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During the healing process, the eyelid skin can often trap dead skin cells and other debris underneath the skin surface. When that happens, little white pearls of material are seen - these are milia. Since the skin surface is closed over the collection of material (forming a "roof"), it must be gently coaxed out from underneath. This can usually be done under the trained eye and steady hand of the surgeon in the office setting. Within a couple of days, the areas will be healed, smooth and looking healthy once again!
Milia are trapped whitish material (keratin) beneath the skin often following eyelid surgery. These tiny cysts have a thin almost translucent skin covering which is usually opened, unroofed, with the tip of a needle allowing the contents to be removed. A simple and often painless office procedure.
The bottom line is a milia is a small plug of dead skin cells trapped under the actual skin surface. It usually is contained in a cyst. These cysts slowly grow until they are visible. It is a simple matter of using a sharp instrument like the tip of a needle or a pointed scalpel to make a tiny nick in the skin over the milia. With a little gentle pressure, the milia in its entirety is the expressed out. No stitch is needed for this this to heal. If you have ever had an extraction facial, the facialist often performs this procedure to remove trapped white heads. It is difficult to characterize this as a "surgical" procedure. It is relatively common to need help with milia after eyelid surgery as to be routine and the procedure should be very comfortable.
Sometimes after surgery, tiny little cysts occur at the sites where sutures were used. "Unroofing" the milia simply means to decapitate, or cut off the top of the cyst so that the contents can come out and no longer form a cyst. Hope this explanation helps.
The term “unroofed” means that the superficial area of skin is opened which essentially eliminates the roof over the “milia” after eye surgery and allows the expression of the white material.