67-5

56/110

460Figure 9　The different desired size of the lid fold in two different ethnic patients by incisional technique (a) A 28-years-old Shan ethnic woman, before operation. (b) 2 months after operation with very satisfied result (lid fold size: 7 mm). (c) A 27-years-old Bamar ethnic woman, before operation. (d) 2 months after operation with very satisfied result (lid fold size: 10 mm) showing the locations of eight major ethnic groups with their traditional dress.The different locations (plain, hilly, delta, coastal and dry zone) lead them into different professions, economics, educations, culture, life style, complexion and preference to beauty. Therefore, people prefer-ences to the shape of double eyelid may also be differed. Among the Shan ethnic people, 44 patients out of 53 patients (83 %) desired for a small or narrow lid fold whereas 87 % of the Bamar people (58 patients out of 67 patients) preferred a large and wide lid fold (Figure 9). The different double eyelid shapes14) should be discussed in detail with the patient to achieve the desired result. It is important not only for the surgeon but also for the patient that the incisional wound must be cared to achieve primary healing. Personal hygiene, envi-ronmental sanitation, educational background, socioeconomic status, and availability of transport should be taken into consideration for an ideal outcome in a developing country. In addition, surgeon should awe that blood glucose level, blood pressure and bleeding tendency are prone to be increased due to some traditional medicines, local herbal supplements and local foods taken in some ethnic groups and people in rural area30). Such patients must be given brief health education about the incisional wound healing, frequent followed-up and checked for condition after operation. Special measures are needed to persuade some patients to take the medication prescribed by the surgeon because there are some local people who believe that medicinal plants, traditional medicines, fortune tellers’ advices and meditation are more effective than Western medicines31, 32). Surgeon should awe and check the condition of wound healing frequently to some patients who have religious attitudes toward foods such as being vegetarian, avoiding