Performing a wider lateral skin excision to address the hooding during upper blepharoplasty (UB) may result in lateral wound dehiscence (LWD). The aim is to report the frequency of LWD, report the technique and results of a simple measure to prevent LWD, and compare its frequency after using this method.

An audit UB procedure was performed in 2009. Subsequently, subjects were divided into two groups based on intra-operative assessment of lateral wound tension (Same technique and surgeon). Group 1 received 1-3 orbicularis/subcutaneous buried sutures (6-0 polyglactin) before interrupted 6-0 nylon skin closure. Group 2 just had skin closure. Subjects with re-operation, skin healing disorders, and incomplete follow up (less than 6 months) were excluded.

There were 14 (14/678, 2%) cases with LWD with a mean age of 36.2 years in the audit (2003- 2009). Prospective study included 68 subjects (68/293, 23.2%) in the group 1 and 225 in the group 2. Two groups were not different with regard to the gender (P=0.3) and simultaneous forehead and eyebrow procedures (P=0.4). However, subjects in group 1 (mean age: 41.4 years) were significantly (P= 0.000) younger than group 2 (mean age: 56.1 years). Frequency of LWD significantly (P=0.04) decreased to 0.3% (1/293).

In the presence of wound tension on skin closure (intra-operative assessment), tension relieving buried orbicularis/subcutaneous 6-0 polyglactin suturing of the lateral UB incision could prevent LWD.