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Treatment of Postblepharoplasty Lower Eyelid Malposition by Aptos Thread

Zhao, Zuo Jun MD; Lu, You BS; Liang, Wei Zhong MD; Wu, Jun Ling BS

doi: 10.1097/SAP.0b013e318248b65f
Aesthetic Surgery

Background Lower eyelid malposition is the most common complication after lower eyelid blepharoplasty. Although the traditional techniques were effective for correcting lower eyelid malposition, they had potential disadvantages, including additional trauma, additional scar, and long recovery period.

Objective To evaluate the efficacy of a minimally invasive surgical technique using Aptos thread for postblepharoplasty lower eyelid malposition.

Methods A retrospective review of all patients undergoing lower eyelid malposition surgery via a minimal invasive, Aptos thread technique from June 2005 to June 2010. Symptoms, including epiphora, ocular irritation, conjunctivitis, and measurement of lower eyelid scleral show (measured from the inferior limbus of cornea) were recorded. Presurgery and postreconstruction photographs were reviewed for functional and cosmetic outcome.

Results A total of 15 patients (24 eyelids) underwent successful lower eyelid malposition surgery using this minimally invasive technique. On clinical examination, all cases of lower eyelid retraction stemmed from overzealous excision of skin and orbicularis. After a follow-up interval of 12 to 25 months (mean, 15 months), inferior corneal exposure and ocular symptoms were corrected thoroughly. The decrease in lower eyelid retraction was 2.7 ± 0.9 mm. The functional and cosmetic result was satisfactory in all cases.

Conclusions Aptos thread technique is a safe, effective, and the least invasive method of managing mild and moderate postblepharoplasty lower eyelid malposition secondary to shortening anterior lamella.

From the Department of Plastic and Cosmetic Surgery, China Mei Tan General Hospital, Beijing, China.

Received November 3, 2011, and accepted for publication, after revision, December 28, 2011.

Conflicts of interest and sources of funding: none declared.

Reprints: Zuo Jun Zhao, MD, Department of Plastic and Cosmetic Surgery, China Mei Tan General Hospital, Beijing 100028, China. E-mail:

© 2013 by Lippincott Williams & Wilkins