Coronal rhytidectomy in conjunction with deep plane walking sutures, modified Hotz‐Celsus and lateral canthoplasty procedure in a dog with excessive brow droop

Abstract

This case report describes a unique technique of rhytidectomy in a Bloodhound to repair excessive brow folding and droop complicating underlying entropion. This case posed specific challenges due to the loose fascial plane connective tissue. A large circular area of coronal skin was excised, followed by placement of deep plane walking fixation sutures for cosmetic realignment and to alleviate brow droop. In addition, a modified Hotz-Celsus procedure and lateral canthoplasty were performed to address the primary entropion. The coronal rhytidectomy was considered a successful approach to repair excessive brow droop in this Bloodhound.

Modified walking suture technique in rhytidectomy in a Shar-Pei dog

“…Despite the description of techniques for rhytidectomy in dogs, such as the elliptical rhytidectomy in the midline of the craniocaudal head described by Bedford (1990); the stellate technique described by Stuhr et al (1997); the coronal rhytidectomy associated with the walking suture adopted by McCallum and Welser (2004) and more recently the bilateral crescent-shape section of skin removal in the supraorbital region associated with shortening of the palpebral fissure (STEINMETZ, 2015), it was noted that none of these techniques would be effective in the present case. Thus, it is presented in this report an association of the mentioned techniques for rhytidectomy, taking advantage of its qualities for the correction of excessive skin folds covering the zygomatic, masseteric and lateral regions of the neck, as well as the supraorbital regions, which included the modified walking suture and walking suture pattern for deep anchorage for closure of the cutaneous wound.…”

“…The weight of the skin folds on the head, especially on the upper eyelids, forcing them down, sometimes makes it impossible to correct the entropion by the technique of Hotz-Celsus alone, making it necessary a combination of techniques (STUHR et al, 1997;WILLIS et al, 1999;GELATT;GELATT, 2011), as well as the resection of the excess of facial folds, called rhytidectomy, term derived from the Greek Rhytis = wrinkles and ektomé = excision, also known as facelift (STUHR et al, 1997;MCCALLUM;WELSER, 2004;STEINMETZ, 2015).…”

The use of hyaluronic acid subdermal filler for entropion in canines and felines: 40 cases

“…Chronic irritation of the cornea and conjunctiva from entropion may lead to the development of corneal edema, ulcerative keratitis, corneal vascularization, and fibrosis, pigmentary keratitis, or even loss of vision with complications becoming more clinically significant over time . Surgical correction has been reported as the only definitive treatment for entropion, and several techniques have been described, such as Hotz‐Celsus, lateral canthal closure, fornix‐based suture placement, medial canthal Y to V‐plasty, stellate rhytidectomy, the Stades method, or some combination of these techniques . A modified, nonsutured Hotz‐Celsus using a carbon dioxide (CO 2 ) laser also was recently described in two cats and two dogs …”

NonsuturedHotz–Celsus technique performed byCO2laser in two dogs and two cats

“…Surgical correction is the only definitive treatment, and several techniques have been described, such as Hotz–Celsus, lateral canthal closure, medial canthal Y to V‐plasty, stellate rhytidectomy, and the Stades method . In each case, the surgeon has to select the most appropriate corrective surgical technique to restore normal eyelid conformation and resolve ocular pain and corneal changes.…”

“…1 Surgical correction is the only definitive treatment, and several techniques have been described, such as Hotz-Celsus, lateral canthal closure, medial canthal Y to V-plasty, stellate rhytidectomy, and the Stades method. 2,[6][7][8][9][10][11][12] In each case, the surgeon has to select the most appropriate corrective surgical technique to restore normal eyelid conformation and resolve ocular pain and corneal changes. White et al, 13 reported the surgical management outcomes of lower eyelid entropion in 124 cats using a combination of Hotz-Celsus and lateral canthal closure techniques, giving an overall success rate of 99.21%.…”