Efficacy of a Technique (Brassiere Sutures)
Conditions
Keywords
Upper blepharoplasty, brassiere sutures, tarsal platform show, eyeshadow space, brow fat span
Brief summary
Increased tarsal platform show (TPS) and decreased brow fat span (BFS) are associated with favorable results in women undergoing cosmetic blepharoplasty. The authors evaluate the efficacy of a technique (brassiere sutures) to increase TPS and decrease the BFS.
Detailed description
This is a prospective, randomized, comparative, case series study of 100 eyelids (50 consecutive women patients) treated with cosmetic upper blepharoplasty by a single surgeon. Patients were randomized to receive traditional upper blepharoplasty with a single running suture skin closure versus orbicularis oculi muscle fixation to periosteum (brassiere sutures) prior to skin closure. Patient age, follow-up length, complications and treatment were analyzed. The mean of TPS, BFS and TPS/BFS ratio was measured before and after surgery at 3 anatomic landmarks. 56 eyelids (28 patients) were treated with traditional single suture blepharoplasty and 44 eyelids (22 patients) had brassiere sutures. After surgery, the mean change in TPS was 2.10 mm with brassiere sutures compared to 2.04 mm without (p \<.001). The mean change in BFS was 3.33 mm with brassiere sutures compared to 3.19 mm without (p \<.001), The mean change in TPS:BFS ratio at all 3 anatomic landmarks was statistically significant in both groups but the change was statistically greater with the use of brassiere sutures (p \<.001). Brassiere sutures during upper blepharoplasty were associated with a postoperative increase in TPS decrease in BFS, and increase in TPS/BFS.
Interventions
PROCEDURETraditional upper blepharoplasty
The skin incisions were marked using a skin marking pen. Preseptal orbicularis skin and muscle were removed using a size-15 scalpel blade and scissors. Hemostasis was achieved with conservative electrocuatery. The skin was closed with a running 6-0 nylon suture.
PROCEDUREBrassiere suture with blepharoplasty
Prior to skin closure as above, three 6-0 polyglactin sutures are passed along the lateral fourth of the orbital rim. The sutures attach the inferior orbicularis oculi edge to the arcus marginalis of lateral ROOF. Sutures are placed until there is a visible plumping of the sub-brow tissues.
Sponsors
Centro de Referência em Oftalmologia
Instituto de Olhos de Goiania
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
35 Years to 81 Years
Healthy volunteers
Yes
Inclusion criteria
* Female underwent cosmetic upper blepharoplasty and brassiere suture with blepharoplasty
Exclusion criteria
* History of thyroid eye disease, levator dehiscence ptosis, blepharospasm, facial nerve paresis, a history of previous upper facial surgery or trauma, and postoperative follow-up for less than 6 months.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Eyelid measurements of traditional blepharoplasty and brassiere suture, before and after surgery | 6 months |
Secondary
| Measure | Time frame |
|---|---|
| Asymmetry of TPS and BFS in traditional blepharoplasty and brassiere suture | 6 months |
Outcome results
None listed