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Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2017 Jul;31(8):996-998

Institute of Reconstructive Plastic Surgery, Weifang Medical University, Weifang Shandong, 261042, P.R.China.

Objective: To investigate the effectiveness of retro-orbicularis oculi fat resection in Park double eyelid surgery to correct the swollen upper eyelid.

Methods: Between September 2015 and July 2016, partial resection of the retro-orbicularis oculi fat was performed on 32 cases with bilateral swollen upper eyelids in Park double eyelid surgery. There were 10 males and 22 females with an average age of 25 years (range, 19-32 years). Read More

Facial Plast Surg 2018 Apr 9;34(2):183-193. Epub 2018 Apr 9.

Perth Facial Plastic and Cosmetic Surgery, Perth, Western Australia, Australia.

Upper blepharoplasty is one of the more common facial plastic procedures. The upper lid and brow complex are managed together. Whether upper blepharoplasty is performed for medical or cosmetic reasons, the aim is to improve appearance while retaining natural shape and maintaining (or improving) function. Read More

Exp Clin Transplant 2018 Mar;16 Suppl 1(Suppl 1):194-197

Department of Plastic and Reconstructive Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.

Objectives: Transplant patients, like the nontransplant population, can have surgical interventions for body shape disorders. Studies on aesthetic surgeries in transplant patients are scarce. Our aim was to share our experiences with various aesthetic procedures in solid-organ transplant recipients. Read More

Ophthalmologe 2018 Apr;115(4):266-274

Augenklinik der LMU, Klinikum der Universität München, Campus Innenstadt, Mathildenstr. 8, 80336, München, Deutschland.

Background: Upper eyelid blepharoplasty is among the most frequent oculoplastic surgical procedures. It is often performed as one of the first esthetic surgical interventions by surgeons of various disciplines. While there is a high probability of happy and satisfied patients postoperatively, there are important potential surgical complications that should be prevented. Read More

Aesthet Surg J 2018 Feb 21. Epub 2018 Feb 21.

From the University of Illinois at Chicago, Chicago, IL.

Background: Upper eyelid dermatochalasis often triggers frontalis hyperactivity in an effort to elevate the upper lids away from the visual axis. Similarly, prior neuromodulator treatment of the brow depressors may cause false elevation of the brows, diminishing the extent of preoperative brow ptosis or dermatochalasis. Studies have quantified postoperative brow ptosis and recurrent dermatochalasis following upper blepharoplasty, but a methodology to predict the postoperative brow position remains to be elucidated. Read More

Neuroophthalmology 2018 Feb 12;42(1):49-51. Epub 2017 Jun 12.

Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, USA.

Brown syndrome is characterised by impaired supraduction worse in adduction due to a restricted superior oblique tendon passing through the trochlea. A few reports have previously described Brown syndrome after upper eyelid surgery, including blepharoplasty and ptosis repair. The authors describe two additional cases of Brown syndrome following ptosis repair. Read More

J Craniofac Surg 2018 May;29(3):747-750

Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea.

Purpose: Change in eyelid position after upper blepharoplasty is an important factor that can affect postoperative patient satisfaction. However, no one has investigated eyelid changes during follow-up for upper eyelid surgery. Thus, the purpose of this study was to investigate position changes in the upper and lower eyelids during the follow-up period after upper blepharoplasty in Korean. Read More

Medicine (Baltimore) 2017 Dec;96(51):e9288

Eye Center, 2nd Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, China.

Rationale: Ptosis is a rare complication of periocular steroid use. Studies report that local injections of steroids produce ptosis. We describe the first 2 cases of ptosis because of long-term treatment with topical steroid eye drops. Read More

Plast Reconstr Surg 2018 Feb;141(2):213e-219e

Bangkok, Thailand From the Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society.

Background: The purpose of this study was to compare the efficacy of external levator advancement and Müller muscle-conjunctival resection in aponeurotic blepharoptosis repair.

Methods: Mild to moderate blepharoptosis patients with good levator function and a positive phenylephrine test were randomized to upper blepharoplasty with either external levator advancement or Müller muscle-conjunctival resection. The primary outcome was marginal reflex distance 1 at 1 month after surgery. Read More

Ann Plast Surg 2018 Feb;80(2S Suppl 1):S40-S47

Background: Floppy eyelid syndrome (FES) is typically characterized by chronic eye irritation and an increased laxity of the upper eyelid that can be easily everted by applying minimal upward traction. However, it is a clinical entity that is less known to most plastic surgeons. Blepharoptosis is one of the most common features, which links to FES, for which a thorough differential diagnosis has become important in directing proper medical treatment. Read More

Ophthalmic Plast Reconstr Surg 2018 Jan 12. Epub 2018 Jan 12.

