Diagnosis and treatment of needle retention after blepharoplasty

Needle retention is a rare but dangerous complication in ophthalmologic and oculoplastic surgery, with a limited literature detailing this issue. This study aimed to summarize the characteristics of needle retention after blepharoplasty, introduce intervention experience, and offer preventive suggestions.

This retrospective case series included six eyes of 6 consecutive Chinese patients that received prior initial blepharoplasties and presented to the emergency unit. Demographics, clinical features, and complications of all patients were collected, and diagnoses were made by three-dimensional computed tomography (3D-CT) scanning with volume rendered technique. All needles were removed by minimally invasive surgery.

All patients accepted their initial blepharoplasty either at private cosmetic clinics (5/6) or at a friend's home (1/6). Only on using 3D-CT scanning, could the location of retained needles be confirmed. Needles were located in the lateral part of the left-sided eyelid for all patients, and resided in the orbicularis layer (5/6) or periosteum (1/6). In needle removal surgeries, four patients (2/3) accepted percutaneous small incision method, and the remaining two (1/3) were treated via their existing wounds. No intra- or postoperative complications during operations or follow up were found.

Diagnosis of needle retention is based on histories, and use of 3D-CT scanning is recommended for location. The retained needle should be removed promptly before its potentially devastating migration begins, and small incisional surgery with an aesthetic design is effective. Authentic private and public institutionally qualified surgeons in cosmetic surgery should be validated and supervised by the Government.