Aesthetic Eyelid Ptosis Correction: A Review of Technique and Cases

Abstract

Upper eyelid ptosis can present both functional and aesthetic problems. Because proper correction of ptosis can be difficult to achieve, numerous surgical procedures have been developed. Plication of levator aponeurosis can be combined with aesthetic blepharoplasty and facial rejuvenation procedures to successfully address ptosis. The authors assessed the effectiveness of levator aponeurosis plication for correction of acquired upper eyelid ptosis in patients presenting for concomitant cosmetic facial procedures. The medical records of 74 consecutive patients (68 women and six men) who had upper eyelid ptosis correction in conjunction with cosmetic facial procedures from January of 1994 to January of 2000 were reviewed. During this period, 400 endoscopic forehead lifts and 479 face lifts were performed. The correction was performed through an external upper blepharoplasty approach removing an ellipse of skin and orbicularis muscle. Once the orbital septum was opened, a plication of the levator aponeurosis was accomplished by one or more horizontal mattress sutures of 6-0 clear nylon (with the first bite placed at or just medial to the vertical level of the pupil). The average follow-up period was 14 months. Long-term correction of the ptosis was excellent. The complications were minor, with the most common occurrence being asymmetry. Revisions were performed on only four patients. Correction of ptosis can be performed safely and effectively in conjunction with periorbital and facial rejuvenation. The technique described is simple, reliable, and reproducible.

Combined Subbrow Excision with Upper Blepharoplasty Using a Tadpole Shaped Excision for Blepharochalasis

“…Owing to the aspect of extirpation being done appropriately throughout the entire eyelid for this method, the medial and lateral perspective of the eyelid can display a relatively even appearance. Moreover, accompanied aponeurotic blepharoptosis may also be corrected without an additional procedure [5,6]. Patients with or without a pre-existent double eyelid may be provided with new double eyelids or double eyelids with a desired height [15].…”

Infraeyebrow Blepharoplasty for Blepharochalasis of the Upper Eyelid: Its Indication and Priority

“…The greatest merit of these approaches is that correction of aponeurotic blepharoptosis can be performed at the same time without a separate procedure [13, 17]. In patients who request a double-eyelid upper blepharoplasty, a low incision in the upper lid is also available to create a new crease by fixing the pretarsal skin to the levator mechanism [14, 18].…”

Overview of Facial Plastic Surgery and Current Developments

“…Of note, blepharoplasty is also performed to correct lid ptosis, which results from several causes. 29 The most common cause is levator palpebrae superioris attenuation. 30…”