29 Surgical Management of Levator Function Less Than 4 mm
Book
Editors: Burnstine, Michael A.; Dresner, Steven C.; Samimi, David B.; Merritt, Helen A.
Title: Ophthalmic Plastic Surgery of the Upper Face
Subtitle: Eyelid Ptosis, Dematochalasis, and Eyebrow Ptosis
Print ISBN: 9781626239210; Online ISBN: 9781626239227; Book DOI: 10.1055/b-006-149698
2020 © 2020 Georg Thieme Verlag KG
Georg Thieme Verlag KG, Stuttgart
Subjects: Plastic, Reconstructive and Cosmetic Surgery;Ophthalmology, Optometry
Thieme Clinical Collections (English Language)
Abstract
Frontalis slings are used to treat congenital or acquired ptosis with a levator palpebrae superioris excursion of less than 4 mm. Many patterns for sling placement and different materials have been reported over the past few decades. This chapter describes a simplified triangular pattern using silicone rods. The procedure is simple to perform with fewer incisions than other methods. The most common complications are undercorrection and late slippage. Fixation of the sling material to the tarsal plate using a nonabsorbable suture through an upper lid crease is preferable to stab incisions and no fixation, as the former has a better chance of creating a symmetric skin crease and avoiding upper lid lash ptosis, and it reduces the risk of recurrent ptosis from late sling slippage.