Eyelid Reconstruction

F: Cross-clamping of levator muscle at level of insertion
into aponeurosis
G: Advancement of levator muscle to tarsal plate, with
fixation by permanent sutures
H, I: Desired lid
level achieved by
advancement of 4
mm of levator
muscle to the
tarsus for each 1
mm of ptosis
• It is usually best in a unilateral ptosis to have the lid
level approximately 1.0 - 1.5 mm higher than the
contralateral eye
• Most surgeons prefer to use levator shortening as the
first procedure, hoping to get a reasonably good
result without having to resort to a fascia sling
• If correction utilizing the patient’s levator muscle
function is possible, it can potentially give a more
natural result
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