Blepharoptosis correction: levator aponeurosis-Müller muscle complex advancement with three partial incisions.

[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.