Fascia Lata Harvest Research Articles

Cosmetic and functional impact of fascia lata harvest for use in surgery for stress urinary incontinence.

There has been increased interest in using autologous tissues since the Food and Drug Administration banned transvaginal mesh for pelvic organ prolapse in 2019. Our study aims to assess patients' perspective of functional and cosmetic impact on the fascia lata harvest site in patients undergoing fascia lata harvest for the treatment of stress urinary incontinence (SUI). This is a prospective survey study of a retrospective cohort of patients who underwent a fascia lata pubovaginal sling between 2017 and 2022. Participants completed a survey regarding the functional and cosmetic outcomes of the harvest site. Seventy-two patients met the inclusion criteria. Twenty-nine patients completed the survey for a completion rate of 40.3%. For functional symptoms, 24.1% (7/29) of patients reported leg discomfort, 10.3% (3/29) reported leg weakness, 10.3% (3/29) reported a bulge, 17.2% (5/29) reported scar pain, 14.8% (4/27) reported scar numbness, and 17.2% (5/29) reported paresthesia at the scar. For cosmetic outcomes, 72.4% (21/29) reported an excellent or good scar appearance. On the PGI-I, 75.9% (22/29) reported their condition as very much better (48.3%, 14/29) or much better (27.6%, 8/29). The majority of patients reported being satisfied with the functional and cosmetic outcomes of their harvest site as well as satisfied with the improvement in their SUI. Less than 25% of patients report harvest site symptoms, including leg weakness, scar bulging, scar pain, scar numbness, or paresthesia in the scar. This is important in the context of appropriate preoperative discussion and counseling regarding fascia lata harvest.

Harvest of large fascia lata autograft: Outcomes in 108 patients.

Due to the reclassification of transvaginal mesh as a high-risk device, there has been renewed interest in the use of fascia lata in pelvic floor reconstruction. Here we report our experience in 108 patients who underwent large fascia lata harvest for pelvic organ prolapse (POP) repair. Our primary objective was to highlight the postoperative morbidity of the large fascia lata harvest in patients who underwent POP repair using fascia lata autograft. Surgery involved harvesting a fascia lata graft through a small lateral upper thigh incision and was used for either autologous transvaginal POP repair or autologous sacrocolpopexy. To prevent seroma, a temporary Jackson-Pratt drain was intraoperatively placed and a mild compression wrap was applied to the area for 4-6 weeks postoperatively. Patient demographics were obtained preoperatively, while physical exam findings and postoperative outcomes related to the fascia lata harvest were collected at sequential follow up visits. One-hundred eight patients underwent 111 large fascia lata harvests for either transvaginal or abdominal/robotic POP repair from July 2016 to January 2022. Mean follow-up was 19.6 months (range: 1-65) with 38 patients having 24 months or more of follow-up. Mean Visual Analog Pain (VAP) score was 1 (range: 0-10). Sixteen patients developed asymptomatic thigh bulges, 16 patients developed harvest site seromas (of which 14 resolved), and 59 patients experienced mild, non-bothersome paresthesia near the incision. Large fascia lata harvest offers a robust autograft for transvaginal or transabdominal POP repair with minimal morbidity. Harvest site complications are minor and typically resolve with expectant management. This technique can be safely utilized in patients who desire graft-augmented repair of POP without the use of synthetic mesh, allograft, or xenograft.

Comparison of perioperative adverse events following suburethral sling placement using synthetic mesh, autologous rectus fascia, and autologous fascia lata in a national surgical registry.

To assess and compare 30-day perioperative adverse events following suburethral sling surgery using synthetic mesh, autologous rectus fascia, and autologous fascia lata in women. This was a retrospective cohort study of patients who underwent fascial or synthetic sling placement for stress urinary incontinence between 2008 and 2021 using the American College of Surgeons' National Surgical Quality Improvement Program database. Current Procedural Terminology codes were used to identify patients undergoing each type of sling procedure. Multivariable regression analysis with stepwise regression was used to assess the odds of composite adverse events (e.g., urinary tract infection, surgical site infection, pulmonary embolism, and other reportable events) between cohorts. Of the 41 533 female patients who underwent isolated suburethral sling placement without concurrent procedures, 41 292 (99.4%) received a synthetic mesh sling, and 241 (0.6%) received an autologous facial sling. In the fascial sling cohort, 160 (66.4%) underwent rectus fascia harvest and 81 (33.6%) underwent fascia lata harvest. Sling surgeries involving autologous fascia were associated with increased odds of adverse events compared to those involving synthetic mesh, even after adjusting for confounders (adjusted odds ratio [aOR]: 3.63, 95% confidence interval [CI]: 2.56-5.15). Compared to fascial slings from rectus fascia, slings from fascia lata were associated with increased odds of composite adverse events (aOR: 2.11, 95% CI: 1.03-4.04). However, with the exclusion of urinary tract infections, the adverse event rate was similar between slings using the two fascial harvest techniques (aOR: 1.93, 95% CI: 0.81-4.63). In this retrospective database study, suburethral sling surgeries using autologous fascia were independently associated with a 3.6-fold increase in odds of 30-day perioperative adverse events compared to sling surgeries using synthetic mesh.

