True eyelid ptosis can be present in the patient seeking aesthetic blepharoplasty. It is important to identify, evaluate, and discuss this eyelid malposition with the patient preoperatively. When ptosis is present, the surgeon must be prepared to address it, if desired by the patient, to prevent postoperative dissatisfaction. The levator aponeurotic approach to ptosis repair is a powerful technique which may be the only option of ptosis repair in selected patients. Successful surgery requires a detailed knowledge of eyelid anatomy, significant experience with the procedure, and a comfort level with surgery on the awake patient and intraoperative surgical adjustments. As compared to standard blepharoplasty, ptosis repair is more complex and time consuming, and can more commonly affect lid dynamics and result in postoperative complications. The best outcomes occur when the procedure is performed by surgeons who undertake it routinely.
Ben Simon GJ, Lee S, Schwarcz RM, et al. External levator advancement vs. Müller’s muscle-conjunctival resection for correction of upper eyelid involutional ptosis. Am J Ophthalmol. 2005;140(3):426–32.CrossRefGoogle Scholar
Lamberts DW, Foster CS, Perrry HD. Schirmer test after topical anesthesia and tear film meniscus height in normal eyes. Arch Ophthalmol. 1979;97(6):1082–5.CrossRefGoogle Scholar
Mainnstone JC, Bruce AS, Golding TR. Tear meniscus measurements in the diagnosis of dry eye. Curr Eye Res. 1996;15:653–61.CrossRefGoogle Scholar