 Hi everyone, Dr. Solter and Beverly Hills. For our second case, we have a really interesting case. Our patient has a xanthoma. Xanthoma and xanthalasma are harmless yellow bumps that are underneath your skin around the eyes. Now, some of these are asymptomatic, but these are cholesterol deposits. So it most commonly happens with people that have problems with their cholesterol. Cholesterol triglycerides or hyperlipidemia. When your numbers get really high, you start getting this deposit. I'll show you some pictures. You see these cholesterol deposits right here? They're yellow and they're underneath the skin. To get rid of them, you've got to dig them out. Our patient has on all four upper and lower on both sides and we're going to show you once we get into OR. They come right in the corner of the eyes. They could expand and they get bigger over time. So my advice to you is when they start, it's the best time to go take them out because they're smaller. As they go on, they could get bigger and much more difficult to take out because they could occur in places where you don't have excess skin to take them out. So stay tuned as we get started on our case. So I want you guys to see the xanthomas here. You can see one in the lower eyelid right there. Huge one up here on the right side. You can see how big it is. I'm going to try to resect all of it. Sometimes you can't because there'll be too much skin to be taken out and it's just not possible. And here it is on the left side. You can see there's one there and here's the lower one. So first we're going to numb them up. Then we're going to let them sit. The lower ones are small enough to take out the upper ones. A little bit of concern, especially on the right upper one. Okay, so we're going to take this out in an ellipse form. You want to get all of it. You saw I went in there. There was a little bit more left. You see the cholesterol deposits right there? I want you guys to see the deposits right there. You see that? You got to get all that out. So it doesn't come back. So we're going to try to take all, not try, but we're going to get all of it out from him. There it is. That's all of it is out. So let's look at the under surface of it. You could, there it is. You see that cholesterol deposits right there? The little tiny ones there. That's it. You could even feel it. They feel a little... So you can see what I'm cutting out is almost like a football. It's up long, but it has to be a little bit longer than the actual xanthoma. It's because, or else I'll have dog ears because once it becomes a circle, you can't close it as well. And I'm putting it right into the lines of the skin of the face. You could see they're kind of going, they're not straight. They're going kind of lateral and slanted. So when they heal, they'll heal within the lines of the face. You could see there we have it. Very superficial, but again, you have to get the whole thing out so they don't grow out. You could see I'm very thin on the skin, but I want to make sure it's incorporated any of the cholesterol deposits. There it is. It's right there. You could see the cholesterol deposit right there. Here it's all red. Here it's gold. If you guys have this, you should get your blood checked. You should make sure that your cholesterol, your lipids and triglycerides are within normal. For the one in the upper eyelid, we're just going to do a bluff and remove as much as that possible. And then we'll go from there. So here we are.