Impact of collagen matrix on reconstructive material selection and postoperative complications in endoscopic endonasal skull base surgery.

The aim of this study was to investigate the impact of collagen matrix on reconstructive material selection and postoperative complications in endoscopic endonasal skull base surgery. The authors retrospectively reviewed the data of consecutive patients who underwent purely endoscopic endonasal skull base surgery from January 2015 to March 2023. Intraoperative CSF leakage was classified according to the Esposito grade, and skull base repair was tailored to the leakage grade. The patients were divided into two groups: before (group A) and after (group B) collagen matrix implementation. The rates of autologous graft harvesting (fat, fascia, and nasoseptal flap), postoperative CSF leakage, and donor-site complications were compared between the two groups. In total, 270 patients were included. Group A included 159 patients and group B included 111 patients. There were no differences in patient characteristics, including age, pathology, and Esposito grade, between the two groups. The overall fat usage rate was significantly higher in group A (63.5%) than in group B (39.6%) (p = 0.0001), and the fascia usage rate was also significantly higher in group A (25.8%) than in group B (4.5%) (p < 0.0001). The nasoseptal flap usage rate did not differ between group A (32.7%) and group B (30.6%) (p = 0.79). Postoperative CSF leakage was similar between the two groups (0.63% in group A vs 1.8% in group B, p = 0.57), and the overall rate of CSF leakage was 1.1%. Donor-site complications occurred in 3 patients in group A, including 1 abdominal hematoma, 1 delayed abdominal infection, and 1 fluid collection after fascia lata harvesting. Collagen matrix implementation significantly decreased autologous graft harvesting without increasing postoperative CSF leakage, contributing to less invasive surgery.

Robotic Sacral Colpopexy Using Autologous Fascia Lata Compared with Mesh.

Objective: The objective is to compare robotic sacral colpopexy (RSC) utilizing autologous fascia lata with RSC with synthetic mesh in the treatment of pelvic organ prolapse (POP). Methods: We performed a prospective nonrandomized case comparison trial at a single institution. We compared RSC utilizing either synthetic mesh or autologous fascia lata in women with symptomatic POP, stages II through IV. The primary outcome was anatomic prolapse recurrence determined by the Pelvic Organ Prolapse Quantification (POP-Q) examination. Secondary outcomes included patient-reported outcomes such as the Urogenital Distress Inventory-6 (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7). Complications were also recorded and categorized using the Clavien-Dindo (CD) system. The hypothesis is that autologous fascia lata would provide equivalent anatomic and patient-reported outcomes compared with mesh while eliminating mesh-related complications. Results: Sixty-four women underwent RSC with 19 (29.7%) receiving fascia lata graft. The overall operative time was greater in the fascia lata group with mean fascia lata harvest time of 24.8 ± 7.4 minutes. Intragroup comparisons of the fascia and mesh groups demonstrated significant improvement in pelvic measurements as well as patient-reported outcomes. Intergroup comparison demonstrated equivalent success rates at 12.1 ± 8.7 months follow-up. There was one apical failure in the fascia lata RSC group; however, the difference was not statistically significant (p = 0.30). Significant complications in the fascia lata harvest group included two CD-II and one CD-IIIb. In the mesh group there was one mesh erosion requiring surgical excision (CD-IIIb). Conclusion: This is the first comparison between RSC with autologous fascia lata and mesh. Short-term anatomic outcomes were similar with autologous fascia lata use without the risk of mesh erosion. Morbidity from graft harvest site was not trivial. These results emphasize the need for a randomized controlled trial.

