Introduction: Blephaoptosis is a condition seen frequently in patients presenting for surgical rejuvenation of the face. From an aesthetic standpoint, the ptotic lid can have a subtle presentation, or it can result in significant deformity including elevation of the tarsal fold, transverse wrinkles in the forehead, and asymmetry of the eyebrows. Ptosis correction procedures should not only improve functional impairment but also address the periorbital aesthetics in a global fashion.

Methods: An IRB approved retrospective review was performed on 74 consecutive patients who underwent correction of ptosis between 1994 and January 2000. To improve the deformities associated with ptosis, simple plication of the levator aponeurosis was combined with periorbital rejuvenation, including endoscopic forehead lift and elevation of the malar fat pad. The complications and long-term results were assessed and evaluated.

Results: The study population consisted of 68 female and 6 male patients with an average age of 60 years (range 42 to 88). The follow up was from six months to 4.5 years with an average of 14 months. Overall, long-term correction of the ptosis was very good. Symmetry was excellent in 50 patients, acceptable in 20 patients and four patients required revision for persistent asymmetry. Thirteen patients had temporary lagopthalomos and seven patients had temporary eye irritation all of which were self-limiting.

Conclusions: Based on this analysis, satisfactory improvement of blepharoptosis can be achieved using suture plication in conjunction with upper lid blepharoplasty and facial rejuvenation. Harmonious aesthetic improvement of the periorbital region was obtained in a single procedure. In addition, this approach to blepharoptosis has demonstrated effective long-term results. Finally, this technique can be safely performed and has a low revision rate.
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