Method of Ptosis Repair - Connecting to Eyebrow?

in a ptosis correction, can the levator eyelid muscle be attached to the eyebrow muscle? which eyebrow muscle is connected to the levator? (such as the corrugator, or obicularis) or is this not possible. What is the [most] common way of ptosis repair?

Doctor Answers 3

Mechanisms of upper eyelid ptosis repair

This may get a bit technical, but the most common technique of upper eyelid ptosis repair that I do is to advance the levator aponeurosis (fascial extension of the levator muscle) onto the upper lid cartilage plate.  This assumes that there is proper muscle function of the levator muscle with an attenuated fascia. 

You describe a ptosis repair for a situation when the levator muscle is not functioning as in congenital, developmental, or myopathic conditions that require external motor assistance.  This comes from the frontalis muscle by making a connection of the periorbital eyebrow tissues to the upper lid cartilage plate. 

Honolulu Plastic Surgeon
4.8 out of 5 stars 36 reviews

Ptosis Repair

You ask a very detailed question that requires in person eye and eyelid examination in order to correctly answer. Also there was no photos attached of the position of the upper eyelid in rest, opening, etc. Medically if you wikepedia ptosis eyelid repairs there are excellent explanations to options. I recommend you see at least 3 boarded surgeons in plastic or oculoplastics in your area, Los Angles has many great doctors. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

The levator is never connected to the eyebrow.

Dear Credible

There are a number of methods that we use to address upper eyelid ptosis.  A lot depends on your exact issues.  In assessing an droopy upper eyelid, it is important to determine the degree of ptosis, the effectiveness of the levator muscle that raises the upper eyelid, and the response to testing with eye drops.  The most common types of ptosis surgery are anterior levator resection ptosis surgery and the conjunctival Muellerectomy ptosis repair.  However, then the levator muscle is weak, a sling type surgery may be considered.  This is typically done with a silicone rod or harvested facia and couples the upper eyelid margin to the eyebrow.  This is most commonly performed for severe congenital ptosis.

I would recommend that you consider seeing an oculoplastic surgeon who is a fellow of the American Society for Ophthalmic Plastic and Reconstructive Surgery to have a personal assessment so you know what makes sense for your situation.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

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