PROBLEMSurgical excision is a commonly used treatment for xanthelasma palpebrarum (XP).Owing to the thin and lax nature of eyelid skin, post-excisional defects are often closed with simple interrupted or mattress sutures. 1Although effective for approximation, these suturing methods may leave visible suture marks on the delicate eyelid skin, which can compromise the final cosmetic outcome and reduce patient satisfaction. 2In addition, minor irregularity of edge apposition may make the scar more conspicuous in this highly visible anatomical site.A closure technique that minimizes surface suture marks while allowing the scar to blend with the natural eyelid folds may therefore offer a cosmetic advantage. SOLUTIONTo improve cosmetic outcomes after XP excision, wound edge approximation can be completed using a running intradermal subcuticular 6-0 polypropylene suture, secured with floating knots at both ends Figure 1 and Video 1.When required, one or more buried absorbable sutures, such as 6-0 polyglactin or polydioxanone, may first be placed to approximate the deeper layer www.cosmoderma.org
Gajula et al. (Tue,) studied this question.