title: Does suture material and technique really matter? Lessons learned from 800 consecutive blepharoplasties.
abstract: OBJECTIVE
  The purpose of this study was to evaluate established suture materials and techniques for blepharoplasty closure and evaluate for any differences in rates of complications between these groups.
  
  
  METHODS
  This was a prospective study of a large sequential series of patients undergoing upper blepharoplasty who were treated by the same senior author over a 5-year period. Patients were assigned one of four techniques for closure of the incision based on the senior author's experience. After 6 weeks, rates of complications and revisions were noted and addressed. Satisfaction rates were noted at 3 months.
  
  
  RESULTS
  In the group whose incisions were closed with running subcuticular polypropylene (Prolene), 5 (2.5%) presented with milia, and 11 (5.5%) had a standing cone deformity (SCD). Use of running cutaneous locked Prolene resulted in 8 patients (17%) with milia and 2 patients (4.4%) requiring revision of a SCD. Use of a running 6-0 plain gut suture resulted in 12 patients (6.7%) with milia and 5 patients (2.8%) with unsightly scarring. In the group whose incisions were closed with running 6-0 fast-absorbing gut, 10 patients (2%) presented with milia, and there were no scar revisions. There were statistically significant differences between the groups with respect to formation of milia, scarring, and persistent erythema (P < .008).
  
  
  CONCLUSIONS
  Blepharoplasty is a safe and effective procedure that can be performed successfully with several established techniques. In our experience, closure with two interrupted 6-0 Prolene sutures and a running 6-0 fast-absorbing gut resulted in the lowest rates of complications and revisions.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, The George Washington University, Washington, DC, USA. arjuns.joshi@gmail.com
authors.forename: Arjun S
authors.initials: AS
authors.lastname: Joshi
authors.forename: Sasa
authors.initials: S
authors.lastname: Janjanin
authors.forename: Neil
authors.initials: N
authors.lastname: Tanna
authors.forename: Craig
authors.initials: C
authors.lastname: Geist
authors.forename: William H
authors.initials: WH
authors.lastname: Lindsey
authors.forename: Charlie
authors.initials: C
authors.lastname: Lindsey
mesh_terms: D019882:Blepharoplasty / Q000295:instrumentation / Q000379:methods*; D004890:Erythema / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006406:Hematoma / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D017060:Patient Satisfaction; D011126:Polypropylenes; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures / Q000592:standards*; D014985:Xerophthalmia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology
chemical_list: D011126:Polypropylenes