Early Grafting Using AlloDerm to Lengthen the Levator Aponeurosis and Correct Upper Eyelid Retraction Caused by Cosmetic Blepharoplasty.

[SUMMARY] Upper eyelid retraction often results from overcorrection of the levator palpebrae muscle during upper eyelid surgery. In such patients, the time between wound healing and reoperation may be prolonged and could result in symptoms, including dry eye. Therefore, the correction surgery-in which the levator aponeurosis that was shortened by cosmetic blepharoplasty is lengthened-should be performed as early as possible for better patient satisfaction and surgical outcomes. Between August of 2020 and September of 2022, the authors performed spacer grafting using AlloDerm dermal matrix after detaching the levator palpebrae muscle from the tarsus in 64 patients who experienced upper eyelid retraction after bilateral eyelid surgery and cosmetic blepharoplasty. Among 64 patients, 50 (78%) had satisfactory results, 8 (12%) had blepharoptosis, and 6 (10%) had insufficient correction. The authors' method produced a normalized levator aponeurosis position, symmetric eyes, and reduced adverse effects, including surprised and dry eyes. In addition, the method is easy to follow and safe.

[CLINICAL QUESTION/LEVEL OF EVIDENCE] Therapeutic, IV.