title: Outcomes of mild to moderate upper eyelid ptosis correction using Müller's muscle-conjunctival resection.
abstract: BACKGROUND
  Müller's muscle-conjunctival resection is used to correct mild to moderate ptosis commonly encountered in the rejuvenation patient population. The authors examined its efficacy and analyzed variables that potentially affect outcomes.
  
  
  METHODS
  Patients who underwent ptosis correction using Müller's muscle-conjunctival resection with greater than 10-month follow-up were included. Amount of ptosis reduction, eyelid symmetry, effects of concomitant facial aesthetic operations, and adverse outcomes were analyzed. Patients were grouped into medium- (<24 months after surgery) and long-term follow-up (>24 months) cohorts to determine whether outcomes changed over time.
  
  
  RESULTS
  Forty patients with a mean follow-up of 28 months combined for a total of 70 resection operations. Resection significantly reduced ptosis by a mean of 1.48 ± 0.88 mm (p < 0.001), corresponding to 0.19 mm of eyelid elevation for every 1.0 mm of Müller's muscle resected. The procedure successfully corrected 84 percent of eyelids to within 0.5 mm and 94 percent to within 1.0 mm of normal eyelid position. On patients with asymmetric ptosis, it significantly improved eyelid symmetry to within 1.0 mm from 85 percent of patients before surgery to 95 percent after surgery, and to within 0.5 mm from 53 percent before surgery to 75 percent of patients after surgery (p = 0.036). Furthermore, the mean correction of ptosis was not significantly different between medium- (1.58 ± 0.93 mm) and long-term (1.32 ± 0.93 mm) follow-up patients (p = 0.258).
  
  
  CONCLUSIONS
  Müller's muscle-conjunctival resection is an effective long-term solution to mild to moderate eyelid ptosis and asymmetry, and can be effectively performed concomitantly with other aesthetic facial procedures.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Cleveland, Ohio; and Tampa, Fla. From Case Western Reserve University School of Medicine; the Department of Surgery, MetroHealth Medical Center; the Department of Plastic Surgery, University Hospitals Case Medical Center; and the Department of Surgery, University of South Florida.
authors.forename: Mengyuan T
authors.initials: MT
authors.lastname: Liu
authors.forename: Ali
authors.initials: A
authors.lastname: Totonchi
authors.forename: Kristopher
authors.initials: K
authors.lastname: Katira
authors.forename: Justin
authors.initials: J
authors.lastname: Daggett
authors.forename: Bahman
authors.initials: B
authors.lastname: Guyuron
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019882:Blepharoplasty / Q000295:instrumentation / Q000379:methods*; D001763:Blepharoptosis / Q000175:diagnosis / Q000601:surgery*; D003228:Conjunctiva / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D018579:Patient Selection; D011183:Postoperative Complications; D012720:Severity of Illness Index; D016896:Treatment Outcome