Milestones in Oculofacial Plastic and Reconstructive Surgery: The Discovery of the Levator Palpebrae Superioris and Its Subsequent History.

Purpose: This review aims to substantiate attributions of priority for the discovery and first description of the levator palpebrae superioris (LPS) muscle to Matteo Realdo Colombo [Columbus] (1516-1559), and to describe the history of this muscle from ancient to modern times.

Methods: Relevant chapters on eyelid and eye muscles in Colombo's De re anatomica (1559) were translated, and the work was further analyzed from a historical perspective. Literature on the anatomy of human eyelid and orbital striated muscles was reviewed from the publication of the Fabrica (1543) by Andreas Vesalius (1514-1564) through modern times. The discovery of the LPS was viewed in relation to other milestones along the road that led to the establishment of the subspecialty of oculofacial and orbital plastic surgery.

Results: The first description of the LPS appeared in De re anatomica (1559) by Colombo who correctly identified the LPS as a retractor of the (upper) eyelid and the orbicularis oculi as its protractor. The current lack of recognition of the priority of Colombo's description of the LPS stemmed from his lifelong rivalries with other anatomists, improved descriptions of the orbital muscles by Gabriele Falloppio (1523-1562) that soon followed, and historical controversies over other anatomical discoveries.

Conclusions: Colombo discovered the LPS and described the antagonistic functions of retractors and protractors of the eyelid, just a portion of his broader contributions to anatomy. Colombo's discoveries of such ophthalmologic and oculofacial plastic surgical importance should be added to the ongoing reappraisals of Colombo by medical historians.