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Updated: Jul 14, 2026

Surgical Correction for Pediatric Epiblepharon and Trichiasis
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Does suture material and technique really matter? Lessons learned from 800 consecutive blepharoplasties.

Arjun S Joshi1, Sasa Janjanin, Neil Tanna

  • 1Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington, DC, USA. arjuns.joshi@gmail.com

The Laryngoscope
|June 5, 2007
PubMed
Summary

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This study compared blepharoplasty closure techniques. Running 6-0 fast-absorbing gut sutures resulted in the lowest complication and revision rates, indicating superior outcomes for this method.

Area of Science:

  • Oculoplastics
  • Plastic Surgery
  • Surgical Techniques

Background:

  • Blepharoplasty is a common cosmetic procedure.
  • Suture selection impacts surgical outcomes and patient satisfaction.
  • Minimizing complications like milia, scarring, and deformities is crucial.

Purpose of the Study:

  • To evaluate established suture materials and techniques for blepharoplasty closure.
  • To compare complication and revision rates among different closure methods.

Main Methods:

  • Prospective study of upper blepharoplasty patients over 5 years.
  • Four different incision closure techniques were utilized.
  • Complications, revisions, and patient satisfaction were assessed post-surgery.

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Main Results:

  • Running subcuticular polypropylene (Prolene) had 2.5% milia and 5.5% standing cone deformity (SCD).
  • Running 6-0 fast-absorbing gut showed the lowest complication rates, with only 2% milia and no scar revisions.
  • Statistically significant differences in milia, scarring, and erythema were observed between groups (P < .008).

Conclusions:

  • Blepharoplasty is safe and effective with various techniques.
  • Closure using two interrupted 6-0 Prolene sutures and running 6-0 fast-absorbing gut yielded the lowest complication and revision rates in this series.