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29.04.2019 | Original Article | Ausgabe 4/2019

Aesthetic Plastic Surgery 4/2019

Minimally Invasive Conjoint Fascial Sheath Suspension for Blepharoptosis Correction

Aesthetic Plastic Surgery > Ausgabe 4/2019
Jing Zhou, Wenli Chen, Zuoliang Qi, Xiaolei Jin
Wichtige Hinweise
Jing Zhou and Wenli Chen contributed equally to this research and listed as first authors.

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Blepharoptosis can not only affect facial appearance but physical and mental health as well. Traditional treatments require long recovery time and leave unpleasant scars. In this study, we explored a simple and effective way to correct mild, moderate blepharoptosis and analyzed the causes and precautions for postoperative complications.


From March 2014 to May 2017, patients presenting with mild or moderate bilateral or unilateral blepharoptosis underwent minimally invasive blepharoptosis correction using suspension of the conjoint fascial sheath of the levator and superior rectus. Mild blepharoptosis was corrected by 1 or 2 of loops suspension sutures, whereas moderate blepharoptosis was corrected by 3 or 5 loops. The postoperative evaluation, including the degree of correction or residual ptosis, asymmetry and presence of lagophthalmos, was performed after a minimum follow-up period of 9 months.


Forty patients (55 eyelids) were included. The mean followed up period was 13.40 ± 4.60 months. Good results were seen in 48 ptosis eyes (87.27%). Double eyelid crease was formed simultaneously without an obvious wound. Two mild ptosis eyelids received a fair result, and 4 moderate ptosis eyelids improved to “mild ptosis.” The mean marginal reflex distance 1 significantly increased postoperatively.


Long-term follow-up indicates that minimally invasive conjoint fascial sheath suspension works well for mild and moderate ptosis. With its short recovery time, simultaneous double eyelid crease formation and long-lasting effect, the surgery is worth popularizing.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.

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