Efficacy of the Modified Frontalis Muscle Flap Technique in Severe Eyelid Ptosis in a Craniofacial Surgery Reference Center.

Introduction: Upper eyelid ptosis is described as an abnormal drooping of the upper eyelid >1 to 2 mm from the corneal scleral margin. There are multiple techniques for the treatment of eyelid ptosis, the following article focuses on those patients with poor upper lid levator function. The authors present a series of cases with severe ptosis using the pulley technique, which allows us to change the vector in a more tangential direction, which is reflected in the following advantages; it provides stronger posterior support, more physiological excursion, horizontal traction, prevents eyelash ptosis, and gives a better aesthetic result.

Methods: Retrospective study where data were collected from January 2014 to September 2024. The inclusion criteria were patients who presented with congenital, traumatic, and involutional bilateral ptosis.

Results: Were obtained a total of 25 cases of blepharoptosis. The mean age of the cohort was 34.2 years and 68% were male. The primary etiology of ptosis was congenital, 80% of patients had severe ptosis. All patients classified as severe in the study presented with deficient preoperative elevator function (<6 mm). Specifically, 75% of patients achieved good function (10-15 mm).

Conclusion: This is an effective technique that allows changing the vector in a more tangential direction, which is reflected in the following advantages: it provides greater posterior support, greater physiological excursion, horizontal traction, prevents eyelash ptosis, and gives a better aesthetic result.