Surgical treatment of thyroid-related lid retraction: a new variation

We describe a cutaneous approach for retraction of the upper eyelid which incorporates a levator aponeurotic/Mueller's muscle recession with maintenance of the normal orbital septum levator aponeurosis anatomy. With success defined as asymmetry between the two eyelids of 1 mm or less, with a marginal reflex distance as close to 4 mm as possible, this technique was successful in 87% of 15 consecutive patients. All patients reported improved comfort. This approach is quick and easy, bleeding is minimal, height and contour are predictable, the upper eyelid crease is preserved, and spacers are avoided, with less postoperative eyelid thickening and reaction.