The anterior layer of the levator aponeurosis in blepharoptosis correction

Kim, Yong Kyu; Chang, Lan Sook; Kim, Eung Hyun

doi:10.1016/j.bjps.2020.10.040

Cited by 7 publications

(11 citation statements)

References 15 publications

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“…The complete release of these bands can reduce the resistance of levator muscle contraction and make the upper eyelid movement more flexible. Some studies suggested that the levator sheath was a good suspension material for blepharoptosis, and it was advocated to fix the levator sheath onto the tarsus to strengthen the suspension effect of the levator aponeurosis 19,20 . However, we found that the elasticity of levator sheath is poor compared with the levator aponeurosis.…”

Section: Discussionmentioning

confidence: 59%

“…Some studies suggested that the levator sheath was a good suspension material for blepharoptosis, and it was advocated to fix the levator sheath onto the tarsus to strengthen the suspension effect of the levator aponeurosis. 19,20 However, we found that the elasticity of levator sheath is poor compared with the levator aponeurosis. Therefore, we do not advocate using the levator sheath to strengthen the suspension effect of the levator aponeurosis so as to avoid lagophthalmos, unless the ptosis is more than mild or LF is poor.…”

Section: Discussionmentioning

confidence: 74%

“…However, this technique did not always achieve satisfactory correction result because of the insufficient understanding of the anatomical structure of the upper eyelid and too simple surgical procedure in the past 14–17 . During the last 2 decades, the precise and complex anatomical structure of upper eyelid has been further understood 18–22 . Based on these changes in the understanding of the upper eyelid structure, our team improved the levator aponeurosis plication in 3 aspects: dissection, fixation, and closure of incision.…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16][17] During the last 2 decades, the precise complex anatomical structure of upper eyelid has been further understood. [18][19][20][21][22] Based on these changes in the understanding of the upper eyelid structure, our team improved the levator aponeurosis plication in 3 aspects: dissection, fixation, and closure of incision.…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16][17] During the last 2 decades, the precise and complex anatomical structure of upper eyelid has been further understood. [18][19][20][21][22] Based on these changes in the understanding of the upper eyelid structure, our team have made modifications to the levator aponeurosis plication in 3 aspects: dissection, fixation, and closure of incision. This technique combined double eyelid blepharoplasty and blepharoptosis correction to yield a natural double eyelid, bright eye, and energetic appearance.…”

mentioning

confidence: 99%

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Simultaneous Double Eyelid Blepharoplasty and Blepharoptosis Correction With Levator Aponeurosis Plication Technique

et al. 2022

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BackgroundFifty percent of Asians are born without a supratarsal fold (also called single eyelid), and double eyelid blepharoplasty is one of the most commonly performed and most popular facial cosmetic surgeries in the Asian population. However, patients with single eyelid frequently present with concomitant mild blepharoptosis (degree of ptosis, ≤2 mm), which often fails to cause the attention of surgeons and misses correction.MethodsA retrospective study of all patients who underwent double eyelid blepharoplasty and blepharoptosis correction simultaneously with the modified levator aponeurosis plication technique was performed from June of 2017 to June of 2020.ResultsA total of 108 patients (155 eyelids) underwent double eyelid blepharoplasty and blepharoptosis correction simultaneously with the modified levator aponeurosis plication technique and were enrolled in the study. The average follow-up period was 11.8 ± 4.5 months. There was a statistically significant difference between the preoperative margin reflex distance 1 (MRD1) and postoperative MRD1 (2.93 ± 0.37 vs 4.21 ± 0.39 mm, P = 0.000), and the mean MRD1 improvement was 1.28 ± 0.50 mm. Sufficient correction was obtained in 148 eyelids (95.5%), whereas undercorrection was observed in 5 eyelids (3.2%) and overcorrection was observed in 2 eyelids (1.3%). One hundred two patients (94.4%) were completely satisfied with the final result.All patients had smooth and elegant upper eyelid margin curve, and no patients complained of distortion of the eyelid margin contour and foreign body sensation.There were no cases of hematoma, infection, suture exposure, corneal abrasion, and keratitis in any patient.ConclusionsThis modified levator aponeurosis plication introduced in this study is a simple and effective method for creating double-eyelid crease and correcting mild blepharoptosis simultaneously, and provides a satisfactory outcome. As such, we recommend this method in treating patients with both single eyelid and mild blepharoptosis.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 74%