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Summary: Upper eyelid retraction often results from overcorrection of the levator palpebrae muscle during upper eyelid surgery. In such patients, the time between wound healing and reoperation may be prolonged and could result in symptoms, including dry eye. Therefore, the correction surgery-in which the levator aponeurosis that was shortened by cosmetic blepharoplasty is lengthened-should be performed as early as possible for better patient satisfaction and surgical outcomes. Between August of 2020 and September of 2022, the authors performed spacer grafting using AlloDerm dermal matrix after detaching the levator palpebrae muscle from the tarsus in 64 patients who experienced upper eyelid retraction after bilateral eyelid surgery and cosmetic blepharoplasty. Among 64 patients, 50 (78%) had satisfactory results, 8 (12%) had blepharoptosis, and 6 (10%) had insufficient correction. The authors' method produced a normalized levator aponeurosis position, symmetric eyes, and reduced adverse effects, including surprised and dry eyes. In addition, the method is easy to follow and safe.
Clinical Question/level Of Evidence: Therapeutic, IV.
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http://dx.doi.org/10.1097/PRS.0000000000011980 | DOI Listing |
Aesthetic Plast Surg
September 2025
Department of Plastic and Reconstructive Surgery, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Doctor's Office, 16th Floor of the First Building, 639 Zhi Zao Ju Road, Shanghai, People's Republic of China.
Plast Reconstr Surg
September 2025
Division of Oculofacial Plastic and Reconstructive Surgery, Viterbi Family Department of Ophthalmology, UC San Diego Shiley Eye Institute, La Jolla, CA, USA.
Reconstruction of large full-thickness medial lower eyelid margin defects often requires centrally-based tarsoconjunctival pedicle flaps from the ipsilateral upper eyelid in combination with anterior lamellar grafting. However, centrally-based flaps may result in temporary obstruction of the visual axis in the affected eye. We present a novel modified surgical technique utilizing a medially-based tarsoconjunctival pedicle flap from the upper eyelid for the reconstruction of large full-thickness medial lower eyelid defects.
View Article and Find Full Text PDFOphthalmic Plast Reconstr Surg
September 2025
Division of Orbital and Ophthalmic Plastic Surgery.
Purpose: To objectively quantify, in East Asians and Caucasians, the width and distribution of the retro-orbicularis oculi and frontalis fat (ROOF) pad, subcutaneous fat, and orbicularis oculi muscle (OOM) at the superior orbital rim margin as well as 5 mm superior and inferior to this point.
Methods: Thirty adults were studied by high-resolution, surface coil MRI. In the quasi-sagittal image through the globe center, the ROOF, subcutaneous fat, and OOM thickness were measured anterior to the orbital septum, at 3 points: at the superior orbital rim, and 5 mm superior, and 5 mm inferior to the rim.
J Surg Case Rep
September 2025
Department of Plastic Surgery, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia.
Periorbital defects resulting from oncologic resections, trauma, or congenital malformations pose a complex reconstructive challenge, due to the need to simultaneously restore eyelid function and facial esthetics. We present the case of a male patient in his seventh decade of life with a right orbitomalar squamous cell carcinoma, who underwent a wide oncologic resection involving the upper and lower eyelids, as well as the malar and infraorbital regions. Reconstruction was performed using a radial free forearm flap from the left arm, including the palmaris longus tendon, which was strategically anchored to the medial canthus and orbital rim to provide dynamic eyelid support.
View Article and Find Full Text PDFOphthalmology
September 2025
Ophthalmic Plastic Surgery, Lions Eye Institute, Department of Ophthalmology, Albany Medical Center, Albany (Slingerlands), New York.
Purpose: To review the literature and identify the health-related quality-of-life (HRQL) outcomes that used a validated instrument in the assessment of upper blepharoplasty, blepharoptosis surgery, or combination surgery.
Methods: A literature search was last conducted in the PubMed database in January 2025 to identify all studies in the English language investigating HRQL outcomes that used a validated instrument in the assessment of upper blepharoplasty, blepharoptosis surgery, or combination surgery. The literature search yielded 773 citations, and 20 studies met the inclusion criteria.