Acellular dermal matrix as an alternative to autologous fascia lata for skull base repair following extended endoscopic endonasal approaches.

Skull base reconstruction after extended endoscopic endonasal approaches (EEAs) can be challenging. In addition to the nasoseptal flap, which has been adopted by most centers, autologous fascia lata is also often utilized. Harvesting of fascia lata requires a separate thigh incision, may prolong recovery, and results in a visible scar. In principal, the use of non-autologous materials would be preferable to avoid a second incision and maintain the minimally invasive nature of the approach, assuming the CSF leak rate is not compromised. To assess the efficacy of acellular dermal matrix (ADM) as a non-autologous alternative to autologous fascia lata graft for watertight closure of the cranial base following EEAs. A retrospective chart review of extended EEAs performed before and after the transition from fascia lata to ADM was performed. Cases were frequency matched for approach, pathology, BMI, use of lumbar drainage, and tumor volume. Power analysis was performed to estimate the sample size needed to demonstrate non-inferiority. ADM was used for watertight closure of the cranial base in 19 consecutive extended endoscopic endonasal approaches (16 gasket-seals and 3 buttons) with 1 postoperative CSF leak at the last follow-up (median 5.3, range 1.0-12.6months). All patients had high-flow intraoperative leaks. The cohort included 8 meningiomas, 8 craniopharyngiomas, 2 chordomas, and 1 pituicytoma ranging in size from 0.2 to 37.2cm3 (median 5.5, IQR 2.8-13.3cm3). In 19 historical controls who received fascia lata, there were 2 postoperative CSF leaks. Preliminary results suggest that ADM provides a non-inferior non-autologous alternative to fascia lata for watertight gasket-seal and button closures following extended EEAs, potentially reducing or eliminating the need to harvest autologous tissue.

Fascia Lata Harvesting: The Donor Site Closure Morbidity.

Fascia lata (FL) is a worldwide adopted source of autologous grafts. In our Department, the endoscopic endonasal transphenoidal surgery (EETS) has been performed regularly for anterior and middle cranial fossa lesions, and FL graft has commonly been a practical resource in repairing tissue defects after EETS.Enough, we used routinely harvesting FL to restore symmetry in facial palsy. To our known, this is the biggest case series about FL harvesting to repare tissue defects after EET. The purpose of our study was to evaluate our experience with the harvesting of FL, in particularly the donor site morbidity. This is a prospective study case series, which evaluated by questionnaire the morbidity of FL donr site. The details of 44 patients were analyzed from 2011 to 2016. Thirty-eight patients needed cranial base reconstruction and 6 patients needed facial reanimation. Adequate length of FL was harvested in all our patients. There were no intraoperative complications. We did not use drain in any case. We analyzed 18 women (40%) and 26 men (59.9%). The estimated median age at presentation was 51.53. For little FL's gap, diameter until 3 × 6 cm, it's possible to suture FL's margin with Nylon, but for bigger gap it's necessary to reconstruct with allograft to avoid muscle bulge or compartmental syndrome.

Minimally invasive fascia lata harvesting in ASCR does not produce significant donor site morbidity.

The aim of this study was to prospectively evaluate donor site morbidity in arthroscopic superior capsular reconstruction using a minimally invasive harvested fascia lata autograft. Fifteen consecutive patients underwent arthroscopic superior capsular reconstruction by the senior author using a fascia lata autograft harvested in a minimally invasive fashion. All patients were prospectively evaluated at 1 week, 6 and 18months postoperatively. The subjects' body mass index, age, actual or previous corticosteroid therapy history and active smoking habits were evaluated. Functional outcomes were assessed by the non-arthritic hip score applied to the harvested and contralateral thighs. Every patient completed standardized subjective satisfaction questionnaires at all evaluations. The median patient age was 65.5years (range 47-77). Nine patients (60%) were females, and six (40%) were males. One patient (6.7%) was within the normal range of weight, nine (60%) were overweight, four (27%) were obese, and one (6.7%) was extremely obese. Two patients (13%) were active smokers. No patients had an active or previous record of corticosteroid therapy. No patients required postoperative lower limb physical therapy. In terms of overall and cosmetic satisfaction, most patients reported that they were satisfied or very satisfied at all evaluations, and the proportion of very satisfied patients increased over time (p < 0.001). The harvested thigh's functional scores were 91% (p = 0.003) and 94% (p = 0.008) of the healthy thigh's score at 6 and 18 months, respectively. The complications reported were mild, and their proportions decreased in the first 18 months after surgery (p = 0.04). The minimally invasive fascia lata harvesting technique for arthroscopic superior capsular reconstruction leads to donor site satisfactory subjective results and good functional outcomes at 18 months after surgery. According to these findings, donor site morbidity is not a valid argument against the use of this autograft for arthroscopic superior capsular reconstruction. Case series, level IV.

