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Surgical Pearls
May/Jun 2015

Upper Eyelid Blepharoplasty With Ptosis Repair by Levator Aponeurectomy

JAMA Facial Plast Surg. 2015;17(3):224-225. doi:10.1001/jamafacial.2015.0198

In a busy cosmetic surgery practice, upper eyelid blepharoplasty will be one of the most frequently performed surgical procedures performed. Often, the patient will also have a ptosis of the upper eyelid, and this must be addressed at the same time. An upper eyelid is considered to have functional ptosis when the upper eyelid margin rests 2.5 mm or less from the center of the pupil.1,2 The most common form of ptosis is involutional, in which an attenuated aponeurosis results in a drooping of the upper eyelid.3 This type of ptosis is characterized by good levator function (≥12 mm), a high eyelid crease (>10 mm), and thinning of the eyelid tissue so that the iris color can occasionally be seen through the eyelid.4

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