| • Other names: Droopy eyelid repair
• Primary goal: Elevation of a drooping (not baggy) upper eyelid
• Secondary goals: (May be performed in conjunction with blepharoplasty)
• Special anatomy: Review: The levator muscle begins in back of the eye and turns into a tendon (the aponeurosis) as it enters the eyelid. Most cases of adult-onset ptosis are the result of thinning or tearing of the levator aponeurosis. Less commonly, rare muscle diseases such as myasthenia gravis may cause the muscle itself to become paralyzed (requiring far different operations from those discussed here.)
• Anesthesia: Local anesthesia with minimal sedation is mandatory to allow for active patient cooperation during surgery
• Operative technique: Through an upper eyelid crease skin incision, the blepharoplasty is carried out as described above to the point through and including the removal of fat. Now on good display, the levator aponeurosis can be inspected by the surgeon (surgery photos). The aponeurosis is "tucked" using non-dissolving sutures. The surgeon must be careful not only to create a smooth lift for the droopy lid, but also to . . . |
