Wound Creation and Closure System and Method for Excess Skin Removal - Patent application

Abstract

Excess skin removal and wound closure devices, such as blepharoplasty devices and methods, are provided. An exemplary device for resecting excess skin (e.g., eyelid skin) and creating wound closure includes a base, a lever mechanism coupled to the base via a lever pivot, a locking mechanism, an elongated curved first jaw member in fixed relationship with the base and having a lower serrated tissue contact surface, and an elongated curved second jaw member in movable relationship with the base and having an upper serrated tissue contact surface. The upper serrated tissue contact surface of the second jaw member can face toward the lower serrated tissue contact surface of the first jaw member. The locking mechanism can be releasably engagable with the second jaw member. Pivoting movement of the lever mechanism can cause linear movement of the second jaw member relative to the first jaw member.

Description

[Technical field]

[0001] (CROSS REFERENCE TO RELATED APPLICATIONS) This application claims the benefit of U.S. Provisional Patent Application No. 63 / 336,861, filed April 29, 2022, the disclosure of which is incorporated herein by reference. [Background technology]

[0002] The present disclosure relates to systems and methods for creating wounds to remove excess skin and closing the wounds, and certain embodiments relate to devices and methods for using same for performing blepharoplasty.

[0003] Blepharoplasty is a surgical procedure that removes excess skin and / or fat from a patient's eyelids. The surgery is performed on patients who have excess eyelid skin and wish to have it removed for aesthetic and / or functional reasons, for example, to improve peripheral vision in individuals whose upper eyelids droop into their field of vision.

[0004] To address excess upper eyelid skin, the surgeon may remove a segment of skin within the upper eyelid and then suture the edges of the resulting incision together. The procedure is generally performed under local anesthesia and / or intravenous or oral sedation and typically takes the surgeon 1-2 hours to perform.

[0005] Good cosmetic and functional results depend on the placement of the incisions and the removal of an appropriate amount of excess skin tissue. Symmetry is desirable to achieve a favorable outcome, therefore surgeons generally attempt to remove a similar amount of tissue from each upper eyelid.

[0006] Traditional blepharoplasty procedures suffer from several drawbacks: 1) surgical planning and patient marking are required to ensure a symmetrical and aesthetically pleasing outcome, 2) surgery can take up to an hour, 3) local anesthetic injection can distend and distort tissues, 4) there is bleeding requiring cauterization, 5) meticulous and time-consuming suturing is required, 6) postoperatively, patients can have disfiguring bruising and swelling for 2-3 weeks, 7) patients must limit activity and freeze their eyelids for several days, 8) patients must return for suture removal, and 9) patients can have postoperative complications including wound dehiscence, suture granulomas, and asymmetry.

[0007] Currently available blepharoplasty systems and methods provide good patient outcomes, but improvements in blepharoplasty techniques are desirable. Similarly, currently available devices and methods for removing excess skin and closing wounds provide good patient outcomes, but improvements in excess skin removal and wound closure techniques are desirable. Embodiments of the present invention can, for example, make such procedures easier and faster for surgeons, avoiding the need for intravenous or oral sedation, local anesthetic injections, cauterization, and wound suturing. Such procedures can be provided at a lower cost, be less invasive, and provide faster healing for patients, thus resolving some of the shortcomings in current blepharoplasty procedures and current excess skin removal and wound closure procedures. Summary of the Invention [Means for solving the problem]

[0008] Embodiments of the present invention are directed to systems and methods for removing excess skin and closing wounds, and in certain embodiments, include devices and methods for using same for performing blepharoplasty.

[0009] Although embodiments of the present invention relate specifically to blepharoplasty systems and methods, it is understood that any aspect, component, feature, or process discussed herein in relation to blepharoplasty may likewise be incorporated into exemplary excess skin removal and wound closure systems and methods in a broader sense, and that such excess skin removal and wound closure systems and methods are also equally encompassed by the present disclosure.

[0010] Exemplary embodiments encompass devices for creating and closing upper eyelid wounds as well as other types of wounds. In some cases, such wounds may be created using any of the devices and / or methods disclosed herein (e.g., using jaws and cutting mechanisms). In some cases, such wounds may be of various sizes and shapes. In some cases, such wounds may be on various areas of the patient's body. For example, the exemplary systems and methods may be used to remove excess skin and close wounds in loose chin areas, loose forehead areas, loose breast areas, loose arm skin, and the like. In some cases, exemplary devices used to close such wounds may include jaws and cutting devices to create such wounds using any of the embodiments disclosed herein and make a zip-lock seal. In some cases, the exemplary devices may embody various sizes, shapes, and / or curvatures to fit or engage these various areas of the body. In some cases, the exemplary wound closure systems and methods can be used to close traumatic wounds by bringing the edges of the wound together and sealing with the jaws to remove tension on the traumatic wound, so that it can be effectively closed with tissue adhesive rather than sutures. In such applications, devices of different sizes and curvatures can be used, optionally in conjunction with a set of adjustable jaws, to accommodate wounds of different sizes.

[0011] Blepharoplasty is a common procedure performed in a surgical operating room or outpatient setting (office suite). The surgeon may typically take 1-2 hours to perform the procedure, use IV or oral sedation and local injection of anesthetic, and require the use of cautery and sutures. The patient may experience significant post-operative bruising, swelling, and disfigurement that typically lasts 2-3 weeks. The patient may have to return for suture removal and may have complications including wound dehiscence, suture granulomas, and asymmetry. The exemplary blepharoplasty systems and methods disclosed herein can enable the surgeon to complete the procedure in less than an hour, are significantly less costly, can be completed in an outpatient setting without IV or oral sedation or injection of local anesthesia, cautery, or sutures, and result in a quicker recovery with less bruising and swelling than the current standard of care.

[0012] Embodiments of the present invention encompass excess skin removal and wound closure systems, including but not limited to blepharoplasty systems, that have: (1) a skin marker with a ruler; (2) an antiseptic; (3) a local anesthetic; (4) a grasper with an elongated surface contact area and saw teeth to tension and prepare the skin tissue and clamp to cut off blood flow to the tissue desired to be removed; (5) an eyelid lift device with saw teeth and a ratchet or latch mechanism that compresses and seals the excess skin; (6) a cutting mechanism that excises the unwanted skin; and (7) a bonding agent to close the incision. In some cases, the ratchet or latch mechanism may be referred to as a locking mechanism. In some cases, the locking mechanism may operate to lock the device in a closed position. Exemplary excess skin removal and wound closure system devices, including but not limited to blepharoplasty system devices, may have saw teeth that clamp the skin and create a desired skin configuration for cutting. The embodiments disclosed herein include excess skin removal and wound closure systems, including but not limited to blepharoplasty systems, having a cutting mechanism attachable to a blepharoplasty or other excess skin removal and wound closure device to provide for the removal of excess skin tissue. Exemplary excess skin removal and wound closure systems, including but not limited to blepharoplasty systems, include a lever mechanism that allows the jaws to be actuated at various distances to adjust the skin tissue to be removed. In some cases, excess skin removal and wound closure systems, including but not limited to blepharoplasty systems, may include a ratchet mechanism that allows the jaw locks to be actuated at various distances to adjust the skin tissue to be removed. The embodiments disclosed herein include excess skin removal and wound closure systems, including but not limited to blepharoplasty systems, having a marking component, a local anesthetic, an iodine swab, and an incision bonding agent to allow the procedure to be completed quickly (e.g., within 10 minutes) after anesthesia is completed. Incision bonding agents may be included in excess skin removal and wound closure systems, including but not limited to blepharoplasty systems, to provide a seal on the incision.Exemplary excess skin removal and wound closure systems, including but not limited to blepharoplasty systems, can include a grasper with serrated teeth for improved manipulation of tissue. The grasper can have an elongated body and a narrow portion for fitting from an anterior direction through an excess skin removal and wound closure device, including but not limited to a blepharoplasty device, and expanding to grasp or grip tissue and pull it therethrough. Exemplary excess skin removal and wound closure systems, including but not limited to blepharoplasty systems, can include a kit for completing the entire procedure.

[0013] In a first aspect, an embodiment of the present invention encompasses a device for resecting excess skin and creating wound closure. An exemplary device can include a base, a lever mechanism coupled to the base, a locking mechanism, an elongated curved first jaw member in fixed relationship with the base and having a lower tissue contacting surface, and an elongated curved second jaw member in movable relationship with the base and having an upper tissue contacting surface, the upper tissue contacting surface of the second jaw member facing toward the lower tissue contacting surface of the first jaw member. Pivoting of the lever mechanism can cause movement of the second jaw member relative to the first jaw member. The locking mechanism can be configured to maintain the first and second jaw members in a fixed relationship relative to each other. In some cases, the lower tissue contacting surface is serrated and the upper tissue contacting surface is serrated. In some cases, the lever mechanism is coupled to the base via a lever pivot. In some cases, pivoting of the lever mechanism causes linear movement of the second jaw member relative to the first jaw member. In some cases, the locking mechanism is releasably engagable with the second jaw member. In some cases, the locking mechanism is coupled to the base via a lock pivot. In some cases, the device further includes a latch mechanism, the locking mechanism being releasably engagable with the latch mechanism. In some cases, the locking mechanism releasably engages the latch mechanism at a position within the base. In some cases, the latch mechanism is coupled to the second jaw member. In some cases, the device includes a latch spring compressible between the latch mechanism and the base. In some cases, the latch spring biases engagement of the latch mechanism against the locking mechanism. In some cases, the locking mechanism is coupled to a lever mechanism. In some cases, the device includes a pawl in fixed relationship with the second jaw member, the locking mechanism including an engagement tooth configured to releasably engage the pawl. In some cases, the device includes a lock spring configured to bias an engagement tooth of the locking mechanism against the pawl. In some cases, at least one of the first jaw member or the second jaw member includes a silicone coating. In some cases, the device includes an actuation jaw spring configured to bias the second jaw member away from the first jaw member.In some cases, the device includes a lever actuated torsion spring configured to bias the second jaw member away from the first jaw member. In some cases, at least one of the first jaw member or the second jaw member includes a tissue contacting side having a contoured surface having a shape customized to the patient's anatomy based on an imaging scan of the patient.

