgery.
Despite our best efforts there is always the possibility that one of these complications could occur.
In Cary, A special thanks, to Ms.
More than any other facial feature, your eyes reveal the most about how you feel.
FINANCIAL RESPONSIBILITIES The cost of surgery involves several charges for the services provided.
In the upper eyelid examination, a determination is made of excessive redundant eyelid skin and herniated orbital fat.
In Cary, Injection treatments are performed in 30-minute sessions and can be repeated as necessary, typically every six to 12 months.
Swelling at the corners of the eyelids.

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Dana Perrone, for her recommendation to your office, and special care given throughout my recovery.
In Cary, Postoperatively, he did well.
Good candidates for eyelid surgery are patients with normal tear production and good eyelid tone and function.
Do not wear contact lenses during the first two weeks.
In the evaluation of aging eyes the forehead and mid face also need to be thoroughly evaluated.
Make-up can usually cover bruising adequately by the end of the first week.
The appropriate anesthesia is then administered, and the superficial eyelid tissues infiltrated with local.

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In Cary, Downtime is usually 7 days, during which there is mild swelling.
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In Cary, If you want to learn more about the positive effects of blepharoplasty, at the in Fort Collins, Colorado today for a consultation.
The thinness and smooth texture of the lid skin transforms into a thicker, coarser, more sebaceous-type skin lateral to the bony orbital margins.
You should limit vigorous activity for several weeks following a browlift.
In Cary, If you're having all four eyelids done, the surgeon will probably work on the upper lids first, then the lower ones.

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Manchester a question regarding cosmetic surgery or schedule a consultation at (800) 367-3223.
Eyelid surgery is available by our board certified plastic surgeons at the best hospitals and eye clinics in Bangkok Thailand.
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This situation can be avoided by recognition of brow sagging and treatment through a brow lift or forehead lift.
In Cary, It’s called Invisalign.

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Local or twilight anesthesia may be used and the procedure takes about thirty to forty-five minutes to complete.
In Cary, Countless men have realized that they need to maximize their projected image in order to prolong their earning potential.
In Cary, Both are very comfortable options.
In Cary, Eyelid surgery can enhance your appearance, but it will not necessarily change your looks.
How should I prepare for surgery? If you are a smoker, you will be asked to stop smoking well in advance of surgery.
On occasion incisions will be closed with absorbable suture and covered via steri-strips.
In Cary, A would be a better option in this situation.
In Cary, Following removal of the redundant skin and any indicated orbicularis muscle the medial fat pocket is exposed by gently spreading the medial orbital septum with a Steven's scissors or a fine hemostat.