Endoscope-assisted harvest of autogenous fascia lata in frontalis suspension surgery: A minimally invasive approach revisited.

Purpose:To report endoscope-assisted fascia lata harvest (EAFH) as a minimally-invasive technique for correction of severe blepharoptosis.Methods:This was a retrospective case series between January 2013 and April 2017. Medical records of all consecutive patients who underwent frontalis suspension by EAFH in the study period were reviewed and outcome was analyzed.Results:Fourteen patients (10 males) were included in the study. Mean age of the group was 18.14 + 17.03 years (range 4-65 years) and 11 patients had simple congenital blepharoptosis. Blepharophimosis syndrome was seen in 3 patients. Eleven patients had bilateral blepharoptosis. The mean preoperative and postoperative MRD1 was –1.60 ± 0.87 mm and +2.12 ± 1.37 mm respectively. Mean lengths of the incision and fascial harvest were 2.25 ± 0.43 cm and 13.0 ± 2.35 cm (range 10-17 cm) respectively. The median follow-up of patients was 4.57 + 4.03 months (range 1-15 months). Complications included a wound dehiscence in two patients and these were resutured. The donor sites healed well in all patients leaving a small thigh scar and none needed scar revision.Conclusion:EAFH is a promising minimally-invasive technique performed with a small incision and achieved adequate length of fascial harvest.

Hemi-transseptal Approach for Pituitary Surgery: A Follow-Up Study.

Objectives The hemi-transseptal (Hemi-T) approach was developed to overcome the potential drawbacks of the nasoseptal flap (NSF) in endoscopic endonasal transsphenoidal skull base surgery. In this study, we describe further refinements on the Hemi-T approach, and report long-term outcomes as compared with traditional methods of skull base reconstruction. Design A retrospective case-control study. Setting Montreal Neurological Institute and Jewish General Hospital, Montreal, Canada. Participants Patients who underwent endoscopic endonasal transsphenoidal approach to skull base pathology. Main Outcome Measures Operative time, CSF rhinorrhea, and postoperative nasal morbidity. Results A total of 105 patients underwent the Hemi-T approach versus 40 controls. Operative time was shorter using the Hemi-T technique (180.51 ± 56.9 vs. 202.9 ± 62 minutes; p = 0.048). The rates of nasal morbidity (septal perforation [5/102 vs. 6/37; p = 0.029] and mucosal adhesion [11/102 vs. 10/39 p = 0.027]), fascia lata harvest (21/100 vs. 18/39; p = 0.0028), and postoperative CSF leak rates (7/100 vs. 9/38; p = 0.006) were lower in the Hemi-T group. Conclusion Advantages of the Hemi-T approach over traditional exposure techniques include preservation of the nasal vascular pedicle, shorter operative time, reduced fascia lata harvest rates, and decreased nasal morbidity.

Intra-eyebrow frontalis suspension using inverted Y-shaped short autogenous fascia lata for blepharoptosis with poor levator function

Frontalis suspension using autogenous fascia lata is a common procedure for blepharoptosis with poor levator function. However, donor-site morbidity associated with fascia lata harvest cannot be ignored. In conventional procedures, the required length of the fascia lata is usually >5-12cm with a lateral thigh skin incision of approximately 5cm or more. The present study introduces a new frontalis suspension procedure in which the required size (length and width) of the fascia lata and length of lateral thigh incision is much smaller. The harvested fascia lata is tailored to an inverted Y shape and the separated caudal legs are fixed to the tarsus while the cephalic end is grafted inside the eyebrow through a suborbital septum tunnel. In the present study, 11 patients who underwent the new procedure with a minimum of 6 months of follow-up were evaluated. The average length and width of the harvested fascia lata in unilateral ptosis cases were 2.85 and 0.89cm, respectively. The average length of the lateral thigh incision was 1.25cm. The margin reflex distance improved in all cases at 6 months postoperatively. The cosmetic result was graded as good to excellent in most of the patients. Trichiasis, widened donor scar, and eyebrow notch were noted as complications. The present method is a good alternative for the treatment of blepharoptosis with poor levator function. It potentially reduces donor-site morbidity as compared with conventional frontalis muscle suspension procedures using autogenous fascia lata.