[0014] In another aspect, an embodiment of the present invention encompasses a skin removal and wound closure device including a base, a lever mechanism coupled to the base via a lever pivot, a locking mechanism, an elongated curved first jaw member in fixed relationship with the base and having a lower serrated tissue contact surface, and an elongated curved second jaw member in pivotal relationship with the lever and having an upper serrated tissue contact surface, the upper serrated tissue contact surface facing toward the lower serrated tissue contact surface of the first jaw member. The locking mechanism can be releasably engageable with a support assembly of the first jaw member. Pivoting movement of the lever mechanism can cause linear movement of the second jaw member relative to the first jaw member. In some cases, the locking mechanism includes a first set of engagement teeth that releasably engages with the support assembly of the first jaw member and a second set of engagement teeth. In some cases, the locking mechanism includes a serpentine portion that allows for compression of the locking mechanism. In some cases, the device includes a jaw actuation handle spring coupled with the base and the lever mechanism. In some cases, the support assembly of the first jaw member is releasably engagable with the base. In some cases, the locking mechanism includes one or more locking mechanism compression tabs.

[0015] In a further aspect, an embodiment of the present invention encompasses a method of performing an excess skin removal and wound closure procedure. An exemplary method may include grasping tissue of a patient with a grasper, positioning the tissue between an upper jaw mechanism and a lower jaw mechanism of an excess skin removal and wound closure device, pivoting a lever of the excess skin removal and wound closure device relative to a base of the excess skin removal and wound closure device to advance the lower jaw mechanism toward the upper jaw mechanism, thereby clamping the tissue therebetween and creating an incision in the tissue, and removing a portion of the tissue from the patient. In some cases, pivoting the lever of the excess skin removal and wound closure device relative to a base of the excess skin removal and wound closure device advances the lower jaw mechanism linearly toward the upper jaw mechanism. In some cases, the method may include applying a bonding agent to the incision. In some cases, the method may include inserting a grasper between the upper jaw mechanism and the lower jaw mechanism of the excess skin removal and wound closure device before grasping the tissue with the grasper. In some cases, the positioning step can include removing the gripper from between the upper and lower jaw mechanisms of the excess skin removal and wound closure device. In some cases, the lever pivots relative to a support assembly of the upper jaw mechanism as the lever pivots relative to the base. In some cases, the lever slides relative to a support assembly of the upper jaw mechanism as the lever pivots relative to the base. In some cases, the method can include locking the lower jaw mechanism in place relative to the upper jaw mechanism prior to creating the incision. In some cases, the locking step includes pivoting a locking mechanism of the excess skin removal and wound closure device. In some cases, the locking step includes compressing a locking mechanism of the excess skin removal and wound closure device. In some cases, the gripper includes a distal end having a microneedle.

[0016] In another aspect, an embodiment of the present invention encompasses a blepharoplasty device that can be used to remove excess eyelid skin tissue from a patient's eyelid. An exemplary blepharoplasty device can include a base, a lever mechanism coupled to the base via a lever pivot, and a locking mechanism. The device can also include an elongated curved first jaw member in fixed relationship with the base and having a lower serrated tissue contact surface, and an elongated curved second jaw member in movable relationship with the base and having an upper serrated tissue contact surface. The upper serrated tissue contact surface of the first jaw member can face toward the lower serrated tissue contact surface of the second jaw member. The locking mechanism can be releasably engagable with the second jaw member. Pivoting movement of the lever mechanism can cause linear movement of the second jaw member relative to the first jaw member. In some cases, the second jaw member includes a shield that limits movement of the cutting mechanism perpendicular to the actuation path. In some cases, the locking mechanism is coupled to the base via a locking pivot. In some cases, the device can include a pawl in fixed relationship with the second jaw member. The locking mechanism can include an engagement tooth configured to releasably engage the pawl. In some cases, the device can include a locking spring configured to bias the engagement tooth of the locking mechanism against the pawl. In some cases, the device can include an actuation jaw spring configured to bias the second jaw member away from the first jaw member. In some cases, the device can include a torsion spring configured to adjust the lever mechanism to bias the second jaw member away from the first jaw member.

[0017] In another aspect, an embodiment of the present invention encompasses a blepharoplasty device having a base, a lever mechanism coupled to the base via a lever pivot, a locking mechanism, an elongated curved first jaw member in fixed relationship with the base and having a lower serrated tissue contact surface, and an elongated curved second jaw member in pivotal relationship with the lever and having an upper serrated tissue contact surface. The upper serrated tissue contact surface of the second jaw member can face toward the lower serrated tissue contact surface of the first jaw member. The locking mechanism can be releasably engagable with a support assembly of the first jaw member. In some cases, the locking mechanism can be releasably engagable with the lever mechanism. Pivoting of the lever mechanism can cause linear motion of the second jaw member relative to the first jaw member. In some cases, the locking mechanism includes a first set of engagement teeth that releasably engage with the support assembly of the first jaw member and a second set of engagement teeth. In some cases, the locking mechanism includes a serpentine portion that allows for compression of the locking mechanism. In some cases, the locking mechanism includes an engagement latch releasably engageable with the lever mechanism. In some cases, the device includes a jaw actuation handle spring coupled with the base and the lever mechanism. In some cases, the first jaw member support assembly is releasably engageable with the base. In some cases, the locking mechanism includes one or more locking mechanism compression tabs.

[0018] In yet another aspect, an embodiment of the present invention provides a method of performing a blepharoplasty procedure. An exemplary method may include gripping eyelid tissue of a patient with a gripper, positioning the eyelid tissue between an upper jaw mechanism and a lower jaw mechanism of a blepharoplasty device, pivoting a lever of the blepharoplasty device relative to a base of the blepharoplasty device to linearly advance the lower jaw mechanism toward the upper jaw mechanism, thereby clamping the eyelid tissue therebetween, making an incision in the eyelid tissue, and removing a portion of the eyelid tissue from the patient. In some cases, the method may include applying a bonding agent to the incision. In some cases, the method may include inserting the gripper between the upper jaw mechanism and the lower jaw mechanism of the blepharoplasty device before gripping the eyelid tissue with the gripper. In some cases, the positioning step may include removing the gripper from between the upper jaw mechanism and the lower jaw mechanism of the blepharoplasty device. In some cases, the lever pivots relative to a support assembly of the upper jaw mechanism as the lever pivots relative to the base. In some cases, the lever slides relative to a support assembly of the upper jaw mechanism as the lever pivots relative to the base. In some cases, the method can include locking the lower jaw mechanism in position relative to the upper jaw mechanism prior to creating the incision. In some cases, the locking can include pivoting a locking mechanism of the blepharoplasty device. In some cases, the locking can include compressing a locking mechanism of the blepharoplasty device.

[0019] In some embodiments, the blepharoplasty device may include silicone coated jaws. The presence of silicone can act to reduce the ability of the jaws to adhere to the skin, allowing the ability to seal the incision with an adhesive while the skin is clamped within the jaws.

[0020] These and other embodiments are described in further detail in the following description taken in conjunction with the accompanying drawings. [Brief description of the drawings]

[0021] Particular embodiments of the disclosed device, surgical system, or method will now be described with reference to the drawings. In this detailed description, it is not intended to imply that any particular component, feature, or step is essential to the invention.

[0022] [Figure 1A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 1B] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention.

[0023] [Figure 2A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 2B] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention.

[0024] [Figure 3A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 3B] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention.

[0025] [Figure 4A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 4B] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention.

[0026] [Figure 5A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 5B]1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 5C] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 5D] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention.

[0027] [Figure 6A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 6B] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 6C] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 6D] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 6E] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 6F] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 6G] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 6H] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 6I] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention.

[0028] [Figure 7A] 1 illustrates aspects of a gripper according to some embodiments of the present invention. [Figure 7B] 1 illustrates aspects of a gripper according to some embodiments of the present invention.

[0029] [Figure 8A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 8B] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention.

[0030] [Figure 9A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 9B] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention.

[0031] [Figure 10A] 13A-13D illustrate aspects of an excess skin removal and wound closure device with a removable jaw mechanism, according to some embodiments of the present invention. [Figure 10B] 13A-13D illustrate aspects of an excess skin removal and wound closure device with a removable jaw mechanism, according to some embodiments of the present invention.

