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Intraoperative Adjustment of Eyelid Level in Aponeurotic Blepharoptosis Surgery

Yabe, Tetsuji MD, PhD*; Tsuda, Tomoyuki MD*; Hirose, Shunsuke MD*; Ozawa, Toshiyuki MD, PhD

doi: 10.1097/SAP.0b013e3182978885
Aesthetic Surgery

There have been numerous reports on the use of aponeurotic surgery to correct involutional blepharoptosis. However, it is still difficult to determine optimal eyelid level during operation. Here we present our new method to adjust eyelid level intraoperatively. After the aponeurosis was temporally sutured to the tarsus, while still in the supine position, the patient was asked to look up, and the position of the eyelid margin was confirmed. The margin should be located above the pupil but within the cornea while the patient gazes up. And it is ideal if the eyelid position is located in the upper half of this range. Although 3 of 29 patients were reoperated on in the follow-up period, only 1 patient required readjustment in the perioperative period. Our method is simple, easy and reduces operative time, because it is not necessary to change patient position during the operation.

From the *Department of Plastic and Reconstructive Surgery, Ishikiri-Seiki Hospital; †Department of Plastic and Reconstructive Surgery, Osaka City University Medical School, Osaka, Japan.

Received January 22, 2013, and accepted for publication, after revision, April 16, 2013.

Conflicts of interest and sources of funding: none declared.

Reprints: Tetsuji Yabe, MD, PhD, Department of Plastic Surgery, Ishikiri-Seiki Hospital, 18–28, Yayoi-Cho, Higashi-Osaka City, Osaka 579-8026, Japan. E-mail:

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