Division of Orbital and Ophthalmic Plastic Surgery, Doheny Eye Center, University of California, Los Angeles, California, U.S.A.

Purpose: This study aims to describe Muller's muscle-conjunctival resection surgery in terms of outcomes and potential factors that may predict final positions.

Methods: This cross-sectional cohort study included patients undergoing Muller's muscle-conjunctival resection surgery for involutional ptosis over a 15-year period. Success was defined in 2 ways: 1) final marginal reflex distance 1 (MRD1) ≥2. Read More

Vestn Oftalmol 2017;133(6):69-75

Moscow Helmholtz Research Institute of Eye Diseases, Ministry of Health of the Russian Federation, 14/19 Sadovaya-Chernogriazskaya St., Moscow, Russian Federation, 105062.

Aim: to develop a modified implant to correct ptosis through brow suspension and to evaluate its effectiveness.

Material And Methods: The clinical group consisted of 20 patients (29 eyes) aged 23 to 69 years (45±5.3 years on the average) and the comparison group - of 20 patients (33 eyes) aged 19 to 77 years (47±9. Read More

Ophthalmic Plast Reconstr Surg 2018 Jan/Feb;34(1):90-92

J Pediatr Ophthalmol Strabismus 2018 Mar 19;55(2):117-121. Epub 2017 Dec 19.

Purpose: Congenital ptosis is a troubling eye condition for pediatric ophthalmologists. There are many considerations to contemplate when deciding when to operate and which technique to use.

Methods: A retrospective chart review of 69 pediatric patients treated for congenital ptosis using a double rhomboid frontalis sling with a nylon suture at a single tertiary care center. Read More

J Craniofac Surg 2018 Mar;29(2):482-485

Department of Plastic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou City.

Background: Some fordless-eyelid patients with moderate upper lid ptosis characterize in a higher eyebrow position which leads to an increased midfacial ratio. Apart from performing blepharoplasty to create dynamic folds, additional procedures such as folding aponeurosis of levator palpebrae superioris muscle were effective to revise the enlarged ratio of midface through lowering eyebrow, which gains good aesthetic results. However, the specific changes in the proportion of facial aesthetics and the importance of these change were serious lack in the literature as far as the authors know. Read More

Semin Ophthalmol 2018 22;33(3):429-434. Epub 2017 Feb 22.

c Ophthalmology Department , New Stobhill Hospital , Glasgow , UK.

Introduction: Medical management can have limitations in improving ptosis in patients with myasthenia gravis (MG). We present our experience of ptosis surgery in MG.

Materials And Methods: Clinical records of all patients with MG undergoing ptosis surgery from September 2007 to November 2013 in a single center were retrospectively reviewed. Read More

J Pediatr Ophthalmol Strabismus 2017 Oct 9;54:e63-e66. Epub 2017 Oct 9.

A case of dissociated vertical deviation, ptosis, and juvenile glaucoma is described. J deformity anteriorization of the normally acting inferior oblique muscles was chosen to preserve the superior fornix for glaucoma surgeries by avoiding superior rectus recession and to prevent narrowing of the palpebral fissure by avoiding an inferior rectus tuck. [J Pediatr Ophthalmol Strabismus. Read More

J Plast Reconstr Aesthet Surg 2018 02 25;71(2):279-280. Epub 2017 Sep 25.

Department of Plastic and Reconstructive Surgery, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands. Electronic address:

J Pediatr Ophthalmol Strabismus 2017 Sep;54(5):320-323

Purpose: To evaluate the therapeutic benefits of frontalis suspension as a repeat intervention in congenital blepharoptosis.

Methods: Pediatric patients diagnosed as having congenital ptosis who had at least 2 years of postoperative follow-up were included in this retrospective study. A successful outcome was defined as a postoperative margin-reflex distance of 3 mm or greater. Read More

J Curr Ophthalmol 2017 Sep 25;29(3):154-168. Epub 2017 Apr 25.

Eye Research Center, Oculo-Facial Plastic Surgery, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Purpose: Since different subspecialties are currently performing a variety of upper facial rejuvenation procedures, and the level of knowledge on the ocular and periocular anatomy and physiology is different, this review aims to highlight the most important preoperative examinations and tests with special attention to the eye and periocular adnexal structures for general ophthalmologist and specialties other than oculo-facial surgeons in order to inform them about the fine and important points that should be considered before surgery to have both cosmetic and functional improvement.

