Correction of senile (atonic) blepharoptosis during cosmetic blepharoplasty

Pseudoptosis, caused by skin laxity or by herniation of periorbital fat, can be remedied by the usual cosmetic blepharoplasty. If there is a concomitant mild senile ptosis due to levator weakness, however, we recommend levator muscle plication during the course of the blepharoplasty. While blepharoptosis of significant degree is best treated by resection of the levator, plication works well in a mild degree of senile (or atonic) ptosis (when there is no more than two to 4 mm of droop). It is a simple and effective maneuver, easily performed in association with a cosmetic blepharoplasty.