Frontalis muscle flap advancement for correction of severe ptosis under general anesthesia: modified surgical design with 162 cases in China

Mingshu Zhou, Mingshu Zhong, Rui Jin, Qingfeng Li, Yongan Duan, Li Huang, L Li, Dong Yu, Dong Huang
Aesthetic Plastic Surgery 2014, 38 (3): 503-9

BACKGROUND: Congenital blepharoptosis is a common pediatric disease. Frontalis muscle flap advancement is an effective surgical technique to treat patients with severe ptosis and poor levator function. However, since eye position changes under general anesthesia, it is necessary to adjust the position of the upper eyelid to achieve a better surgical outcome.

METHODS: A total of 162 children with severe congenital blepharoptosis underwent frontalis muscle flap advancement under general anesthesia. Patients were divided into two groups according to the different positions of eyelid suspension. The eyelid position of 82 children (96 eyes) in group A was adjusted to set at the superior limbus under general anesthesia, while the eyelid level of 80 children (94 eyes) in group B was adjusted according to the level labeled before anesthesia or the orthophoria level predicted using Krimsky's test. Lid level, ptosis recurrence, cosmetic appearance, and complications were evaluated 12 months after surgery.

RESULTS: Excellent functional and cosmetic results were achieved in 61 (63.5 %) children from group A and 85 (90.4 %) from group B. Fewer complications were observed in group B (36.5 vs. 9.6 %).

CONCLUSION: To achieve better surgical results after frontalis flap advancement for severe ptosis, it is necessary to adjust the eyelid level according to eye position changes that occur when the patient is under general anesthesia.

LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.