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Upper Lid Ptosis Blepharoplasty Workup

  • Author: Jorge I de la Torre, MD, FACS; Chief Editor: James Neal Long, MD, FACS  more...
 
Updated: Jan 11, 2016
 

Laboratory Studies

Laboratory studies should be performed as needed for routine preoperative evaluation. However, a comprehensive evaluation for patients with ptosis of unclear etiology can include clinical examination by a neurologist and ophthalmologist; radiographic evaluation of the brain, orbits, and chest; and blood work.

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Other Tests

A thorough evaluation of both functional and aesthetic problems is required prior to ptosis repair surgery. This includes assessment of visual acuity, corneal irritation, and excessive or insufficient tearing. Test for myasthenia gravis using the Tensilon test. Horner syndrome can be tested by stimulation with 10% phenylephrine hydrochloride solution, which corrects the ptosis. Preoperative photographs document the degree of ptosis and asymmetry as well as provide a comparison to evaluate postoperative results.

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Contributor Information and Disclosures
Author

Jorge I de la Torre, MD, FACS Professor of Surgery and Physical Medicine and Rehabilitation, Chief, Division of Plastic Surgery, Residency Program Director, University of Alabama at Birmingham School of Medicine; Director, Center for Advanced Surgical Aesthetics

Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, American Society for Reconstructive Microsurgery, Association for Academic Surgery, Medical Association of the State of Alabama

Disclosure: Nothing to disclose.

Coauthor(s)

Luis O Vasconez, MD 

Luis O Vasconez, MD is a member of the following medical societies: American Head and Neck Society, American Society of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Aesthetic Plastic Surgery, American Society for Surgery of the Hand, American Society of Maxillofacial Surgeons, American Society for Reconstructive Microsurgery, American Surgical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

James Neal Long, MD, FACS Founder of Magnolia Plastic Surgery; Former Associate Professor of Plastic and Reconstructive Surgery, Division of Plastic Surgery, Children's Hospital and Kirklin Clinics, University of Alabama at Birmingham School of Medicine; Section Chief of Plastic, Reconstructive, Hand, and Microsurgery, Birmingham Veterans Affairs Medical Center

James Neal Long, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American College of Surgeons, American Medical Association, American Society of Plastic Surgeons, Plastic Surgery Research Council, Sigma Xi, Southeastern Society of Plastic and Reconstructive Surgeons, Southeastern Surgical Congress

Disclosure: Nothing to disclose.

Additional Contributors

Neal R Reisman, MD, JD Chief of Plastic Surgery, St Luke's Episcopal Hospital; Clinical Professor of Plastic Surgery, Baylor College of Medicine

Neal R Reisman, MD, JD is a member of the following medical societies: American Society of Plastic Surgeons, American College of Surgeons, American Society for Aesthetic Plastic Surgery, Lipoplasty Society of North America, Texas Medical Association, Texas Society of Plastic Surgeons

Disclosure: Nothing to disclose.

References
  1. Bowman W. Report of a chief operation performed at the Royal London Ophthalmic Hospital for the quarter ending 25th of September 1857. Royal London Ophth Hosp Rep. 1859. 11:34.

  2. Fasanella RM, Servat J. Levator resection for minimal ptosis: another simplified operation. Arch Ophthalmol. 1961 Apr. 65:493-6. [Medline].

  3. Beard C. The surgical treatment of blepharoptosis: a quantitative approach. Trans Am Ophthalmol Soc. 1966. 64:401-87. [Medline].

  4. Payr E. Plastischen erfolgreicher ersatz aller 4 auenlinder. Arch Lin Chir. 1928. 152:532.

  5. Lexer E. Ptosisoperation, Herstelung der oberlidfalte und herstelung des unterlides durch faszienzugel. Klin Mbl Augenheik. 1923. 70:464.

  6. Risdon F. Plastic operations about the orbit. Bull Acad Med Toronto. 1945. 18:139.

  7. Tillett CW, Tillett GM. Silicone sling in the correction of ptosis. Am J Ophthalmol. 1966 Sep. 62(3):521-3. [Medline].

  8. McCord CD, Shore JW. Silicone rod frontalis suspension. Adv Ophthalmol Plast Reconstr Surg. 1982. 1:213.

  9. Bagheri A, Tavakoli M, Najmi H, Erfanian Salim R, Yazdani S. Comparison between eyelid indices of ptotic eye and normal fellow eye in patients with unilateral congenital ptosis. J Plast Reconstr Aesthet Surg. 2016 Jan. 69 (1):e5-9. [Medline].

  10. Satariano N, Brown MS, Zwiebel S, Guyuron B. Environmental factors that contribute to upper eyelid ptosis: a study of identical twins. Aesthet Surg J. 2015 Mar. 35 (3):235-41. [Medline].

