Lateral Scar Dehiscence After Upper Blepharoplasty: Incidence and the Impact of Additional Tension-Relieving Sutures

Abstract

Purpose: To evaluate the incidence of lateral scar dehiscence following upper eyelid blepharoplasty and to determine whether the addition of lateral subcutaneous tension-relieving sutures reduces the occurrence of this complication.

Methods: A retrospective comparative study was conducted including female patients who underwent primary upper blepharoplasty during two consecutive periods. Group 1 (2022–2023; n = 404) underwent standard wound closure. Group 2 (2023–2024; n = 396) received additional buried subcutaneous tension-relieving sutures placed in the lateral third of the incision. All procedures were performed by the same surgeon using an identical technique and suture material (Vicryl 6-0). The primary outcome was the incidence of clinically diagnosed lateral scar dehiscence. Statistical analysis was performed using Fisher’s exact test.

Results: Lateral scar dehiscence occurred in 5 of 404 cases (1.24%) in Group 1 and in 1 of 396 cases (0.25%) in Group 2. The reduction was statistically significant (p = 0.048). The absolute risk reduction was 0.99% (95% CI: 0.02%–1.96%), corresponding to a relative risk reduction of 80%.. Dehiscence occurred predominantly in younger patients (mean age 36 ± 4 years in Group 1; 33 years in Group 2).

Conclusions: Lateral scar dehiscence is an infrequent but clinically relevant complication following upper blepharoplasty, particularly in younger female patients. The addition of lateral buried subcutaneous sutures significantly reduces its incidence and may improve postoperative wound stability.