[0032] [Figure 11A] 1 illustrates aspects of a removable jaw mechanism according to some embodiments of the present invention. [Figure 11B] 1 illustrates aspects of a removable jaw mechanism according to some embodiments of the present invention. [Figure 11C] 1 illustrates aspects of a removable jaw mechanism according to some embodiments of the present invention. [Figure 11D] 1 illustrates aspects of a removable jaw mechanism according to some embodiments of the present invention.

[0033] [Figure 12A] 1 illustrates aspects of a removable jaw mechanism according to some embodiments of the present invention. [Figure 12B] 1 illustrates aspects of a removable jaw mechanism according to some embodiments of the present invention. [Figure 12C] 1 illustrates aspects of a removable jaw mechanism according to some embodiments of the present invention. [Figure 12D] 1 illustrates aspects of a removable jaw mechanism according to some embodiments of the present invention. [Figure 12E] 1 illustrates aspects of a removable jaw mechanism according to some embodiments of the present invention.

[0034] [Figure 13A] 1 illustrates aspects of an attachable cutting mechanism according to some embodiments of the present invention. [Figure 13B] 1 illustrates aspects of an attachable cutting mechanism according to some embodiments of the present invention. [Figure 13C] 1 illustrates aspects of an attachable cutting mechanism according to some embodiments of the present invention. [Figure 13D] 1 illustrates aspects of an attachable cutting mechanism according to some embodiments of the present invention.

[0035] [Figure 14A] 1 illustrates aspects of an attachable cutting mechanism according to some embodiments of the present invention. [Figure 14B] 1 illustrates aspects of an attachable cutting mechanism according to some embodiments of the present invention. [Figure 14C] 1 illustrates aspects of an attachable cutting mechanism according to some embodiments of the present invention. [Figure 14D] 1 illustrates aspects of an attachable cutting mechanism according to some embodiments of the present invention.

[0036] [Figure 15A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 15B] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention.

[0037] [Figure 16A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 16B]1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention.

[0038] [Figure 17A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 17B] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention.

[0039] [Figure 18A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 18B] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 18C] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention.

[0040] [Figure 19A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 19B] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention.

[0041] [Figure 20A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 20B] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 20C] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention.

[0042] [Figure 21A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 21B]1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 21C] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention.

[0043] [Figure 22A] 1 illustrates aspects of a gripper, according to some embodiments of the present invention. [Figure 22B] 1 illustrates aspects of a gripper, according to some embodiments of the present invention.

[0044] [Figure 22C] 1 illustrates aspects of a gripper according to some embodiments of the present invention. [Figure 22D] 1 illustrates aspects of a gripper according to some embodiments of the present invention. [Figure 22E] 1 illustrates aspects of a gripper according to some embodiments of the present invention.

[0045] [Figure 23A] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. [Figure 23B] 1 illustrates aspects of an excess skin removal and wound closure device, according to some embodiments of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0046] Various embodiments of blepharoplasty devices and methods of use thereof are disclosed herein. The following description is exemplary in nature and is in no way intended to limit the scope, applicability, or configuration of the invention. Various changes to the described embodiments can be made in the function and arrangement of the elements described herein without departing from the scope of the invention.

[0047] As used in this application and claims, the singular forms "a," "an," and "the" include the plural unless the context clearly indicates otherwise. Additionally, the term "include" means "comprise." Additionally, the term "coupled" generally means electrically, electromagnetically, and / or physically (e.g., mechanically or chemically) coupled or linked, and does not exclude the presence of intermediate elements between coupled or associated items, unless specifically stated to the contrary. As used herein, the term "superior" means toward the top of the patient's head, and the term "inferior" means toward the patient's feet.

[0048] Although the operations of exemplary embodiments of the disclosed methods may be described in a particular order for convenience of presentation, it should be understood that the disclosed embodiments may encompass orders of operations other than the particular order disclosed. For example, operations described in sequence may in some cases be reordered or performed simultaneously. Furthermore, descriptions and disclosures provided in connection with one particular embodiment are not limited to that embodiment and may apply to any embodiment disclosed.

[0049] The devices and methods disclosed herein may generally improve the overall efficiency of a blepharoplasty procedure by simplifying the steps required to perform a blepharoplasty procedure, improving the consistency of the procedure, and / or promoting faster healing and less cosmetology for the patient following the procedure.

[0050] Blepharoplasty is a common plastic surgery procedure performed in an operating room, although some procedures are available in an outpatient environment (office suite). A surgeon may typically take 1-2 hours to perform the procedure, with the associated high costs of an outpatient environment. Post-operative care from an operating room procedure can last 2-3 weeks with disfiguring bruising and swelling. The exemplary blepharoplasty systems and methods disclosed herein can enable a surgeon to complete the procedure in less than an hour, at significantly less cost, and can be completed in an outpatient environment, with faster recovery and less bruising and swelling than the current standard of care.

[0051] An exemplary blepharoplasty procedure disclosed herein may include marking the area of ​​eyelid tissue desired to be removed with a marker and providing a local anesthetic to temporarily anesthetize the surgical area. After the surgical area is fully anesthetized, the surgical site may be disinfected with an iodine swab. A grasper (e.g., forceps) may enter through the open jaws of the device, compress into a closed position, grasp the marked eyelid skin tissue area, and then pull the tissue through the open jaws of the device. One of the device jaws may then be actuated into a closed position to fully clamp the tissue and cut off blood flow. A cutting mechanism may then be used to cut away the eyelid skin tissue. In some cases, the cutting mechanism is integrated with the blepharoplasty device. In some cases, the cutting mechanism may be a separate device for use following the clamping of the skin tissue by the blepharoplasty device. After the excess tissue is removed, an incision bonding agent may be applied to the incision to seal it and allow it to heal.

[0052] 1A and 1B show one embodiment of a blepharoplasty device 100 configured to capture eyelid tissue to facilitate tissue resection from a portion of the eyelid. The device 100 is a tissue grasping device (e.g., clamp) consisting of a pair of elongated jaw members 102, 104 operably connected together such that they can be moved relative to one another between an open position (FIG. 1A) and a closed position (FIG. 1B). The upper jaw member 102 and the lower jaw member 104 can be curved to follow the contours of the eyelid area to create a desired incision shape. In some embodiments, the jaw members can have a top-bottom curve of 13 / 8 inch radius and a front-to-back curve of 15 / 8 inch radius to establish the contour. With reference to FIGS. 16A and 16B, the jaw member 1502 (or its tissue contacting surface 1506) has a top-bottom curve 1507 (dashed lines). In some embodiments, an up-down curve corresponds to this arch 1507, which is in the plane of the drawing sheet and is higher in the center and lower on each side, e.g., where the center is further away from the viewer and the sides are closer to the viewer, as opposed to a curve that is (perpendicular) to the plane of the drawing sheet. With reference to FIG. 21A, jaw member 2102 (or its tissue contacting surface) has an anterior-posterior curve 2107 (dashed line). In some embodiments, an anterior-posterior curve corresponds to this arch 2107, which is lower in the center and higher on each side, e.g., where the center is closer to the viewer and the sides are farther away from the viewer, as opposed to a curve that is (perpendicular) to the plane of the drawing sheet. In some cases, the contours created are established from imaging of the patient's anatomy using data or information from a photograph, computed tomography (CT) scan, or other imaging device.

[0053] In some embodiments, the upper jaw member is considered a superior jaw member and the lower jaw member is considered a inferior jaw member because of their relative location to the head and foot. For simplicity, the terms "upper" and "lower" are used herein to refer to superior and inferior members, but it should be understood that "upper" and "lower" do not imply any positional relationship except as to anatomical reference points on the body.

[0054] The upper jaw member 102 has a first tissue contacting surface 106, and the lower jaw member 104 has a second tissue contacting surface 108. The first tissue contacting surface 106 and the second tissue contacting surface 108 generally face each other in an opposing manner such that when eyelid tissue is positioned between the upper jaw member 102 and the lower jaw member 104, the first tissue contacting surface 106 and the second tissue contacting surface 108 can move toward each other to capture and secure the eyelid tissue between the first tissue contacting surface 106 and the second tissue contacting surface 108.

[0055] When the upper and lower jaw members 102, 104 are in the open position (FIG. 1A), the first and second tissue contacting surfaces 106, 108 are separated by a distance to form an opening or space large enough to receive eyelid tissue. When the upper and lower jaw members 102, 104 are moved together to the closed position (FIG. 1B), the distance between the first and second contacting surfaces 106, 108 is reduced to a smaller distance. This smaller distance causes the opening or space between the first and second tissue contacting surfaces 106, 108 to be small enough to capture and secure any eyelid tissue positioned between the first and second tissue contacting surfaces 106, 108.

