Tarsal Sling: An Essential Stitch to Prevent Scleral Show in Lower Blepharoplasty

Pascali, Michele; Avantaggiato, Anna; Brinci, Lorenzo; Cervelli, Valerio

doi:10.1093/asj/sju018

Cited by 14 publications

(9 citation statements)

References 19 publications

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“…Traction on the lower eyelid would lead to exposure of the sclera above the lower eyelid (scleral show), which, in addition to the unsatisfactory aesthetic aspect of a tearful expression, can lead to discomfort, with tearing, dryness, and a foreign body sensation. 7 A possible scleral show should be examined in a side-by-side comparison. Our second patient had a clearly visible sclera below the iris when looking upward even before the flap surgery.…”

Section: Discussionmentioning

confidence: 99%

The visor flap – bipedicled bridge flap for closure of longitudinally oval defects on the lower eyelid

Hübner,

Löser

2024

J Deutsche Derma Gesell

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Section: Discussionmentioning

confidence: 99%

The visor flap – bipedicled bridge flap for closure of longitudinally oval defects on the lower eyelid

Hübner,

Löser

2024

J Deutsche Derma Gesell

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Section: Discussionmentioning

confidence: 99%

“…However, obtaining an autograft requires additional surgery. In addition, for patients who had undergone reconstructive surgery that failed, as expected, the traditional tarsal sling method 14–16 may not be able to provide reliable effects, for the following reasons: (1) the periosteum in the lateral orbital rim area might become damaged by long-term cutting through suspension, resulting in sutures having a certain tendency to detach from the periosteum at a late stage and thereby weakening or eliminating the suspension effect 17 ; and (2) ectropion may recur because of the lack of a strong suspension site coupled with the formation of severe postsurgical scar tissue and adhesions.…”

Section: Discussionmentioning

confidence: 99%

Absorbable Suture Anchor Technique

Zhao²

2022

Ann Plast Surg

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Postblepharoplasty ectropion is a very complex problem to deal with because its relevance is far to be only a functional complaint. Therefore, the best surgical approach requires both aesthetic and functional consideration. Here, we introduce the absorbable suture anchor technique, which can meet both needs, and its surgical procedure is simple and effective and has excellent stability for long-term results. This series included only ectropion patients caused by lower eyelid blepharoplasty, with or without receiving revision surgery. Forty-seven cases (64 eyes) were treated by a single surgeon through this method. Forty-six patients (97.9%) displayed adequate correction of the eyelid ectropion and a marked degree of improvement both in aesthetic terms and with regard to the functional disorders reported. One patient (2.1%) presented complications but brought under control after drainage and dressing change. His previous symptoms were also largely relieved. Absorbable suture anchor technique is an effective, minimally invasive, and safe method to correct postblepharoplasty ectropion. Objective: In this study, we describe an absorbable suture anchor technique and its outcomes in the repair of ectropion caused by lower eyelid blepharoplasty. Methods: From December 2017 to January 2021, 47 patients (64 eyes) with lower eyelid ectropion were treated with this technique (mean age, 43 years; age range, 27-61 years). This series included only patients with ectropion caused by lower eyelid blepharoplasty, with or without revision surgery. Patients were assessed with the Ectropion Grading Scale and distraction test preoperatively. All patients first underwent the release of middle lamellar adhesions and scar tissue, and then, the absorbable suture anchor technique was used to suspend the lower eyelid; 9 patients also underwent eyelid wedge excision because of severe lower eyelid laxity. Results: The success rate was 100% for grade I-III and V ectropion and 95% for grade IV. The overall success rate was 98%. In terms of correction iterations, the success rate 100% for patients undergoing their first reconstructive surgery and 90% for patients who had 1 or more reconstructive surgeries. Surgical success was defined in terms of the Ectropion Grading Scale and clinical examination. One patient (1 eye) developed a lower eyelid tissue infection that was controlled with drainage and dressing changes; his previous symptoms were largely relieved. Conclusions: The absorbable suture anchor technique is an effective, minimally invasive, and safe method for correcting postblepharoplasty lower eyelid ectropion.

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“…Ein Zug am Unterlid würde zum Freiliegen der Sklera oberhalb des Unterlids führen (scleral show), was neben dem unbefriedigenden ästhetischen Aspekt im Sinne eines weinerlichen Ausdrucks zu Missempfindung mit Tränenträufeln, Trockenheit und Fremdkörpergefühl führen kann. 7 Kommt es zu einem scleral show, sollte dies im Seitenvergleich geprüft werden. Bei unserer zweiten Patientin ist zu erwähnen, dass sie bereits vor der Lappenplastik eine deutlich sichtbare Sklera unterhalb der Iris beim Blick nach oben aufwies.…”

Section: Diskussionunclassified

Der Visierlappen – doppelt gestielte Brückenlappenplastik zur Deckung längsovaler Defekte am Unterlid

Hübner,

Löser

2024

J Deutsche Derma Gesell

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Tarsal Sling: An Essential Stitch to Prevent Scleral Show in Lower Blepharoplasty

Abstract: Through quantitative analysis, the authors demonstrated the effectiveness of a simplified canthopexy procedure. Tarsal sling is an easy, quick, and efficacious procedure to prevent eyelid malposition after lower blepharoplasty.

Cited by 14 publications

References 19 publications

The visor flap – bipedicled bridge flap for closure of longitudinally oval defects on the lower eyelid

The visor flap – bipedicled bridge flap for closure of longitudinally oval defects on the lower eyelid

Absorbable Suture Anchor Technique

Der Visierlappen – doppelt gestielte Brückenlappenplastik zur Deckung längsovaler Defekte am Unterlid

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