Use of orbicularis oculi muscle flap for undercorrected blepharoptosis with previous levator muscle resection.

Based on the detailed anatomy, the orbicularis oculi muscle and the orbital septum are the continuation of the frontalis muscle and its fascia. Therefore, the shortened orbicularis oculi muscle and orbital septum would transmit the frontalis muscle action more effectively. The superior-based orbicularis oculi muscle and orbital septum flap, as a single flap, were advanced and attached to the tarsal plate for the correction of blepharoptosis. Six patients with undercorrected blepharoptosis were included in this study. Each patient had undergone more than two levator resection procedures by ophthalmologists or plastic surgeons. Conventionally, the frontalis suspension procedure was the next choice in these cases. The shortened orbicularis oculi muscle and orbital septum flap was used in these cases. Postoperative results were satisfactory after 3-year follow-up.