Fascia Lata Harvest and Hybrid Sling for Robotic Abdominal Sacrocolpopexy

Fascia Lata Harvest and Hybrid Sling for Robotic Abdominal Sacrocolpopexy

Endoscopic access to fascia lata for use in static facial reanimation—a cadaveric and clinical study

Background Current methods of autogenous fascia lata harvest for the static surgical treatment of longstanding facial paralysis often result in a high level of donor site morbidity and unsightly visual scarring on the patient’s lateral thigh due to the open technique traditionally used. With endoscopic access already being widely used in other areas of plastic and reconstructive surgery, it was hypothesised that it would be feasible to retrieve sufficient amounts of fascia lata endoscopically to achieve satisfactory static facial reanimation.

Fascia Lata Harvesting: Minimal Access for Maximum Harvest. A New Technique

Fascia Lata Harvesting: Minimal Access for Maximum Harvest. A New Technique

Muscle Prolapse After Harvesting Autogenous Fascia Lata Used for Frontalis Suspension in Children

To evaluate the long-term results at the donor site in children who underwent harvesting of autogenous fascia lata for frontalis suspension in ptosis correction. The study design consists of a retrospective, nonrandomized case series. Medical records of 30 patients were reviewed. Each patient was reexamined, evaluating bulging at the donor site. Muscle prolapse was graded as not visible and not palpable, not visible but palpable, mildly visible, or obviously visible. Measurement of the width and length of the leg scar was recorded. Discomfort at the donor site was graded as no discomfort, occasional discomfort, or frequent discomfort. The mean age of the patients was 7 years (range, 1-15), with a mean follow-up period of 27 months (range, 3-63 months). Fifteen patients (50%) had invisible and impalpable bulging, 2 patients (6.7%) had invisible but palpable bulging, 5 patients (16.7%) had mildly visible bulging, and 8 patients (26.7%) had obviously visible bulging. The mean width of the scar was 7.5 mm, and the mean length was 3.6 cm. Twenty-seven patients (90%) had no functional discomfort of the leg, 2 patients (6.7%) had occasional discomfort, and 1 patient (3.3%) had frequent discomfort that occurred during exercise. After fascia lata harvesting, most patients had no cosmetic complaints or functional complications. The technique of harvesting fascia lata using a Crawford stripper seems to be safe and satisfactory.

Unilateral ptosis correction with mersilene mesh frontalis sling in infants: thirteen-year follow-up report

To assess surgical, visual, refractive, and aesthetic outcomes 13 years after mersilene mesh frontalis sling (MMFS) operation for severe unilateral congenital ptosis performed in 10 infants before 1 year of age. Longitudinal follow-up of an interventional case series by structured ocular examinations, external photographs, and questionnaire-based interviews. Mean age at surgery was 6.9+/-2.7 months. After a mean follow-up of 13.0+/-0.6 years, one patient (10%) had recurrent ptosis with the upper lid 2 mm below the superior limbus at 3 months postoperatively. Best-corrected visual acuities were within two Snellen lines between the two eyes in all patients. Astigmatic errors were 1.20+/-1.00 D and 1.10+/-1.70 D between operated and unoperated eyes. Four patients had 2 mm lid lag on down-gaze and one of them had 2 mm lagophthalmos. Mean satisfaction scores (scale of 1 to 100) for lid position, cosmesis, function, and to the procedure were 83.3+/-11.8, 77.0+/-22.9, 89.4+/-5.5, and 86.8+/-6.3, respectively. No case of overcorrection, sling extrusion, stitch granuloma, or exposure keratopathy was noted. In view of the low recurrence rate (10%) and absence of serious complication or need for revision after 13 years, the use of MMFS seems effective and feasible in infants less than 1 year old. Achieving compatible long-term stability, satisfactory aesthetic, and visual outcomes, MMFS may offer an alternative to delaying operations for autogenous fascia lata harvesting in infants requiring early ptosis correction.

