• In a previous study, one of us (W.H.F.) has shown excess suture line tension to be measurably related to the formation of ectropion. The ratios of suture line closing pressure to opening pressure that exceed 4:1 have been shown to produce ectropions consistently in monkeys. In humans, it has been shown that ratios of this magnitude seldom occur in cosmetic blepharoplasty. This clinical study was performed as a follow-up in which ratios of 3.0 to 4.0 were deliberately created in humans to enhance the lower blepharoplasty, while approaching the maximum safe limit of skin-muscle excision ratio of 4.0. While three early reversible complications occurred that necessitated moderation, cosmetic results were enhanced by maximizing the skin-muscle excision in all 30 patients. In this way, the measurement of suture line tension was helpful during surgery, and this measurement could be of further usefulness in the routine preoperative examination of patients who are about to undergo blepharoplasties.
(Arch Otolaryngol 1981;107:443-445)