Objective: To compare the efficacy of tranexamic acid (TXA) versus etamsylate (ETM) in reducing postoperative ecchymosis in upper blepharoplasty. Introduction: With an increase in demand for shortened recoveries after facial aesthetic surgery, various optional approaches have been sought out. In terms of ecchymosis, TXA and ETM have been most commonly used. Method: A prospective, intrapatient split face study was conducted from January 2020 to January 2021 in 40 patients who underwent upper blepharoplasty under local anesthesia. Two equal anesthetic solutions were prepared; Solution A contained TXA and solution B contained ETM. Solution A was injected in the right eyelid and solution B in the left eyelid. Postoperative ecchymosis was assessed by 2 blinded evaluators, the assisting surgeon (Observer 1) and an external surgeon (Observer 2) at 48 h and on the seventh day using a scale published by Sagiv et al. Results: Postoperative ecchymosis was found to be less at 48 h by both observers with TXA solution. Moreover, at the seventh day, no ecchymosis was found in 32.5% with TXA solution compared to 2.5% with ETM solution. Kappa analysis showed concordance between observers. Conclusion: In our study, TXA solution was a more effective therapy when compared to ETM solution for reducing ecchymosis. Larger case studies are required to prove the difference for validation.
The objective of the study was to compare wound dehiscence in upper blepharoplasty between the traditional suturing technique and the modified suturing technique in split-face study. A prospective, intrapatient split-face study was conducted from October 2019 to August 2020 in 40 patients who underwent upper blepharoplasty. The incision was made on both eyes, where the left eye received 3 subcutaneous buried sutures (6-0 polyglactin) before interrupted 6-0 nylon skin closure (modified technique), and the right eye underwent skin closure only (traditional technique). At 3 months, the aesthetic results using Hollander wound scale were evaluated by patients and an independent surgeon blinded to the method of closure. The study included 40 patients with an average age of 45 years. At 3 months, 39 patients (97.5%) recorded lateral wound dehiscence on the right eye and 0 patients (0%) on the left eye. The patient was scored 2 on the right eye and 5 on the left eye by the surgeon, whereas the patient scored 3 on right eye and 5.5 on left eye on Hollander wound scale. The modified technique in upper blepharoplasty proved to be a more aesthetically appealing and effective method to achieve a better scar in inverted canoe-shaped incisions with high-tension closure in well-positioned eyebrow.
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