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Blepharoptosis correction: levator aponeurosis-Müller muscle complex advancement with three partial incisions
Jin Ho Lee1, Seung Min Nam, Yong Bae Kim
1Seoul and Bucheon, Republic of Korea From Dr. Lee's Aesthetic Surgical Clinic; and the Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University.
Background:
Ptosis of the upper eyelid, blepharoptosis, is defined as an abnormally low-positioned upper eyelid margin in the primary gaze, which results in narrowing of the palpebral fissure and opening. Blepharoplasty, including a double-eyelid fold operation, is the most common aesthetic operation in the East Asian population. Patients who want to undergo blepharoplasty often have mild to moderate blepharoptosis.
Methods:
A retrospective review was conducted of the medical records and preoperative and postoperative photographs of 74 patients who underwent simultaneous blepharoptosis correction and double-eyelid surgery between January of 2007 and October of 2011. All patients had mild (1 to 2 mm) or moderate (3 to 4 mm) bilateral blepharoptosis and excellent or good levator function (>8 mm). All patients underwent levator aponeurosis-Müller muscle complex advancement through three partial incisions.
Results:
A primary blepharoptosis operation was performed in 46 patients, with a secondary operation performed in 28 patients. Double-eyelid fold operations were performed in all cases. The average preoperative margin reflex distance 1 measured 0.8 ± 0.19 mm. No intraoperative complications occurred. The average postoperative margin reflex distance 1 was 3.6 ± 0.25 mm. There was a statistically significant difference between preoperative and postoperative distance values (p < 0.05). Excellent results occurred in 62 patients (83.8 percent), good results occurred in 11 (14.9 percent), fair results occurred in one (1.35 percent), and poor results did not occur.
Conclusion:
Blepharoptosis correction with levator aponeurosis-Müller muscle complex advancement through three partial incisions is an effective technique for young patients with mild to moderate blepharoptosis who do not want incision scars.
Clinical Question/Level Of Evidence:
Therapeutic, IV.
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