Subscribe to RSS
DOI: 10.5999/aps.2016.43.2.172
Ten Years of Results of Modified Frontalis Muscle Transfer for the Correction of Blepharoptosis
Background Conventional frontalis transfer may cause a range of complications. In order to overcome complications, we made modifications to the surgical technique, and compared the outcomes of patients who underwent conventional frontalis transfer with those of patients who underwent modified frontalis transfer.
Methods We conducted a retrospective study of 48 patients (78 eyes) who underwent conventional frontalis transfer between 1991 and 2003 (group A) and 67 patients (107 eyes) who underwent modified frontalis transfer between 2004 and 2014 (group B). The frontalis transfer procedures were modified conform to the following principles. The tip of the frontalis muscle flap included soft tissue that was as thick as possible and the soft tissue on the tarsal plate was removed to the greatest extent possible. A double fold was created in cases of unilateral ptosis. In order to evaluate the objective effects of modification, preoperative and postoperative values of the marginal distance reflex 1 (MRD1), the corneal exposure area, and the decrease in eyebrow height were compared between the two groups.
Results In group A, patients showed an improvement of 1.19 mm in the MRD1, a 6.31% improvement in the corneal exposure area, and a 7.82 mm decrease in eyebrow height. In group B, patients showed an improvement of 2.17 mm in the MRD1, an 8.39% improvement in the corneal exposure area, and an 11.54 mm decrease in eyebrow height. The improvements in group B were significantly greater than those in group A.
Conclusions Modified frontalis transfer showed better results than the conventional procedure and provided satisfactory outcomes.
This article was presented as a free paper at the 72nd Congress of the Korean Society of Plastic and Reconstructive Surgeons on November 7, 2014 in Seoul, Korea.
Publication History
Received: 18 July 2015
Accepted: 07 February 2016
Article published online:
20 April 2022
© 2016. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Beard C. Examination and evaluation of the ptosis patient. In: Smith BC, Nesi FA, Levine MR. et al. Smith's ophthalmic plastic and reconstructive surgery. 2nd ed. St. Louis, MO: Mosby; 1998: 339-358
- 2 Park DH, Ahn KY, Han DG. et al. Blepharoptosis repair by selective use of superiorly based muscle flaps. Plast Reconstr Surg 1998; 101: 592-603
- 3 Song R, Song Y. Treatment of blepharoptosis: direct transplantation of the frontalis muscle to the upper eyelid. Clin Plast Surg 1982; 9: 45-48
- 4 Han J, Do ER, Kim TS. et al. Clinical application and evaluation of preoperative bleeding tendency using platelet function analyzer (PFA(R))-100. Arch Aesthetic Plast Surg 2013; 19: 56-63
- 5 Kim TS, Han DG, Do ER. et al. The change of eyebrow height after blepharoptosis correction. Arch Aesthetic Plast Surg 2013; 19: 46-50
- 6 Souther SG, Corboy JM, Thompson JB. The Fasanella-Servat operation for ptosis of the upper eyelid. Plast Reconstr Surg 1974; 53: 123-128
- 7 Jordan DR, Anderson RL. The aponeurotic approach to congenital ptosis. Ophthalmic Surg 1990; 21: 237-244
- 8 Bae TH, Kim JC, Kim WS. et al. A photogrammetic study of the eyes in Korean youths. J Korean Soc Plast Reconstr Surg 2007; 34: 37-43
- 9 Park DH, Lee SJ, Song CH. Recurrence of blepharoptosis after a superiorly based muscle flap: treatment by frontalis muscle advancement. Plast Reconstr Surg 2005; 116: 1954-1959
- 10 Ramirez OM, Pena G. Frontalis muscle advancement: a dynamic structure for the treatment of severe congenital eyelid ptosis. Plast Reconstr Surg 2004; 113: 1841-1849
- 11 Vasquez LM, Alonso T, Medel R. Direct frontalis flap with and without levator pulley for correction of severe ptosis with poor levator function in the same patient. Orbit 2012; 31: 102-106
- 12 Callahan MA, Beard C, Beard C. Beard's ptosis. Birmingham: Aesculapius Pub. Co.; 1990
- 13 Choi CJ, Chou JC, Lefebvre DR. et al. Margin reflex distance: differences based on camera and flash positions. Ophthal Plast Reconstr Surg 2015 Apr 3 DOI: 10.1097/iop.0000000000000456.
- 14 Flynn TH, Rose GE, Shah-Desai SD. Digital image analysis to characterize the upper lid marginal peak after levator aponeurosis repair. Ophthal Plast Reconstr Surg 2011; 27: 12-14
- 15 Coombes AG, Sethi CS, Kirkpatrick WN. et al. A standardized digital photography system with computerized eyelid measurement analysis. Plast Reconstr Surg 2007; 120: 647-656
- 16 Zhou M, Jin R, Li Q. et al. Frontalis muscle flap advancement for correction of severe ptosis under general anesthesia: modified surgical design with 162 cases in China. Aesthetic Plast Surg 2014; 38: 503-509
- 17 Hwang K, Kim DJ, Hwang SH. Insertion of frontalis muscle relating to blepharoptosis repair. J Craniofac Surg 2005; 16: 965-967