[0056] The first tissue contacting surface 106 and the second tissue contacting surface 108 are configured to grasp and hold eyelid tissue positioned between the opposing first tissue contacting surface 106 and second tissue contacting surface 108. The device 100 also includes a cutting member or cutting mechanism slider 160. The cutting mechanism slider 160 can include or be coupled to a cutting blade (not shown), which can move along and / or within a blade guide 144. As shown here, the blade guide 144 can be a curved slit, track, or edge along the upper jaw 102. Advantageously, as discussed further herein, such a cutting mechanism can be actuated in a medial-lateral direction through the skin tissue for removal of a desired amount of skin tissue. In some embodiments, the lower jaw member 104 can be referred to as an actuating jaw. As shown in FIGS. 1A and 1B, the actuating jaw 104 can include a tissue contacting side 105. The device 100 may also include an actuation jaw lever 120 and a locking mechanism 130, such as a ratchet mechanism post. Embodiments of the present invention include devices having a ratchet mechanism that allows the jaw lock to be actuated at various distances, allowing adjustment of the skin tissue to be removed. In some cases, the locking mechanism may be attached to an actuation handle component of the device.

[0057] Thus, embodiments of the present invention provide a unique blepharoplasty system, including associated devices, kits, and methods for removing eyelid skin tissue and sealing the incised skin. An exemplary device can include two curved, serrated, skin-contacting jaws, with one fixed jaw (e.g., upper member 102) and one actuating jaw (e.g., lower member 104), whereby the configuration of the device can be alternated between a closed position (e.g., FIG. 1B) and an open position (e.g., FIG. 1A), whereby the open position allows the eyelid skin tissue to protrude between the jaws, and the closed position clamps the skin tissue restricting blood flow to the eyelid skin tissue. The actuation mechanism can include a lever 120 having a pivot 122, whereby actuation of the actuating jaw lever 120 about the pivot 122 allows adjustment of the linear position of the actuating jaw 104 relative to the fixed jaw 102 (e.g., between an open configuration shown in FIG. 1A with the lever 120 in an up position and a closed configuration shown in FIG. 1B with the lever in a down position).

[0058] In some cases, the actuating jaw 104 may be releasably coupled to a ratchet mechanism 130, allowing the distance between the jaws 102, 104 to be locked at various distances between fully open (e.g., 8 mm) and fully closed (e.g., 0 mm). The ratchet mechanism 130 may include a mechanism for releasing the ratchet mechanism coupling to allow re-adjustment of the actuating jaw 104. As discussed further elsewhere herein, in some embodiments, the device may include or be configured to operate in conjunction with a cutting attachment, which may include an actuation mechanism for severing the clamped eyelid skin tissue.

[0059] In some embodiments, the blepharoplasty device may include silicone coated jaws (e.g., jaws 102, 104). The presence of silicone can act to reduce the ability of adhesive to adhere to the jaws of the device, allowing the ability to seal the incision with adhesive while the skin is clamped within the jaws.

[0060] 2A and 2B provide additional views of the device 100 in an open position or configuration (FIG. 2A) where the upper jaw 102 and the lower jaw 104 are further apart, and in a closed position or configuration (FIG. 2B) where the upper jaw 102 and the lower jaw 104 are closer together. Alternation between the open and closed configurations can involve linear motion of the lower jaw 104 relative to the upper jaw 102, as shown by arrow A. The first contact surface 106 and the second contact surface 108 can have serrated edges. Thus, embodiments of the invention encompass devices having jaws with serrations to allow the clamped skin to collapse upon itself to create a desired site for cutting. The serrations can interlock to allow the skin tissue to deform to a point where a desired amount of skin remains protruding and the skin remains collapsed for removal after the clamps are released.

[0061] 3A and 3B provide additional views of the device 100 in a closed position or configuration (FIG. 3A) in which the upper and lower jaws 102, 104 are closer together, and an open position or configuration (FIG. 3B) in which the upper and lower jaws 102, 104 are further apart. The device 100 can include an actuation jaw lever 120 and a locking mechanism 130, such as a ratchet mechanism post. A pivot 122 allows the actuation jaw lever 120 to pivot relative to a base 180 of the device 100.

[0062] 4A and 4B provide additional views of the device 100 in a closed position or configuration (FIG. 4A) in which the upper jaw 102 and the lower jaw 104 are closer together, and an open position or configuration (FIG. 4B) in which the upper jaw 102 and the lower jaw 104 are further apart. The device 100 can include an actuation jaw lever 120 and a locking mechanism 130, such as a ratchet mechanism post 131. As shown here, the locking mechanism can include a locking spring 132, a gear 134, and a pivot 136. The gear 134 is configured to engage a pawl 138. In FIG. 4B, the actuation jaw lever 120 is raised or actuated, the actuation jaw spring 142 is expanded, the locking spring 132 is compressed, and the pawl 138 is positioned lower (relative to the position shown in FIG. 4A), such that the gear 134 of the locking or ratcheting mechanism 130 is not engaged with the pawl 138 and the locking (ratcheting) mechanism 130 is released. In FIG. 4A, the locking (ratchet) mechanism 130 is engaged.

[0063] Thus, the device 100 can have a ratchet mechanism 130 that includes an elongated post 131 that rotates about a pivot 136. The post or elongated body 131 can include sawtooth, teeth, gears, etc. that couple with the device actuation jaw 104 (or actuation jaw extension 104A). For example, rotation or pivoting of the post 131 about the pivot 136 can allow the post teeth 134 to engage and disengage with a pawl 138 of the actuation jaw 102 (or lower jaw extension 104A), thereby locking the jaws 104, 104 in position relative to one another in a configuration in which the distance between the jaws varies, thereby allowing adjustment of the target distance between the jaws. The ratchet mechanism post 131 can be biased or spring loaded (e.g., via a locking spring 132) to naturally rotate to a locked position and also allow rotation to a disengaged position.

[0064] In some embodiments, the device actuation jaw 104 can be spring loaded with a compression spring 142 along the direction of linear motion. In some embodiments, the device handle or lever 120 can be spring loaded (e.g., via the spring 142) to an open position and allows manual compression of the actuation jaw to a closed position (e.g., by actuation of the lever 120 in the direction indicated by arrow B). The handle or lever 120 can be coupled with a lift mechanism to actuate the actuation jaw 104 from the open position to the closed position. Thus, as shown here, when the proximal portion 133 of the post 131 is moved as indicated by arrow A, the spring 132 is compressed, the tooth 134 is disengaged from the pawl 138, and the spring 142 can then push the lower jaw 104 downward (e.g., by pushing the lower jaw extension 104A downward). Movement of the lever 120 in the direction indicated by arrow B can move the lower jaw 104 upward toward the upper jaw 102, causing compression of the spring 142.

[0065] 5A and 5B provide additional views of the device 100 in an open position or configuration in which the upper and lower jaws 102 and 104 are further apart (FIG. 5A), and a closed position or configuration in which the upper and lower jaws 102 and 104 are closer together (FIG. 5B). As shown therein, the device 100 includes an actuation jaw lever pivot 122 (about which the actuation jaw lever 120 can pivot relative to the base 180) and an actuation jaw guide post 124. Thus, in contrast to devices that include movable and fixed handles that move in a linear motion, embodiments of the present invention encompass devices having a pivot feature 122 for providing a lever 120 that actuates the adjustable jaw 104. Advantageously, the exemplary blepharoplasty system device uses pivotal rotation (e.g., about pivot 122) to establish linear adjustment between the two surface-contacting jaws, as well as pivotal rotation (e.g., about pivot 136 shown in FIG. 4A) to establish a releasable lock between the two jaws. As shown in Figure 5C, a portion of eyelid tissue T can be clamped between the upper jaw 102 and the lower jaw 104. The eyelid tissue can then be removed, as shown in Figure 5D.

[0066] 6A-6F provide various views of a blepharoplasty device 100 according to an embodiment of the present invention. As shown therein, the device 100 can include a cutting mechanism 140 having a cutting member or blade 142. The cutting member 142 has a cutting edge 143. The cutting mechanism 140 can be a sliding cutting mechanism and can slide from one side of the device to the other side of the device, for example, in the direction indicated by arrow A. As shown herein, the blade 142 can slide along or within a blade guide 144 of the upper jaw 102. FIGS. 6G-6I illustrate how eyelid tissue T can be removed via operation of the cutting mechanism.

[0067] 7A and 7B show an embodiment of a grasper or forceps 200 in an open position or configuration (FIG. 7A) and a closed position or configuration (FIG. 7B). The grasper 200 can include skin-contacting serrations 210.

[0068] The elongated end of the forceps or grasper (e.g., 205) can be of various curvatures, widths, and lengths. In some embodiments, the distal end of the forceps or grasper (e.g., 206) can be curved to conform to the intended tissue object for manipulation, and in association, the distal end of the grasper can include any of the curved features disclosed herein (e.g., as discussed with reference to FIGS. 1A, 1B, 16A, and 16B) that correspond to the jaw members of the device. The present disclosure further contemplates the inclusion of various lengths and widths for the tissue contacting distal end (e.g., 206) that can be configured to grasp a surface area of ​​tissue. It should be understood that the grasper or forceps 2200 shown in FIGS. 22A and 22B and / or the grasper or forceps 2200A shown in FIGS. 22C and 22D can have elongated ends of various curvatures, widths, and lengths as well. Similarly, the distal end of the forceps or grasper (2200 or 2200A) can be curved to conform to the tissue object intended for manipulation, and relatedly, the distal end of the grasper can include any of the curved features disclosed herein (e.g., as discussed with reference to FIGS. 1A, 1B, 16A, and 16B) that correspond to the jaw members of the device. The present disclosure further contemplates the inclusion of various lengths and widths for the tissue contacting distal end of the forceps or grasper 2200 or 2200A that can be configured to grasp a surface region of tissue.

