Eyelid Reconstruction

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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 62
― Aesthetic eyelid ptosis correction: a review of technique and cases‖ PRS;2003,Alabama Levator aponeurosis plication blepharoplasty approach COMPLICATIONS • The best results are obtained in those patients who have the least severe ptosis with the greatest amount of levator muscle function • Selection of the proper operation for the patient is the most important part of the process • Under correction: the most common complication 63
Page 1 and 2:
Eyelid Reconstruction Introduction
Page 3 and 4:
Anatomy Tarsus - Dense, fibrous ti
Page 5 and 6:
Anatomy Orbital Septum - Fascial b
Page 7 and 8:
• Lower - marginal artery • Up
Page 9 and 10:
• V - median palpebral arterial v
Page 11 and 12: Anatomy Anatomy 11
Page 13 and 14: Anatomy Lateral canthal tendon - l
Page 15 and 16: Anatomy Lacrimal Excretory Pump Lac
Page 17 and 18: Eyelid Reconstruction • Skin graf
Page 19 and 20: Lower Eyelid Reconstruction PARTIAL
Page 21 and 22: Direct Closure 30% defects in youn
Page 23 and 24: The “extensile” approach: A:
Page 25 and 26: C: If lateral cantholysis is not ad
Page 27 and 28: Mustarde Rotational Cheek Flap Goo
Page 29 and 30: • Over correction in the vertical
Page 31 and 32: Free Tarsal Graft Tripier bipedicle
Page 33 and 34: Hughes Procedure (continued) ―Use
Page 35 and 36: ― Medial canthal reconstruction u
Page 37 and 38: • An excellent flap for local cov
Page 39 and 40: Sliding Tarsoconjunctival Flap Iso
Page 41 and 42: Posterior Lamellar Graft with Local
Page 43 and 44: Pedicle Flap From Lower Lid Full-th
Page 45 and 46: Lateral Canthal Reconstruction Late
Page 47 and 48: Medial Canthal Reconstruction Relat
Page 49 and 50: CORRECTION OF PTOSIS • When deali
Page 51 and 52: • Neurogenic ptosis includes CN I
Page 53 and 54: • Previous problems:excessive tea
Page 55 and 56: B: Fascia is inserted between the o
Page 57 and 58: Mild/Moderate ptosis with fair to g
Page 59 and 60: Mustarde’s “split-level” tars
Page 61: • The usual amount of plication i
Page 65 and 66: • Loss of eyelashes: may occur, p
Page 67 and 68: Entropion Correction of congenital
Page 69 and 70: Entropion Correction of involution
Page 71 and 72: Entropion Correction of cicatricia
Page 73 and 74: Ectropion Congenital - Insufficien
Page 75 and 76: Ectropion Correction of paralytic
Page 77 and 78: Ectropion Correction of cicatricia
Page 79 and 80: Ectropion Correction of involution
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Eyelid Reconstruction

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