Involutional or senile ptosis commonly occurs simultaneously with dermatochalasis. Levator aponeurosis dehiscence or disinsertion is the most common etiology of acquired involutional ptosis in our practice. The presence of ptosis should be ascertained prior to performing an upper-lid blepharoplasty. The surgical repair of a levator dehiscence or disinsertion can be performed simultaneously with a blepharoplasty or may be the indicated procedure rather than a blepharoplasty. The recognition and appropriate management of acquired ptosis will provide better cosmetic and functional surgical results in patients undergoing upper-eyelid surgery.
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