  11. Srinath N, Balaji R, Basha MS. Ptosis correction: a challenge following complex orbital injuries. J Maxillofac Oral Surg. 2012 Jun. 11(2):195-9. [Medline].

  12. Chang S, Lehrman C, Itani K, Rohrich RJ. A systematic review of comparison of upper eyelid involutional ptosis repair techniques: efficacy and complication rates. Plast Reconstr Surg. 2012 Jan. 129(1):149-57. [Medline].

  13. Frueh BR, Musch DC, McDonald HM. Efficacy and efficiency of a small-incision, minimal dissection procedure versus a traditional approach for correcting aponeurotic ptosis. Ophthalmology. 2004 Dec. 111(12):2158-63. [Medline].

  14. Zhong M, Jin R, Li Q, Duan Y, Li L, Huang D. Frontalis Muscle Flap Advancement for Correction of Severe Ptosis Under General Anesthesia: Modified Surgical Design with 162 Cases in China. Aesthetic Plast Surg. 2014 Mar 8. [Medline].

  15. Har-Shai Y, Hirshowitz B. Extended upper blepharoplasty for lateral hooding of the upper eyelid using a scalpel-shaped excision: a 13-year experience. Plast Reconstr Surg. 2004 Mar. 113(3):1028-35; discussion 1036. [Medline].

  16. Bellinvia G, Klinger F, Maione L, Bellinvia P. Upper lid blepharoplasty, eyebrow ptosis, and lateral hooding. Aesthet Surg J. 2013 Jan. 33(1):24-30. [Medline].

  17. Cho IC, Kang JH, Kim KK. Correcting upper eyelid retraction by means of pretarsal levator lengthening for complications following ptosis surgery. Plast Reconstr Surg. 2012 Jul. 130(1):73-81. [Medline].

  18. Bernardini FP, de Conciliis C, Devoto MH. Mini-invasive ptosis surgery. Orbit. 2006 Jun. 25(2):111-5. [Medline].

  19. Borman H. New adjustable suture technique for managing eyelid ptosis. Ann Plast Surg. 2001 Dec. 47(6):673-7. [Medline].

  20. Carraway JH. Reconstruction of the eyelids and correction of ptosis of the eyelid. Aston SJ, Beasley RW, Thorne CH, eds. Grabb and Smith's Plastic Surgery. Lippincott-Raven; 1997. 538-44.

  21. Finsterer J. Ptosis: causes, presentation, and management. Aesthetic Plast Surg. 2003 May-Jun. 27(3):193-204. [Medline].

  22. Frueh BR, Musch DC, McDonald HM. Efficacy and efficiency of a small-incision, minimal dissection procedure versus a traditional approach for correcting aponeurotic ptosis. Ophthalmology. 2004 Dec. 111(12):2158-63. [Medline].

  23. Harley RD, Nelson LB, Flanagan JC, Calhoun JH. Ocular motility disturbances following cosmetic blepharoplasty. Arch Ophthalmol. 1986 Apr. 104(4):542-4. [Medline].

  24. Jelks G, Smith B. Reconstruction of the eyelids and associated structures. McCarthy J, ed. Plastic Surgery. 1990. 1752-73.

  25. Jelks GW, Jelks EB. Blepharoplasty. Complications and Problems in Aesthetic Plastic Surgery. 1992.

  26. Jones LT, Quickert MH, Wobig JL. The cure of ptosis by aponeurotic repair. Arch Ophthalmol. 1975 Aug. 93(8):629-34. [Medline].

  27. Lemke BN. Anatomy of the Ocular Adenexa and Orbit. Ophthalmic Plastic and Reconstr Surg. 1987.

  28. Mahaffey PJ, Wallace AF. Blindness following cosmetic blepharoplasty--a review. Br J Plast Surg. 1986 Apr. 39(2):213-21. [Medline].

  29. Rycroft B. Tearing: management with transantral vidianectomy. Troutman RC, Converse JM, Smith B, eds. Plastic and Reconstructive Surgery. 1962.

  30. Siegel RJ. Advanced upper lid blepharoplasty. Clin Plast Surg. 1992 Apr. 19(2):319-28. [Medline].

  31. Singh D. Orbicularis plication for ptosis: a third alternative. Ann Ophthalmol (Skokie). 2006. 38(3):185-93. [Medline].

  32. Stasior OG, Ballitch HA 2nd. Ptosis repair in aesthetic blepharoplasty. Clin Plast Surg. 1993 Apr. 20(2):269-73. [Medline].

  33. von Graefe CF. De Rhinoplastice. 1818. 13.

  34. Whitnall SE. On a ligament acting as a check to the action of the palpebral superioris muscle. J Anat Physiol. 1910. 14:131.

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