A dynamic technique for the treatment of severe or recurrent blepharoptosis: frontalis-orbicularis oculi muscle flap shortening.

Background: Severe or recurrent blepharoptosis remains a great challenge to most plastic surgeons. A variety of techniques have been developed according to the function of the levator palpebrae superioris and frontalis muscles. In this study, the frontalis-orbicularis oculi (FOO) muscle flap is designed as an entity to treat severe or recurrent blepharoptosis with satisfactory results.

Methods: Between January 1997 and July 2007, FOO muscle flap shortening was applied to correct severe or recurrent blepharoptosis in 29 patients (38 eyelids), aged from 3 to 77 years. There were 11 males and 18 females, with bilateral ptosis in 9 patients. The follow-up period ranged from 10 to 52 months.

Results: Twenty-four patients (82%) had good results, with the degree of ptosis less than 2 mm. The remaining 5 patients had fair results, and received readjustment in 2 cases.

Conclusion: In our study, fresh cadaver dissection revealed that the frontalis muscle is connected and interdigitated very closely with the orbicularis oculi muscle. Based on the anatomic study and literature review, we suggest that the FOO muscle flap shortening is a good alternative to treat severe or recurrent blepharoptosis.