[0069] 7A and 7B, the grasper can be used (e.g., by a surgeon or operator) to position patient tissue relative to the blepharoplasty device. For example, when the blepharoplasty device is in the open position, a portion of patient tissue can be positioned between its upper and lower jaws. The grasper 200 can be used to facilitate movement of tissue into the space between the upper and lower jaws. For example, the grasper 200 can grasp the patient's upper eyelid tissue and draw it away from the patient into the space between the upper and lower jaws.

[0070] An embodiment of the present invention can include a kit having a skin grasper (e.g., forceps 200), a local anesthetic, an incision bonding agent, a marker, and an iodine swab. The grasper (e.g., forceps 200) can have an elongated body that is split into two serrated tissue contact surfaces at a distal end. The contact surfaces can be curved to match the anterior-posterior curvature of eyelid skin tissue. The distal end contact surfaces can be adjustable between two distances, an open position (e.g., 8 mm) and a closed position (e.g., 0 mm). In some embodiments, the distance between the surfaces is manually adjustable by compression. The serrations on the contact surfaces can provide a shear force between the eyelid skin tissue and the grasper, allowing for positioning of the skin tissue through the jaws of a device component. The elongated body can include a portion with a reduced width to fit through the open jaws of a device component. In operation, a skin grasper (eg, forceps 200) can be fitted through the device from the anterior direction and expands and compresses to grasp or grip tissue and pull it through.

[0071] An exemplary treatment procedure may include marking the area of ​​eyelid tissue desired to be removed with a marker and providing a local anesthetic to temporarily anesthetize the surgical area. After the surgical area is fully anesthetized, the surgical site may be disinfected with an iodine swab. A grasper may enter through the open jaws of the device, compress into a closed position, grasp or grip the marked eyelid skin tissue area, and then pull the tissue through the open jaws of the device. The device may then fully close, clamping the tissue and cutting blood flow. A cutting mechanism may then be used to remove the eyelid skin tissue. After the tissue is removed, an incision bonding agent may be applied to the incision to seal it and allow it to heal.

[0072] Thus, embodiments of the present invention include a kit having a skin grasper, a marker, a local anesthetic, an iodine swab, and an incision adhesive to fully complete a blepharoplasty procedure.

[0073] 8A and 8B show one embodiment of a blepharoplasty device 300 configured to capture eyelid tissue to facilitate tissue resection from a portion of the eyelid. The device 300 is a tissue grasping device (e.g., a clamp) consisting of a pair of elongated jaw members 302, 304 operably connected together such that they can be moved relative to one another between an open position (FIG. 8A) and a closed position (FIG. 8B). The upper and lower jaw members 302, 304 can be curved to follow the contours of the eyelid area to create a desired incision shape.

[0074] In some embodiments, the upper jaw member is considered a superior jaw member and the lower jaw member is considered a inferior jaw member because of their relative location to the head and foot. For simplicity, the terms "upper" and "lower" are used herein to refer to superior and inferior members, but it should be understood that "upper" and "lower" do not imply any positional relationship except as to anatomical reference points on the body.

[0075] The upper jaw member 302 has a first tissue contacting surface 306, and the lower jaw member 304 has a second tissue contacting surface 308. The first tissue contacting surface 306 and the second tissue contacting surface 308 generally face each other in an opposing manner such that when eyelid tissue is positioned between the upper jaw member 302 and the lower jaw member 304, the first tissue contacting surface 306 and the second tissue contacting surface 308 can move toward each other to capture and secure the eyelid tissue between the first tissue contacting surface 306 and the second tissue contacting surface 308.

[0076] When the upper jaw member 302 and the lower jaw member 304 are in the open position (FIG. 8A), the first tissue contacting surface 306 and the second tissue contacting surface 308 are separated by a distance to form an opening or space large enough to receive eyelid tissue. As the upper and lower jaw members 302, 304 move together to the closed position (FIG. 8B), the distance between the first tissue contacting surface 306 and the second tissue contacting surface 308 is reduced to a smaller distance. This smaller distance causes the opening or space between the first tissue contacting surface 306 and the second tissue contacting surface 308 to be small enough to capture and secure any eyelid tissue positioned between the first tissue contacting surface 306 and the second tissue contacting surface 308. As shown here, the first tissue contacting surface 306 and the second tissue contacting surface 308 may include a serrated jaw feature or sawtooth. Thus, embodiments of the present invention include devices having jaws with serrations to allow the clamped skin to collapse upon itself to create a desired site for cutting. In some embodiments, the upper jaw member 302 can be referred to as the fixed jaw and the lower jaw member 304 can be referred to as the working jaw.

[0077] The first and second tissue contacting surfaces 306, 308 are configured to grasp and hold eyelid tissue positioned between the opposing first and second tissue contacting surfaces 306, 308. The device 300 can be used in combination with a grasper. The device 300 can also include a jaw actuated handle 320 and a jaw actuated lift 330.

[0078] The present invention provides a unique blepharoplasty system, including associated devices, kits, and methods for the removal of excess eyelid skin tissue and sealing of incised skin. An exemplary device can include two curved, serrated, skin-contacting jaws with one jaw (e.g., upper member 302) that is fixed and one jaw (e.g., lower member 304) that operates between closed and open positions, the open position allowing the eyelid skin tissue to protrude between the jaws and the closed position clamping the skin tissue and restricting blood flow to the eyelid skin tissue. The actuation mechanism can include a lever or handle with a pivot rotation that adjusts the linear position of the actuation jaw relative to the fixed jaw. For example, as shown in FIG. 8A, the jaw actuation handle 320 can pivot about a handle pivot 352 relative to a base 380. In some cases, the actuation jaw or handle can be coupled to a ratchet mechanism, allowing the distance between the jaws to be locked at various distances between fully open (e.g., 8 mm) and fully closed (e.g., 0 mm). The ratchet mechanism can include a mechanism for disengaging the ratchet mechanism to allow readjustment of the actuating jaws. In some embodiments, the device can include or be configured to operate in conjunction with a cutting attachment, the cutting attachment can include an actuation mechanism for severing the clamped eyelid skin tissue.

[0079] In some embodiments, the blepharoplasty device may include silicone coated jaws (e.g., jaws 302, 304). The presence of silicone can act to reduce the ability of adhesive to adhere to the jaws of the device, allowing the ability to seal the incision with adhesive while the skin is clamped within the jaws.

[0080] 9A and 9B provide additional views of the device 300 in an open position or configuration (FIG. 9A) where the upper and lower jaws are further apart, and a closed position or configuration (FIG. 9B) where the upper and lower jaws are closer together. As shown therein, the device 300 includes a handle pivot 352, a jaw actuation handle spring 354, and an actuation lift pivot 356. Thus, in contrast to devices including movable and fixed handles that move in a linear motion, embodiments of the present invention encompass devices having pivot features to provide a lever to actuate the adjustable jaws. Advantageously, the exemplary blepharoplasty system device uses a pivot rotation to establish linear adjustment between the two surface-contacting jaws. For example, as shown here, the handle 320 can be pressed in a downward pivoting direction, as shown by arrow A, resulting in upward movement of the handle extension 320A, which in turn causes linear upward movement of the lower jaw 304 relative to the upper jaw 302, as shown by arrow B.

[0081] FIG. 10A illustrates aspects of one embodiment of a blepharoplasty device 300 according to embodiments of the present invention. As shown here, the blepharoplasty device 300 includes a handle mechanism 360 and a removable jaw mechanism 370. FIG. 10B illustrates aspects of the removable jaw mechanism 370 according to some embodiments. The removable jaw mechanism 370 can include an actuation jaw guide locking post 372, a locking mechanism compression tab 374, and a locking (ratchet) mechanism 376. The locking (ratchet) mechanism 376 can be operable to control the distance between the upper jaw member 302 and the lower jaw member 304 when locked. Embodiments of the present invention encompass devices having a ratchet mechanism that allows the jaw locks to be actuated at various distances, allowing adjustment of the skin tissue to be removed. In some embodiments, the post 372 can comprise or be part of a support assembly 373 of the first jaw member 302. In some embodiments, the support assembly 373 includes a recess 375 and the base 380 includes a tab 382. The recess 375 and the tab 382 can provide a releasably engageable connection between the first jaw member and the base. In some cases, the support assembly 373 can include multiple recesses and the base 380 can include multiple tabs.

[0082] 11A-11D show aspects of a removable jaw mechanism 370, according to some embodiments. FIG. 11B shows engagement between an actuating jaw guide locking post 372 and a locking (ratchet) mechanism 376. For example, teeth of the locking (ratchet) mechanism 376 can engage teeth of the actuating jaw guide locking post 372 at engagement zones A and B. As shown in FIG. 11C, the locking mechanism compression tabs 374 can be brought closer together toward one another (e.g., in the directions shown by arrows C and D) to compress the locking (ratchet) mechanism 376 from each side, thereby disengaging the locking (ratchet) mechanism 376 from the actuating jaw guide locking post 372, as shown in FIG. 11D. Thus, FIGS. 11A and 11B depict a configuration in which the locking mechanism is engaged, and FIGS. 11C and 11D show a configuration in which the locking mechanism is released or disengaged. When the locking mechanism is released or disengaged, the positioning of the upper jaw member 302 relative to the lower jaw member 304 can be adjusted or readjusted because the upper jaw member is in a fixed relationship to the operating jaw guide locking post 372 .

