Blepharoptosis Reoperation With Combining Excision of Tarsus and Levator Muscle

Although various techniques have been reported to correct blepharoptosis, undercorrection is still a commonly occurring complication and needs further revision procedure. Scar formation and distorted anatomy make reoperation more difficult than the primary surgery. However, tarsus is usually fully maintained in the first correction process, and this study combined tarsus resection with levator resection. The resected tarsus can offset the amount of levator excised, which makes this technique applicable for ptosis secondary revision. Fifty-nine patients with undercorrection complication were included who underwent secondary revision by combining excision of tarsus and levator muscle. The correction and symmetry results were evaluated and analyzed in different groups, which were based on patients' different primary correction techniques. Adequate correction can be achieved in 51 cases (86.4%). The patients who took frontalis suspension surgery in the first correction surgery showed higher adequate correction rate than patients who underwent levator-based technique in their primary surgery. In all patients, 43 cases (72.9%) achieved good or fair symmetry results. Combining excision of levator and tarsus is effective with respect to blepharoptosis reoperation, with better biomechanics and a satisfying aesthetic outcome. It provides a new method in limited secondary revision techniques.