A comparison of fibrin glue versus suture for anchoring fat pedicles in transconjunctival lower eyelid blepharoplasty.

[INTRODUCTION] Lower eyelid blepharoplasty involves several surgical techniques. In conventional procedures, fat pedicles are temporarily sutured with the external skin or internally fixed with the periosteum to anchor the fat. In this study, we compare a new method, which requires no sutures, of anchoring fat using fibrin glue to the conventional way of temporarily suturing with external skin.

[METHODS] We retrospectively collected data to identify 127 patients who underwent transconjunctival lower eyelid blepharoplasty with fat transposition to correct tear troughs. The patients were divided into two groups: 55 patients had the repositioned fat anchored with sutures and 72 patients had the fat anchored using fibrin glue. We focused on the score of postoperative complications multiple times.

[RESULTS] In terms of skin discoloration, 57.14 % of the patients in the suture group exhibited Grade 2 changes and 42.85 % reached Grade 3. In contrast, only 36.36 % of the patients in the fibrin glue group reached Grade 2, with the majority (54.54 %) showing mild Grade 1 discoloration, and no cases reaching Grade 3. For eyelid tension, no patients in the fibrin glue group experienced severe Grade 3 tension, compared to 2.04 % of the patients in the suture group. Additionally, severe Grade 3 contusions appeared in 71.42 % of the patients the suture group but only in 36.36 % of the patients in the fibrin glue group.

[CONCLUSIONS] Among the patients who underwent transconjunctival lower eyelid blepharoplasty with fat transposition, the use of fibrin glue produced substantially lowered the severity of skin discoloration and reduced hematoma tension compared to sutures.