[0083] Thus, embodiments of the present invention encompass devices having a ratchet mechanism that may include sawtooth, teeth, gears, etc. on each end that interlock with a post of the device actuation jaw. An exemplary ratchet or locking mechanism 376 may include a series of cutting or serpentine sections that provide a bend that allows the entire elongate body to compress, disengaging the ratchet from the actuation jaw and allowing adjustment of the tissue desired for removal.

[0084] 12A-12D show aspects of a removable jaw mechanism 370, according to some embodiments. FIG. 12B shows engagement between an actuating jaw guide locking post 372 and a locking (ratchet) mechanism 376. For example, teeth of the locking (ratchet) mechanism 376 can engage teeth of the actuating jaw guide locking post 372 at engagement zones A and B. As shown in FIG. 12C, the locking mechanism compression tabs 374 can be brought closer together toward one another (e.g., in the directions shown by arrows C and D) to compress the locking (ratchet) mechanism 376 from each side, thereby disengaging the locking (ratchet) mechanism 376 from the actuating jaw guide locking post 372, as shown in FIG. 12D. Thus, FIGS. 12A and 12B depict a configuration in which the locking mechanism is engaged, and FIGS. 12C and 12D show a configuration in which the locking mechanism is released or disengaged. When the locking mechanism is released or disengaged, the positioning of the upper jaw member 302 relative to the lower jaw member 304 can be adjusted or readjusted because the upper jaw member is in a fixed relationship to the operating jaw guide locking post 372 .

[0085] Thus, an embodiment of the present invention provides a device having a ratchet mechanism that includes an elongated body 376 with teeth 376A, 376B at each end that interlock with a post 372 on the device actuation jaw 304. The ratchet mechanism can have a series of cuts or serpentine sections that provide a bend that allows the entire elongated body to compress to decouple the ratchet from the actuation jaw. The ratchet mechanism can have a post 372 that extends perpendicular to the elongated body 376, allowing manual disengagement of the ratchet mechanism from the actuation jaw and actuation from a closed position to an open position. FIG. 12E shows eyelid tissue T positioned between the upper jaw 302 and the lower jaw 304.

[0086] 13A-13C show aspects of an attachable cutting mechanism 400, according to an embodiment of the present invention. The attachable cutting mechanism 400 can include an actuating cutting guide locking post 472, a locking mechanism compression tab 474, and a locking (ratchet) mechanism 476. The locking (ratchet) mechanism 476 can operate to control the distance between the upper cutting member 402 and the lower cutting member 404 when locked. According to some embodiments, the locking mechanism components of the attachable cutting mechanism 400 operate similarly to the locking mechanism components of the removable jaw mechanism 370. FIGS. 13A-13C show the attachable cutting mechanism 400 in a closed or chop cutting position or configuration. FIG. 13D shows eyelid tissue T disposed between the upper cutting member 402 and the lower cutting member 404. In some embodiments, the blepharoplasty device can include silicone coated jaws (e.g., jaws 402, 404). The presence of silicone can act to reduce the ability of the jaws to adhere to the skin, allowing the ability to seal the incision with adhesive while the skin is clamped within the jaws.

[0087] 14A-14C show aspects of an attachable cutting mechanism 400, according to an embodiment of the present invention. The attachable cutting mechanism 400 can include an actuation cutting guide locking post 472, a locking mechanism compression tab 474, and a locking (ratchet) mechanism 476. The locking (ratchet) mechanism 476 can operate to control the distance between the upper cutting member 402 and the lower cutting member 404 when locked. The upper cutting member 402 includes a cutting blade pocket 403, and the lower cutting member 404 includes a cutting blade 404 configured to engage the pocket 403 to effect a cut in tissue when tissue is disposed therebetween. In some cases, the pocket is disposed on the lower member 404 and the blade is disposed on the upper member 402. According to some embodiments, the locking mechanism components of the attachable cutting mechanism 400 operate similarly to the locking mechanism components of the removable jaw mechanism 370. FIGS. 14A-14C show the attachable cutting mechanism 400 in an open position or configuration. FIG. 14D shows eyelid tissue T disposed between the upper and lower cutting members 402, 404. Such a cutting attachment 400 can thus be actuated in an up and down direction through the skin tissue for removal of a desired amount of skin tissue. According to some embodiments, the use of the removable jaw mechanism 370 shown in FIGS. 13A-13C can be combined with the use of the cutting attachment 400 shown in FIGS. 14A-14C. In some embodiments, the skin response under the clamping force and saw teeth can operate to keep the skin portion (desired for removal) protruding after the clamp is released (e.g., after the jaws 302, 304 shown in FIG. 12E are separated). The cutting mechanism can then be attached to the handle mechanism and / or base (e.g., as shown in FIG. 13D) and actuated to encircle and remove the protruding tissue.

[0088] The embodiments of the blepharoplasty devices disclosed herein can be provided in a variety of widths, allowing for alternatives for various patient anatomies. In some cases, the cutting mechanism can be preassembled within the device that clamps the skin (e.g., as shown in FIGS. 1A and 1B and 6A-6F). In some cases, the cutting mechanism can be provided as a separate assembly from the device that clamps the skin (e.g., as shown in FIGS. 14A-14C).

[0089] In some cases, the cutting mechanism may be a sliding cutting mechanism that operates in a medial-lateral direction perpendicular to the clamped tissue, as shown, for example, in Figures 6A-6F. Thus, embodiments of the invention encompass devices having cutting mechanisms that can cut skin that slide in a medial-lateral direction. In some cases, the cutting mechanism can operate in an up-down direction perpendicular to the skin tissue surface, as shown, for example, in Figures 14A-14C. Thus, embodiments of the invention encompass devices that can chop skin with a cutting mechanism that moves perpendicular to the clamped skin site.

[0090] 15A and 15B show one embodiment of a blepharoplasty device 1500 configured to capture eyelid tissue to facilitate tissue resection from a portion of the eyelid. The device 1500 is a tissue grasping device (e.g., clamp) consisting of a pair of elongated jaw members 1502, 1504 operably connected together so that they can be moved relative to one another between an open position (FIG. 15B) and a closed position (FIG. 15A). The upper jaw member 1502 and the lower jaw member 1504 can be curved to follow the contour of the eyelid area to create the desired incision shape. In some embodiments, the jaw members can have a top-bottom curve with a 13 / 8 inch radius and a front-to-back curve with a 15 / 8 inch radius to establish the contour. In some cases, the contour created is established from imaging of the patient's anatomy.

[0091] In some embodiments, the upper jaw member is considered a superior jaw member and the lower jaw member is considered a inferior jaw member because of their relative location to the head and foot. For simplicity, the terms "upper" and "lower" are used herein to refer to superior and inferior members, but it should be understood that "upper" and "lower" do not imply any positional relationship except as to anatomical reference points on the body.

[0092] The upper jaw member 1502 has a first tissue contacting surface 1506, and the lower jaw member 1504 has a second tissue contacting surface 1508. The first tissue contacting surface 1506 and the second tissue contacting surface 1508 generally face each other in an opposing manner such that when eyelid tissue is positioned between the upper jaw member 1502 and the lower jaw member 1504, the first tissue contacting surface 1506 and the second tissue contacting surface 1508 can move toward each other to capture and secure the eyelid tissue between the first tissue contacting surface 1506 and the second tissue contacting surface 1508. In some embodiments, the first tissue contacting surface 1506 and the second tissue contacting surface 1508 have respective serrated portions facing toward each other.

[0093] When the upper and lower jaw members 1502, 1504 are in the open position (FIG. 15B), the first and second tissue contacting surfaces 1506, 1508 are separated by a distance to form an opening or space large enough to receive eyelid tissue. As the upper and lower jaw members 1502, 1504 move together to the closed position (FIG. 15A), the distance between the first and second contacting surfaces 1506, 1508 is reduced to a smaller distance. This smaller distance causes the opening or space between the first and second tissue contacting surfaces 1506, 1508 to be small enough to capture and secure any eyelid tissue positioned between the first and second tissue contacting surfaces 1506, 1508.

[0094] The first tissue contacting surface 1506 and the second tissue contacting surface 1508 are configured to grasp and hold eyelid tissue positioned between the opposing first tissue contacting surface 1506 and second tissue contacting surface 1508. The device 1500 also includes a cutting member or cutting mechanism slider 1560. The cutting mechanism slider 1560 can include or be coupled to a cutting blade (not shown), which can move along and / or within a blade guide 1544. As shown here, the blade guide 1544 can be a curved slit, track, or edge along the upper jaw 1502. Advantageously, as discussed further herein, such a cutting mechanism can be actuated in a medial-lateral direction through the skin tissue for removal of a desired amount of skin tissue. In some embodiments, the lower jaw member 1504 can be referred to as an actuating jaw. As shown in FIGS. 15A and 15B, the actuating jaw 1504 can include a tissue contacting side 1505. In some cases, the tissue contacting side 1505 may be referred to as an eyelid contacting surface or an eyelid contacting contour surface. The device 1500 may also include an actuation jaw lever or lever mechanism 1520 and a locking mechanism 1530, such as a lever latch lock mechanism or a ratchet mechanism post. Embodiments of the invention include devices having a ratchet mechanism that allows the jaw lock to be actuated at various distances, allowing adjustment of the skin tissue to be removed. In some cases, the locking mechanism may be attached to an actuation handle component of the device.

