TPS After Upper Blepharoplasty

Instituto de Olhos de Goiania2 enrolled

Overview

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.

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.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Efficacy of a Technique (Brassiere Sutures)

Interventions

Traditional upper blepharoplastyPROCEDURE

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.

Brassiere suture with blepharoplastyPROCEDURE

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.

Eligibility

Sex: FEMALEMin age: 35 YearsMax age: 81 YearsHealthy volunteers:

Medical Language ↔ Plain English

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.

Outcomes

Primary Outcomes

Eyelid measurements of traditional blepharoplasty and brassiere suture, before and after surgery

Time frame: 6 months

Secondary Outcomes

Asymmetry of TPS and BFS in traditional blepharoplasty and brassiere suture

Time frame: 6 months

Data from ClinicalTrials.gov

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