A Novel Technique for Small-Incision Fascia Lata Harvesting without a Fasciatome for the Frontalis Suspension Procedure

Abstract

Aim: To introduce a small-incision technique for fascia lata (FL) harvesting for the frontalis suspension blepharoptosis procedure. Technique and Methods: A skin incision was made along a line between the lateral condyle of the tibia and the anterior superior iliac crest, starting 4–5 cm above the knee and extending upward 2–2.5 cm. Approximately 8 cm superior to the first incision, a second skin incision was made with the same length. The FL was dissected from the subcutaneous tissue from 1 cm above the superior border of the upper incision to 1 cm below the inferior border of the lower incision. A 15 mm × 5–10 mm strip of FL was excised. The fascial defect was left open. Subcutaneous and deep layers were closed with three 4–0 plain catgut sutures and the skin was closed with subcuticular 5–0 prolene sutures. Results: The technique was used in 22 patients from 4 to 47 years of age (mean: 18.29) for 34 frontalis sling procedures. Mean follow-up time was 6.17 (3–16) months. Wound hematoma (1/22, 4.5%), wound discharge (2/22, 9%), pain at rest (100%, for up to 4 days), pain on walking (20/ 22, 90%; for up to 3 weeks), and limping (13/22, 59.1%; for up to 7 days) were the main postoperative complications. No significant skin scar was observed and none of the patients needed scar revision. Conclusion: The small-incision FL harvesting procedure is a good alternative method when the FL stripper is not available.

KEYWORDS:

• Fascia lata harvesting
• frontalis suspension procedure
• blepharoptosis
• eyelid surgery