A Novel Technique for Small-Incision Fascia Lata Harvesting without a Fasciatome for the Frontalis Suspension Procedure

Aim: To introduce a small-incision technique for fascia lata (FL) harvesting for the frontalis suspension blepharoptosis procedure. Technique and Methods: A skin incision was made along a line between the lateral condyle of the tibia and the anterior superior iliac crest, starting 4-5 cmabove 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 the subcutaneous tissue from 1 cm above the superior border of the upper incision to 1 cm below the inferior border of the lower incision. A 15 mm x 5-10mmstrip 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 was closed with subcuticular 5-0 prolene sutures. Results: The technique was used in 22 patients from 4 to 47 years of age (mean: 18.29) for 34 frontalis sling procedures. Mean follow-up time was 6.17 (3-16) months. Wound hematoma (1/22, 4.5%), wound discharge (2/22, 9%), pain at rest (100%, for up to 4 days), pain on walking (20/22, 90%; for up to 3 weeks), and limping (13/22, 59.1%; for up to 7 days) were the main postoperative complications. No significant skin scar was observed and none of the patients needed scar revision. Conclusion: The small-incision FL harvesting procedure is a good alternative method when the FL stripper is not available.