novel technique of small incision fascia lata harvesting without a faciatome for frontalis suspension procedure

ABSTRACT

To introduce a small incision technique of fascia lata [FL] harvesting for frontalis suspension blepharoptosis procedure. A skin incision was made in 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 subcutaneous tissue from 1 cm superior to superior border of upper incision to 1 cm inferior to inferior border of lower incision. A 15 mm x 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 with subcuticular 5-0 prolene sutures. The technique was used in 22 patients from 4 to 47 years of age [Mean 18.29 +/- 14.20] for 34 frontalis sling procedures. Mean follow-up time was 6.17 +/- 3.21 [3-16] months. Wound hematoma [1/22, 4.5%], wound discharge [2/22, 9%], pain at rest [100%, up to 4 days], pain on walking [20/22, 90%; up to 3 weeks], limping [13/22, 59.1%; up to 7 days] were the main postoperative complications. No significant skin scar was observed and none of the patients needed scar revision. Small incision FL harvesting procedure is a good alternative method when the FL stripper is not available