title: Optimizing closure materials for upper lid blepharoplasty: a randomized, controlled trial.
abstract: BACKGROUND
  Although upper eyelid blepharoplasty is a common procedure, subtleties in surgical technique can affect cosmetic outcomes. Suture materials commonly used include polypropylene, monofilament nylon, fast-absorbing gut, and ethylcyanoacrylate (ECA) tissue adhesive.
  
  
  OBJECTIVE
  To assess upper lid blepharoplasty scars in participants whose incision had been closed with 6-0 polypropylene sutures, 6-0 fast-absorbing gut sutures, or ECA.
  
  
  METHODS
  A randomized, split-eyelid, single-blind, prospective study of the short- (1 month) and intermediate-term (3 months) efficacy of polypropylene, fast-absorbing gut, and ECA on 36 consecutive upper lid blepharoplasties. Participants and a blinded physician evaluator evaluated cosmetic outcome 1 and 3 months after the procedure.
  
  
  RESULTS
  Three subgroups tested were ECA versus fast-absorbing gut, ECA versus polypropylene, and fast-absorbing gut versus polypropylene. At 1 month, ECA was superior to fast-absorbing gut (p=.03) and had a marginally better outcome than polypropylene (p=.25), and polypropylene had an equivalent outcome to fast-absorbing gut (p=.46). At 3-month follow-up, ECA remained superior to fast-absorbing gut (p=.03).
  
  
  CONCLUSIONS
  Although sutured epidermal closure and tissue adhesive are highly efficacious for upper eyelid blepharoplasty, physicians and participants felt that cosmesis with ECA was superior to that with fast-absorbing gut.
authors.affiliation: Department of Dermatology, Henry Ford Health System, Detroit, Michigan, USA. dkouba1@hfhs.org
authors.forename: David J
authors.initials: DJ
authors.lastname: Kouba
authors.forename: Emily
authors.initials: E
authors.lastname: Tierney
authors.forename: Bassel H
authors.initials: BH
authors.lastname: Mahmoud
authors.forename: Denise
authors.initials: D
authors.lastname: Woo
mesh_terms: D019882:Blepharoplasty / Q000379:methods*; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013529:Surgical Wound Dehiscence / Q000453:epidemiology; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D014014:Tissue Adhesives