[0095] Thus, embodiments of the present invention provide a unique blepharoplasty system, including associated devices, kits, and methods for removing eyelid skin tissue and sealing the incised skin. An exemplary device can include two curved, serrated, skin-contacting jaws, one jaw fixed (e.g., upper member 1502) and one jaw actuating (e.g., lower member 1504), whereby the configuration of the device can alternate between a closed position (e.g., FIG. 15A) and an open position (e.g., FIG. 15B), where the open position allows the eyelid skin tissue to protrude between the jaws, and the closed position clamps the skin tissue and restricts blood flow to the eyelid skin tissue. The actuation mechanism can include a lever 1520 having a pivot 1522, whereby actuation of the actuating jaw lever 1520 about the pivot 1522 allows adjustment of the linear position of the actuating jaw 1504 relative to the fixed jaw 1502 (e.g., between an open configuration shown in FIG. 15B in which the lever 1520 is in an upward position and a closed configuration shown in FIG. 15A in which the lever is in a downward position).

[0096] In some cases, the fixed jaw 1502 (or a component in fixed relationship to the fixed jaw) can be releasably coupled to a ratchet mechanism 1530 to allow the distance between the jaws 1502, 1504 to be locked at various distances between fully open (e.g., 8 mm) and fully closed (e.g., 0 mm). The ratchet mechanism 1530 can include a mechanism for releasing the coupling of the ratchet mechanism to allow re-adjustment of the actuating jaw 1504. As discussed further elsewhere herein, in some embodiments, the device can include or be configured to operate in conjunction with a cutting attachment, which can include an actuation mechanism for severing the clamped eyelid skin tissue.

[0097] In some embodiments, the blepharoplasty device may include silicone coated jaws (e.g., jaws 1502, 1504). The presence of silicone can act to reduce the ability of adhesive to adhere to the jaws of the device, allowing the ability to seal the incision with adhesive while the skin is clamped in the jaws.

[0098] 16A and 16B provide additional views of the device 1500 in an open position or configuration (FIG. 16B) where the upper and lower jaws 1502, 1504 are further apart, and in a closed position or configuration (FIG. 16A) where the upper and lower jaws 1502, 1504 are closer together. Alternation between the open and closed configurations can involve linear motion of the lower (e.g., actuating) jaw 1504 relative to the upper (e.g., fixed) jaw 1502, as shown by arrow A. The first contact surface 1506 and the second contact surface 1508 can have serrated edges. Thus, embodiments of the invention encompass devices having jaws with serrations to allow clamped skin to collapse upon itself to create a desired site for cutting. The serrations can interlock to allow the skin tissue to deform to a point where a desired amount of skin remains protruding and the skin remains collapsed for removal after the clamps are released.

[0099] 17A and 17B provide additional views of the device 1500 in a closed position or configuration in which the upper and lower jaws are closer together (FIG. 17A), and an open position or configuration in which the upper and lower jaws are further apart (FIG. 17B). The device 1500 can include an actuating jaw lever 1520 and a locking mechanism 1530, such as a lever latch locking mechanism or a ratchet mechanism post. A pivot 1522 allows the actuating jaw lever 1520 to pivot relative to a base 1580 of the device 1500.

[0100] 18A and 18B provide additional views of the device 1500 in a closed position or configuration in which the upper and lower jaws are closer together or in contact with one another. The device 1500 can include an actuation jaw lever 1520 having a locking mechanism 1530, such as a lever latch lock mechanism or a ratchet mechanism post. The device 1500 can also include a latch mechanism 1540 having a latch mechanism engagement component 1541. As shown in FIG. 18A, the latch mechanism engagement component 1541 can engage the locking mechanism 1530 such that the latch mechanism 1540 and the locking mechanism 1530 are in a locked configuration relative to one another.

[0101] As shown in FIG. 18B, the latch mechanism engagement component 1541 can be disengaged from the locking mechanism 1530 such that the latch mechanism 1540 and the locking mechanism 1530 are not in a locked configuration relative to one another. This can be accomplished by a latch-unlatching motion or moving the latch mechanism in a distal direction as shown by arrow A, which can then operate to compress the latch spring 1550 (e.g., compressing the spring 1550 between the base 1580 and the latch mechanism 1540). FIG. 18C provides a cross-sectional view of the device 1500 in an open configuration. As shown here, the actuation jaw lever 1520 can pivot relative to the handle 1580 via the actuation jaw lever pivot 1522.

[0102] 19A and 19B provide cross-sectional views of the device 1900 in a closed position or configuration (FIG. 19A) where the upper and lower jaws 1902, 1904 are closer together or in contact with one another, and in an open configuration (FIG. 18B) where the upper and lower jaws 1902, 1904 are further apart from one another. The device 1900 can include an actuation jaw lever 1920 having a locking mechanism 1930, such as a lever latch lock mechanism or a ratchet mechanism post. The device 1500 can also include a latch mechanism 1540 having a latch mechanism engagement component 1541. The latch mechanism engagement component 1941 can engage the locking mechanism 1930 such that the latch mechanism 1940 and the locking mechanism 1930 are in a locked configuration relative to one another. The latch mechanism engagement component 1541 can be disengaged from the locking mechanism 1530 such that the latch mechanism 1540 and the locking mechanism 1530 are not in a locked configuration relative to one another. This can be accomplished by a latch release motion or moving the latch mechanism in a distal direction as shown by arrow A. When the actuation jaw lever 1920 and handle 1980 are pressed or squeezed together as shown in FIG. 19A, the lever spring 1950 is compressed. When the actuation jaw lever 1920 and handle 1980 are allowed to move away from one another as shown in FIG. 19B, the lever spring 1950 is uncompressed. In some embodiments, the lever spring 1950 can be referred to as a lever actuation torsion spring. In some embodiments, the lever actuation torsion spring is configured to bias the second jaw member away from the first jaw member. In some embodiments, the biasing force of the lever spring 1950 can operate to move the actuation jaw lever 1920 away from the handle 1980, for example about the actuation jaw lever pivot 1922.

[0103] 20A-20C provide various views of a blepharoplasty device 2000 in accordance with an embodiment of the present invention. As shown therein, the device 2000 can include a cutting mechanism 2140 having a cutting member or blade 2142. The cutting member 2142 can have one or more cutting edges 2143. The cutting mechanism 2140 can be a sliding cutting mechanism, e.g., can slide from one side of the device to the other side of the device and vice versa, in the direction indicated by arrow A. As shown here, the blade 2142 can slide along or within a blade guide 2144 of the upper jaw 2102.

[0104] 21A-21C provide various views of a blepharoplasty device 2100 in accordance with an embodiment of the present invention. As shown therein, the device 2000 can include a cutting mechanism 2240. The cutting mechanism 2240 can be a sliding cutting mechanism, e.g., capable of sliding in the direction indicated by arrow A from one side of the device to the other side of the device and vice versa.

[0105] 22A and 22B show an embodiment of a grasper or forceps 2200 in an open position or configuration (FIG. 22A) and a closed position or configuration (FIG. 22B). The grasper 2200 can include skin-contacting sawtooth 2210. The grasper can be used (e.g., by a surgeon or operator) to position patient tissue relative to the blepharoplasty device. For example, when the blepharoplasty device is in the open position, a portion of the patient tissue can be positioned between its upper and lower jaws. The grasper 2200 can be used to facilitate movement of tissue into the space between the upper and lower jaws. For example, the grasper 2200 can grasp the patient's upper eyelid tissue and pull it away from the patient into the space between the upper and lower jaws. As shown here, the grasper or forceps 2200 provides a curved grasping surface 2230.

[0106] 22C-22E show an embodiment of a grasper or forceps 2200A in an open position or configuration. The grasper 2200A can include a microneedle 2210A at one or both of its distal ends 2205A. In use, the microneedle can operate to sensitize tissue to a localized local anesthetic and / or to manipulate tissue. The grasper can be used (e.g., by a surgeon or operator) to position patient tissue relative to the blepharoplasty device. For example, when the blepharoplasty device is in the open position, a portion of the patient tissue can be positioned between its upper and lower jaws. The grasper 2200A can be used to facilitate movement of tissue into the space between the upper and lower jaws. For example, the grasper 2200A can grasp upper eyelid tissue of a patient and draw it away from the patient into the space between the upper and lower jaws. As shown here, grasper or forceps 2200A provides a curved grasping surface 2230.

