Absorbable versus non-absorbable sutures in upper eyelid blepharoplasty: a systematic review of clinical outcomes and follow-up burden.

BACKGROUND: Upper eyelid blepharoplasty is a common surgical procedure requiring meticulous wound closure. The choice between absorbable and non-absorbable sutures remains debated, with implications for clinical outcomes, patient comfort, and postoperative follow-up burden. OBJECTIVE: This systematic review aims to compare absorbable and non-absorbable sutures in upper eyelid blepharoplasty, focusing on clinical outcomes (scar quality, complications) and postoperative burden (follow-up visits, discomfort). METHOD: Following PRISMA 2020 guidelines, a comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar. Included studies were randomized controlled trials, prospective/retrospective cohort studies, or case series directly comparing suture types. Data were extracted and synthesized qualitatively due to heterogeneity. RESULTS: Eleven studies met inclusion criteria. Absorbable and non-absorbable sutures demonstrated equivalent scar quality and complication rates. While absorbable sutures theoretically reduce follow-up burden by eliminating removal needs, no included study provided quantitative data on visit numbers or resource utilization. A potential reduction in patient discomfort is often cited, but was also not quantitatively measured. Suture technique (running vs. interrupted) influenced early edema but not long-term outcomes. Risk factors for adverse events were technique-dependent rather than suture material-dependent. CONCLUSION: Both suture types are clinically viable, with absorbable sutures offering logistical advantages. The choice should consider patient preferences and surgical context. Future research should quantify follow-up burden and evaluate newer suture technologies.