Methods: English literature review was performed using PubMed with the different keywords of "periorbital rejuvenation", "blepharoptosis", "eyebrow ptosis", "blepharoplasty", "eyelid examination", "facial assessment", and "lifting". Initial screening was performed by the senior author to include the most pertinent articles. Read More

Ophthalmic Plast Reconstr Surg 2017 Sep/Oct;33(5):392-393

Ophthalmic Plast Reconstr Surg 2017 Sep/Oct;33(5):392

Ophthalmic Plast Reconstr Surg 2017 Sep/Oct;33(5):392

Ophthalmic Plast Reconstr Surg 2017 Sep/Oct;33(5):391

Ophthalmic Plast Reconstr Surg 2017 Sep/Oct;33(5):390-391

Ophthalmic Plast Reconstr Surg 2017 Sep/Oct;33(5):390

Ann Plast Surg 2017 Oct;79(4):334-340

From the *Gyalumhan Plastic Surgery, Seoul; and †Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital, Daejeon, South Korea; ‡ELEE Plastic Surgery, Houston, TX; and §Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Severance Hospital, Seoul; ∥Department of Plastic and Reconstructive Surgery, Chungnam National University College of Medicine, Daejeon; and ¶Department of Medicine, Graduate School of Yonsei University, Seoul, South Korea.

Background: Mild to moderate blepharoptosis, or ptosis, is relatively common among Asians, and it is not uncommon to offer ptosis correction at the time of double-eyelid surgery in this patient population. The traditional open approaches to ptosis correction are subject to scarring and prolonged recovery time, whereas the newer nonincisional approaches are marred by issues of incomplete correction or recurrence. This study describes a new nonincisional technique that overcomes the limitations of current methods by using conjoint fascial sheath (CFS) for suspension. Read More

J Craniofac Surg 2017 Oct;28(7):1849-1851

*S leaders Aesthetic Surgical Clinic, Daegu †Department of Plastic Surgery, Inha University School of Medicine, Incheon, Korea ‡University of California, Los Angeles, CA.

The authors innovated the levator aponeurosis and Muller muscle plication reinforced with levator sheath advancement (AMPSA) for blepharoptosis correction. The orbital septum was opened 1 mm above its fusion with the levator aponeurosis. The preaponeurotic fat was retracted and the thickened part of the levator sheath was identified. Read More

Eye (Lond) 2017 Dec 11;31(12):1716-1723. Epub 2017 Aug 11.

Eye Unit, Royal Bournemouth Hospital, Bournemouth, UK.

PurposeAnterior approach white line advancement presents a novel surgical option for correction of blepharoptosis. The technique draws on several advantages of other approaches. The aim of this study was to present outcomes using this technique at a minimum follow-up of 18 months. Read More

J Craniofac Surg 2017 Sep;28(6):1435-1436

Department of Plastic and Reconstructive Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China.

In double eyelid blepharoplasty, unexpected bleeding may cause intraoperative hematoma, swelling, and temporary ptosis, which could cause asymmetry and prolong recovery time. In 1725 patients (3450 eyes), double eyelid blepharoplasties were performed on Chinese patients from January 2014 to July 2016 by our senior author. In 36 eyes, the authors identified a variant artery, which the authors named the "sentinel artery," located in the inferolateral superficial orbital septum. Read More

J AAPOS 2017 Oct 14;21(5):365-369. Epub 2017 Jul 14.

Department of Ophthalmology, VMMC & Safdarjung Hospital, Ansari Nagar, New Delhi, India.

Purpose: To compare the results of two different frontalis sling surgery techniques with silicon rod for ptosis: Fox's single pentagon technique and a modification of Crawford's double triangle technique.

Methods: In a randomized clinical trial, 52 eyes of 50 patients with severe ptosis and poor levator function (≤4 mm) were randomly assigned to the Fox group or the modified Crawford group. Cosmetic outcome, functional success, and lagophthalmos were compared. Read More

Orbit 2017 Oct 11;36(5):325-330. Epub 2017 Jul 11.

a Orbital, Plastic & Lacrimal Unit , Royal Victorian Eye and Ear Hospital , East Melbourne , Victoria , Australia.

The aim of this study was to determine whether pre-operative levator function and degree of ptosis affect surgical outcomes in children with congenital ptosis undergoing anterior levator resection under general anaesthesia. Retrospective cohort study. Children with 'simple' congenital ptosis who underwent anterior levator resection under general anaesthesia. Read More

J Plast Reconstr Aesthet Surg 2017 Dec 24;70(12):1768-1775. Epub 2017 May 24.

