Is Enduragen the best option for tissue shaping the eyelid?

Question

Hello. I have to have lower eyelid retraction / entropion reconstructive surgery due to a messed up lower blepharoplasty. I do not want to go through a repair more than once! One of the surgeons I am considering uses Enduragen for grafting for tissue shaping the eyelid. I find this calming compared to the roof of my mouth since I have to do 2 eyelids and I have heard the roof of mouth is very very painful and then you have a hole. Please advise what is best for the tissue?

Kenneth D. Steinsapir, MD · Answer

Enduragen is derived from pig dermis. It is decelularized and chemically cross-linked collagen material. Surgeons who do eyelid reconstruction often favor these "off the shelf" reconstruction materials because they save operative time compared to harvesting graft material like hard palate graft. Alloderm, prepared from human cadaveric dermis, is just human dermis collagen without chemical cross linking. Small case series suggest that no one of these materials is better than the other. Generally I often need to remove the cross-linked material due to low grade chronic inflammation. I do not believe it is understood why some individuals react this way and others do not. However, I have removed enough of this material that I do not recommend it for lower eyelid reconstruction. It sounds like you have been frighten by a surgeon who does not know how to manage hard palate grafts. The mouth is only uncomfortable if it is left open. However it is a simple proposition to have a dentist fabricate an acrylic stent for the roof of the mouth. It looks like a retainer and it covers the roof of the mouth sealing the site where the hard palate graft was harvested. This prevents bleeding from the wound and also instantly makes the roof of the mouth comfortable. Surgeons who do not use a palate stent are missing an essential aspect that makes the use of the hard palate graft possible.

Ayse Dolar Bilge, MD · Answer

If your lower eyelid retraction isn't too severe, Enduragen might be beneficial, but it could be insufficient for more significant retractions. A more stable product might be necessary. For this purpose, I use ear cartilage grafts. It can be considered as an option.

Is Enduragen the best option for tissue shaping the eyelid?

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Is Enduragen the best option for tissue shaping the eyelid?

Answers (2)

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Recommended reading

Everything you need to know about Eyelid Retraction Repair

Our mission is to create a world where every investment in modern beauty is Worth It.