[0107] An embodiment of the present invention can include a kit having a skin grasper (e.g., forceps 2200 or 2200A), a local anesthetic, an incision bonding agent, a marker, and an iodine swab. The grasper (e.g., forceps 2200 or 2200A) can have an elongated body that is split into two serrated tissue contact surfaces at the distal end. The contact surfaces can be curved to match the anterior-posterior curvature of eyelid skin tissue. The distal end contact surfaces can be adjustable between two distances, an open position (e.g., 8 mm) and a closed position (e.g., 0 mm). In some embodiments, the distance between the surfaces is manually adjustable by compression. The serrations on the contact surfaces can provide a shear force between the eyelid skin tissue and the grasper, allowing for positioning of the skin tissue through the jaws of the device component. The elongated body can include a portion with a reduced width to fit through the open jaws of the device component. In operation, a skin grasper (eg, forceps 2200 or 2200A) can be fitted through the device from the anterior direction and expands and compresses to grasp or grip tissue and pull it through.

[0108] 23A and 23B illustrate aspects of a blepharoplasty procedure, showing the configuration of the eyelid tissue T after the clamp or device has been released.

[0109] An exemplary treatment procedure may include marking the area of ​​eyelid tissue desired to be removed with a marker and providing a local anesthetic to temporarily anesthetize the surgical area. After the surgical area is fully anesthetized, the surgical site may be disinfected with an iodine swab. A grasper may enter through the open jaws of the device, compress into a closed position, grasp or grip the marked eyelid skin tissue area, and then pull the tissue through the open jaws of the device. The device may then fully close, clamping the tissue and cutting blood flow. A cutting mechanism may then be used to remove the eyelid skin tissue. After the tissue is removed, an incision bonding agent may be applied to the incision to seal it and allow it to heal.

[0110] Any of the blepharoplasty systems, devices, kits, or methods disclosed herein may be used for any cosmetic skin removal (e.g., eyebrows, cheeks, underarms, neck, etc.). In some embodiments, one or more components of the blepharoplasty device can be manufactured from medical grade plastic. In some embodiments, one or more components of the blepharoplasty device (e.g., cutting blade components) can be manufactured from stainless steel or plastic. In some cases, graspers or forceps can be manufactured from stainless steel or plastic.

[0111] In some embodiments, the width of the clamped skin has a value within the range of about 35 mm to about 45 mm. In some cases, the distance between the jaws has a value within the range of about 0 mm to about 10 mm.

[0112] Advantageously, any of the blepharoplasty systems, devices, kits, or methods disclosed herein may be used in an office environment, thus avoiding the cost and inconvenience of a hospital or surgery center. The local anesthetic is temporary and can be targeted to the surgical area, thus avoiding general anesthesia. In some embodiments, the procedure after local anesthesia takes about 10 minutes to complete. Device adjustability allows for adjustment of the amount of eyelid tissue removed, reducing asymmetric complications. The embodiments disclosed herein may also eliminate the need for sutures, reducing bruising, bleeding, and post-operative recovery.

[0113] While the foregoing description contains considerable detail regarding certain preferred embodiments, this should not be construed as limiting the scope of the invention, but rather as providing exemplification of preferred embodiments.

[0114]

[0013] Embodiments of the present invention include kits having the blepharoplasty system disclosed herein. In some embodiments, the kit includes one or more blepharoplasty system components along with instructions for using the device(s), e.g., according to any of the methods disclosed herein.

[0115] All features of the systems and devices described are applicable to the methods illustrated mutatis mutandis, and vice versa.

[0116] Each reference provided herein is incorporated by reference in its entirety to the same extent as if each reference was individually incorporated by reference. In relation thereto, all publications, patents, patent applications, journal articles, books, technical references, etc. mentioned herein are incorporated by reference to the same extent as if each individual publication, patent, patent application, journal article, book, technical reference, etc. was specifically and individually indicated to be incorporated by reference.

[0117] Although the foregoing invention has been described in some detail by way of illustration and example for purposes of clarity of understanding, those skilled in the art will appreciate that certain changes, modifications, alternative constructions, and / or equivalents may be implemented or adopted, as desired, within the scope of the appended claims.

Claims

1. 1. A device for resecting excess skin and creating wound closure, comprising: A base and a lever mechanism coupled to the base; A locking mechanism; an elongated curved first jaw member in fixed relationship with the base and having an underlying tissue contacting surface; an elongated, curved second jaw member in movable relationship with said base and having an upper tissue contacting surface, said upper tissue contacting surface of said second jaw member facing toward said lower tissue contacting surface of said first jaw member; pivoting of the lever mechanism causes movement of the second jaw member relative to the first jaw member; the locking mechanism is configured to maintain the first and second jaw members in a fixed relationship relative to one another.

2. The device of claim 1 , wherein the lower tissue contacting surface is serrated and the upper tissue contacting surface is serrated.

3. The device of claim 1 , wherein the lever mechanism is coupled to the base via a lever pivot.

4. The device of claim 1 , wherein pivoting of the lever mechanism causes linear movement of the second jaw member relative to the first jaw member.

5. The device of claim 1 , wherein the locking mechanism is releasably engagable with the second jaw member.

6. The device of claim 1 , wherein the locking mechanism is coupled to the base via a locking pivot.

7. The device of claim 1 , further comprising a latch mechanism, the locking mechanism being releasably engagable with the latch mechanism.

8. The device of claim 7 , wherein the locking mechanism releasably engages the latch mechanism at a location within the base.

9. The device of claim 7 , wherein the latch mechanism is coupled to the second jaw member.

10. The device of claim 7 , further comprising a latch spring compressible between the latch mechanism and the base.

11. The device of claim 10 , wherein the latch spring biases the latch mechanism into engagement with the locking mechanism.

12. The device of claim 1 , wherein the locking mechanism is coupled to the lever mechanism.

13. The device of claim 1 , further comprising a pawl in fixed relationship with the second jaw member, the locking mechanism comprising an engagement tooth configured to releasably engage the pawl.

14. The device of claim 13 , further comprising a locking spring configured to bias the engagement tooth of the locking mechanism against the pawl.

15. The device of claim 1 , wherein at least one of the first jaw member or the second jaw member has a silicone coating.

16. The device of claim 1 , further comprising an actuation jaw spring configured to bias the second jaw member away from the first jaw member.

17. The device of claim 1 , further comprising a lever-actuated torsion spring configured to bias the second jaw member away from the first jaw member.

18. 10. The device of claim 1, wherein at least one of the first jaw member or the second jaw member comprises a tissue contacting side having a contoured surface having a shape customized to a patient's anatomy based on an imaging scan of the patient.

19. 1. An excess skin removal and wound closure device comprising: A base and a lever mechanism connected to the base via a lever pivot; A locking mechanism; an elongated, curved first jaw member in fixed relationship with the base and having a lower serrated tissue contacting surface; an elongated, curved second jaw member in pivotal relationship with said lever and having an upper serrated tissue contacting surface facing toward the lower serrated tissue contacting surface of the first jaw member; the locking mechanism is releasably engagable with a support assembly of the first jaw member; An excess skin removal and wound closure device, wherein pivoting movement of the lever mechanism causes linear movement of the second jaw member relative to the first jaw member.

20. 20. The device of claim 19, wherein the locking mechanism comprises a first set of engagement teeth and a second set of engagement teeth that releasably engage the support assembly of the first jaw member.

21. 20. The device of claim 19, wherein the locking mechanism comprises a serpentine portion that allows for compression of the locking mechanism.

22. 20. The device of claim 19, further comprising a jaw actuation handle spring coupled to the base and the lever mechanism.

23. The device of claim 19 , wherein the support assembly of the first jaw member is releasably engagable with the base.

24. The device of claim 19 , wherein the locking mechanism comprises one or more locking mechanism compression tabs.

25. 1. A method of performing an excess skin removal and wound closure procedure, comprising: Grasping tissue of a patient with a grasper; positioning the tissue between an upper jaw mechanism and a lower jaw mechanism of an excess skin removal and wound closure device; pivoting a lever of the excess skin removal and wound closure device relative to a base of the excess skin removal and wound closure device to advance the lower jaw mechanism toward the upper jaw mechanism, thereby clamping the tissue between the lower jaw mechanism and the upper jaw mechanism; making an incision in the tissue; and removing the portion of tissue from the patient.

26. 26. The method of claim 25, wherein pivoting the lever of the excess skin removal and wound closure device relative to the base of the excess skin removal and wound closure device advances the lower jaw mechanism linearly toward the upper jaw mechanism.

27. 26. The method of claim 25, further comprising applying a bonding agent to the incision.

28. 26. The method of claim 25, further comprising inserting the grasper between the upper and lower jaw mechanisms of the excess skin removal and wound closure device prior to grasping the tissue with the grasper.

29. 26. The method of claim 25, wherein the positioning step includes removing the grasper from between the upper and lower jaw mechanisms of the excess skin removal and wound closure device.

30. 26. The method of claim 25, wherein the lever pivots relative to a support assembly of the upper jaw mechanism when the lever pivots relative to the base.

31. 26. The method of claim 25, wherein the lever slides against a support assembly of the upper jaw mechanism as the lever pivots relative to the base.

32. 26. The method of claim 25, further comprising the step of locking the lower jaw mechanism in position relative to the upper jaw mechanism prior to making the incision.

33. 33. The method of claim 32, wherein the locking step comprises pivoting a locking mechanism of the excess skin removal and wound closure device.

34. 33. The method of claim 32, wherein the locking step comprises compressing a locking mechanism of the excess skin removal and wound closure device.

35. 26. The method of claim 25, wherein the gripper comprises a distal end having a microneedle.

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