Dept. of Plastic and Reconstructive Surgery, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, South Korea. Electronic address:

Background: Sunken upper eyelid is a commonly found deformity among Asians, mostly due to the aging process and excessive orbital fat removal during oriental blepharoplasty procedures. This deformity is frequently accompanied by multiple, poorly defined upper eyelid folds and blepharoptosis. To date, autologous fat graft has been the treatment of choice for this group of patients. Read More

Orbit 2017 Jun 3;36(3):147-153. Epub 2017 Mar 3.

b Bristol Eye Hospital , Bristol , United Kingdom.

This qualitative study sought to explore the experiences of patients who had undergone successful ptosis correction surgery. Participants were recruited from Bristol Eye Hospital. Nine participants were interviewed using a semi-structured interview schedule and open ended questions. Read More

Ophthalmic Plast Reconstr Surg 2018 May/Jun;34(3):246-253

TOC Eye and Face, Austin, Texas.

Purpose: To compare revision rates for ptosis surgery between posterior-approach and anterior-approach ptosis repair techniques.

Methods: This is the retrospective, consecutive cohort study. All patients undergoing ptosis surgery at a high-volume oculofacial plastic surgery practice over a 4-year period. Read More

J Plast Reconstr Aesthet Surg 2017 08 20;70(8):1129-1135. Epub 2017 May 20.

The First Hospital Affiliated to the People's Literative Army Hospital, 51#, Fucheng Road, Haidian District, Beijing, 100048, China.

Background: Double eye-lid surgery is one of the most popular performed aesthetic procedures in young Asians. Reliable measurement of patient reported outcomes is crucial for facial aesthetics. The FACE-Q is a new patient-reported outcome tool (PRO) composed of numerous independently functioning scales and checklists designed to measure outcomes. Read More

J Craniofac Surg 2017 Jul;28(5):e419-e422

*Department of Ophthalmology, Soonchunhyang University College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon †Department of Ophthalmology, Myung-Gok Eye Research Institute, Konyang University College of Medicine, Kim's Eye Hospital, Seoul, Korea.

Purpose: To compare preoperative incision design markings between both eyelids in upper blepharoplasty.

Methods: This retrospective study examined 22 patients who underwent bilateral upper blepharoplasty surgery resulting from senile dermatochalasis and/or blepharoptosis. The initial preoperative incision design markings were drawn with the patient sitting upright. Read More

Curr Eye Res 2017 09 30;42(9):1248-1253. Epub 2017 May 30.

a Department of Ophthalmology , Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo , São Paulo , Brazil.

Purpose: To measure spontaneous blink metrics and brow motion in patients with congenital ptosis operated with frontalis slings with autogenous fascia lata.

Methods: An infrared three-dimensional video motion analyzer was employed to simultaneously measure brow motion and spontaneous blinks of 17 patients with congenital ptosis who underwent frontalis sling with autogenous fascia lata and a control group of equal number of healthy subjects. A customized software identified and quantified the amplitude and maximum velocity spontaneous blinks eyelid and brown motion during a 5-minute observation of a commercial movie. Read More

J Pediatr Ophthalmol Strabismus 2017 Sep 17;54(5):288-294. Epub 2017 May 17.

Purpose: To evaluate the clinical outcomes of single-stage surgery for treatment of patients with congenital ptosis and coexisting strabismus.

Methods: A retrospective analysis was performed on 10 patients (17 eyes) with congenital ptosis and coexisting strabismus. Patients were treated with levator resection or frontalis suspension for ptosis and ocular muscle surgery for strabismus, performed as a single-stage procedure. Read More

Curr Opin Ophthalmol 2017 Sep;28(5):539-543

aDepartment of Ophthalmology bDepartment of Ophthalmology and Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA.

Purpose Of Review: Aesthetic concerns about upper eyelid and brow position are very common in ophthalmic practice. Management of brow descent and devolumization requires an approach customized to each patient taking into consideration preoperative examination and patient desires. This article will review several minimally invasive techniques that can be used to address the needs of patients with mild-to-moderate brow ptosis. Read More

JAMA Facial Plast Surg 2017 Dec;19(6):490-495

Allure Laser Center and Medispa, Kirkland, Washington.

Importance: External surgical treatment of involutional ptosis with normal levator function is challenging owing to lack of an established algorithm. Developing an algorithm-based technique could improve postoperative results while limiting intraoperative inefficiencies.

