To describe the technique and results of frontalis muscle flap advancement for correction of ptosis associated with jaw-winking.
Four cases of unilateral jaw-winking ptosis were corrected with frontalis muscle flap advancement after excision of levator muscle on the affected side.
Three of the 4 patients achieved good results with the correction within 1 mm of the opposite eyelid. The residual asymmetry on downgaze after follow-up of 4 to 18 months ranged from 1 to 5 mm. The main complication was mild forehead hypoesthesia in 2 patients, which resolved over a period of 1 month.
Frontalis muscle flap advancement is an effective procedure when performed unilaterally for jaw-winking ptosis. It is simple, safe, and involves a single surgical field. Eyelid lag on downgaze improves considerably over time, and the remaining asymmetry between the two eyelids is cosmetically acceptable to most patients.