A NEW TECHNIQUE FOR SINGLE-PERSON FASCIA LATA HARVEST

Reconstitution of a watertight dural closure at the conclusion of most neurosurgical operations is a very important step to prevent cerebrospinal fluid leak, encephalocele formation, or infection. If sufficient native dura is not available to accomplish this goal, a dural substitute is required. We have developed a system of single-person fascia lata harvest that is fast, safe, and easily mastered. Through a standard incision along the iliotibial band, the fascia lata is dissected from the underlying muscle, and with the use of a simple system of stainless steel plates, a tray, and 2 nonperforating towel clips, a large volume of fascia is harvested. We have used this technique on 23 patients in the past 12 months, with good results. We have had fewer postoperative pain complaints and less seroma formation compared with the standard technique. This technique requires only simple instrumentation and, because the harvesting is done by 1 person, it can proceed independently of the main operation, thus eliminating any added operative time and inconvenience. It reliably produces a large volume of high-quality fascia that can be used in a variety of neurosurgical procedures.

A New Technique for Single-Person Fascia Lata Graft Harvesting

Reconstitution of a water-tight dural closure at the conclusion of skull base surgery is a very important step in the operation to prevent cerebrospinal fluid leak, encephalocele formation, or infection. Often, sufficient native dura is not available to accomplish this goal and a dural substitute is required. Options include nonautologous, commercially available products or autologous tissue harvested at the time of the primary operation. Autologous tissue has the advantage of no risk of foreign body reaction and very low risk of infection, even if exposed to paranasal sinuses, etc. It is also readily available but often requires a separate incision and added operative time to perform the harvest procedure. We have developed a system of single-person fascia lata harvest that is fast, safe, and easily mastered. It reliably produces a large volume of high-quality fascia that can be used in a variety of skull base procedures. It requires only simple instrumentation and because the harvesting is done by one person, it can proceed independently of the main operation, thus eliminating any added operative time and inconvenience. We have used this technique on 23 patients in the past 12 months with good results.

Endoscopic Harvesting of Autogenous Fascia Lata

To describe a technique of endoscopic harvesting of autogenous fascia lata. A retrospective, noncomparative clinical study to evaluate the technique of videoendoscope assistance in harvesting autogenous fascia lata was conducted during a 1-year period in 2002. A small incision approximately 2 cm long is made over the lateral aspect of the thigh, either as a low or high approach. A sheathed 4-mm rigid 0- or 30-degree endoscope is used to visualize the length of the fascia lata along both its superficial aspect and its undersurface. Standard endoscopic brow lifting instruments are then used to dissect a length of fascia under direct visualization. Three patients underwent harvesting of autogenous fascia lata under endoscopic visualization (2 high-thigh and 1 low-thigh technique). Adequate lengths of fascia lata, approximately 12 cm long, were harvested and no complications occurred. The endoscope was particularly useful in identifying the anatomical structures adjacent to the fascia. The technique was easy to use, but took twice as long as traditional harvesting techniques. Videoendoscopy allows complete visualization of anatomical structures during harvesting of autogenous fascia lata. It highlights the anatomy for teaching and provides an alternative approach to conventional harvesting methods.

A Novel Technique for Small-Incision Fascia Lata Harvesting without a Fasciatome for the Frontalis Suspension Procedure

Aim: To introduce a small-incision technique for fascia lata (FL) harvesting for the frontalis suspension blepharoptosis procedure. Technique and Methods: A skin incision was made along a line between the lateral condyle of the tibia and the anterior superior iliac crest, starting 4–5 cm above the knee and extending upward 2–2.5 cm. Approximately 8 cm superior to the first incision, a second skin incision was made with the same length. The FL was dissected from the subcutaneous tissue from 1 cm above the superior border of the upper incision to 1 cm below the inferior border of the lower incision. A 15 mm × 5–10 mm strip of FL was excised. The fascial defect was left open. Subcutaneous and deep layers were closed with three 4–0 plain catgut sutures and the skin was closed with subcuticular 5–0 prolene sutures. Results: The technique was used in 22 patients from 4 to 47 years of age (mean: 18.29) for 34 frontalis sling procedures. Mean follow-up time was 6.17 (3–16) months. Wound hematoma (1/22, 4.5%), wound discharge (2/22, 9%), pain at rest (100%, for up to 4 days), pain on walking (20/ 22, 90%; for up to 3 weeks), and limping (13/22, 59.1%; for up to 7 days) were the main postoperative complications. No significant skin scar was observed and none of the patients needed scar revision. Conclusion: The small-incision FL harvesting procedure is a good alternative method when the FL stripper is not available.