Objective: To investigate the postoperative success of an algorithmic external levator aponeurosis resection technique for aponeurotic ptosis with good levator function. Read More

Ann Plast Surg 2017 Jun;78(6S Suppl 5):S279-S281

From the *University of Alabama at Birmingham School of Medicine; †Division of Plastic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL; ‡Department of Pediatrics, University of California, San Diego, La Jolla, CA; and §Morsani School of Medicine, University of South Florida, Tampa, FL.

Background: Several procedures have been proposed for the treatment of eyelid ptosis, and both levator advancement and levator plication are widely used to shorten the levator palpebrae superioris. The purpose of this study was to quantify perioperative lid measurements in patients undergoing bilateral levator aponeurosis advancements to aid in preoperative planning.

Methods: Between July 2014 and June 2016, the authors performed a retrospective analysis of all bilateral upper eyelid levator advancement procedures for ptosis performed by the senior surgeon. Read More

J Plast Reconstr Aesthet Surg 2017 06 7;70(6):861-862. Epub 2017 Apr 7.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.

J Glaucoma 2017 Sep;26(9):e200-e201

*School of Medicine †Department of Ophthalmology, Queen's University ‡Department of Ophthalmology, Hotel Dieu Hospital §Kingston General Hospital, Kingston ∥Institute for Clinical Evaluative Sciences, Kingston, ON, Canada.

Purpose: To highlight the potential risk of glaucoma drainage device erosion following ptosis surgery.

Methods: Case report.

Results: A 71-year-old man underwent uncomplicated superotemporal Ahmed glaucoma valve implantation in the left eye in 2008. Read More

Aesthetic Plast Surg 2017 Aug 4;41(4):856-862. Epub 2017 Apr 4.

Mylike Medical Cosmetic Hospital, Mylike Tower, 789 West Yan'an Road, Changning District, Shanghai, China.

Background: The classical levator resection (LR) technique for correcting ptosis involves separating the levator palpebrae superioris muscle (LPS) completely, which will inevitably collapse the muscle. The modified surgical method involving retention of the LPS suspensory system can allow for more contractility of the levator muscle and thus maximize protection of the eyelid structure.

Methods: Ninety patients (132 eyelids) with different degrees of ptosis were enrolled. Read More

PLoS One 2017 29;12(3):e0174607. Epub 2017 Mar 29.

Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States of America.

Purpose: To determine if tangent visual fields gathered during assessment of superior visual field deficits caused by blepharoptosis and dermatochalasis offer good correlation to clinical exam in a time and cost efficient manner.

Methods: Prospective, observational case series. Subjects included all patients referred to a single surgeon (CCN) who underwent surgical correction of blepharoptosis and/or dermatochalasis. Read More

Ophthalmic Plast Reconstr Surg 2017 Nov/Dec;33(6):474-476

*Ophthalmic Plastic and Reconstructive, and Orbital Surgery Division, Department of Ophthalmology, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, U.S.A.; and †Ocular Plastics Unit, Department of Ophthalmology, Prince of Wales Hospital, University of New South Wales, Sydney, New South Wales, Australia.

Purpose: To describe in detail a technique for a modified Fasanella-Servat procedure that provides a simplified method for graded Mueller muscle excision with minimal and controlled tarsal excision.

Methods: A retrospective study of 71 patients (102 eyelids) who underwent the modified Fasanella-Servat procedure is reported. Measurements include the preoperative, post-phenylephrine, and postoperative margin-to-reflex distance-1, and postoperative upper eyelid height symmetry as determined by the absolute difference between right- and left-sided margin-to-reflex distance-1. Read More

Aesthet Surg J 2017 Jul;37(7):743-754

Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.

Background: Lower eyelid retraction is a difficult problem to treat, but it is a prevalent condition and a common complication of blepharoplasty. The use of spacer grafts to increase eyelid height and improve symptoms has been described for a long time, but the optimal choice of spacer graft material is unknown.

Objectives: The authors reviewed the currently available evidence to determine the best available spacer graft material in terms of efficacy and complications. Read More

Semin Ophthalmol 2018 15;33(4):454-460. Epub 2017 Mar 15.

d Plastic and Reconstructive Surgery Service , Ospedale San Raffaele , Milan , Italy.

Background: Several treatments have been described for the treatment of congenital ptosis, but there are few studies that analyze the effectiveness of a therapeutic approach rather than a single technique.

Aims: In this study, we aim to evaluate the effectiveness of our therapeutic algorithm, which relies on levator muscle resection and frontalis suspension with silicone rods, polytetrafluoroethylene (PTFE), or autologous fascia lata.

Methods: We retrospectively analyzed all patients affected by congenital ptosis who underwent corrective surgery at a single department between January 1998 and January 2016. Read More