A Novel Technique of Small Incision Fascia Lata Harvesting without a Faciatome for Frontalis Suspension Procedure

Purpose: To introduce a small incision technique of fascia lata (FL) harvesting for frontalis suspension blepharoptosis procedure. Methods: 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. Results: 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. Conclusion: Small incision FL harvesting procedure is a good alternative method when the FL stripper is not available.