title: Intra-eyebrow frontalis suspension using inverted Y-shaped short autogenous fascia lata for blepharoptosis with poor levator function.
abstract: Frontalis suspension using autogenous fascia lata is a common procedure for blepharoptosis with poor levator function. However, donor-site morbidity associated with fascia lata harvest cannot be ignored. In conventional procedures, the required length of the fascia lata is usually >5-12 cm with a lateral thigh skin incision of approximately 5 cm or more. The present study introduces a new frontalis suspension procedure in which the required size (length and width) of the fascia lata and length of lateral thigh incision is much smaller. The harvested fascia lata is tailored to an inverted Y shape and the separated caudal legs are fixed to the tarsus while the cephalic end is grafted inside the eyebrow through a suborbital septum tunnel. In the present study, 11 patients who underwent the new procedure with a minimum of 6 months of follow-up were evaluated. The average length and width of the harvested fascia lata in unilateral ptosis cases were 2.85 and 0.89 cm, respectively. The average length of the lateral thigh incision was 1.25 cm. The margin reflex distance improved in all cases at 6 months postoperatively. The cosmetic result was graded as good to excellent in most of the patients. Trichiasis, widened donor scar, and eyebrow notch were noted as complications. The present method is a good alternative for the treatment of blepharoptosis with poor levator function. It potentially reduces donor-site morbidity as compared with conventional frontalis muscle suspension procedures using autogenous fascia lata.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan. Electronic address: yyssprs@gmail.com.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Shimizu
authors.affiliation: Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Nagasao
authors.affiliation: Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Shido
authors.affiliation: Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Fujii
authors.affiliation: Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Marie
authors.initials: M
authors.lastname: Aoki
authors.affiliation: Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Takada
authors.affiliation: Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kishi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004954:Esthetics; D005206:Fascia Lata / Q000601:surgery / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D020858:Tissue and Organ Harvesting / Q000379:methods; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: Blepharoptosis; Fascia lata; Frontal suspension; Intra-eyebrow; Levator function