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29.04.2019 | Original Article | Ausgabe 4/2019

Aesthetic Plastic Surgery 4/2019

Transconjunctival Müller’s muscle Tucking Method for Non-incisional Correction of Mild Ptosis: The Effectiveness and Maintenance

Aesthetic Plastic Surgery > Ausgabe 4/2019
Hyun Ho Han, Min Soo Kim
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00266-019-01379-5) contains supplementary material, which is available to authorized users.

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In patients with a mild degree ptosis who undergo non-incisional double-eyelid blepharoplasty, simultaneous correction of ptosis is needed to prevent loosening. The transconjunctival Müller’s muscle tucking (TMMT) method may be useful in these cases.


The authors performed this study to present the details of the current use of the TMMT method and to provide objective evidence for ptosis correction and its sustained effect.


A total of 322 eyelids in 161 patients who underwent mild ptosis correction with the TMMT method from July 2012 to December 2017 were retrospectively examined. The continuous suture method using a single stitch was used for double-fold formation, and the TMMT method was used for ptosis correction for the other incision. The margin to reflex distance (MRD) 1 was evaluated at pre-operation, immediate post-operation, and at 2, 6 months post-operation.


A total of 34 patients who had more than 6 months of follow-up were included. Right-side MRD1 values were 2.08 (± 0.19) mm before the surgery, 3.49 (± 0.16) mm immediately after the surgery, 3.33 (± 0.14) mm at postoperative 2 months, and 3.22 (± 0.17) mm at postoperative 6 months (p < 0.001). The difference of MRD1 between immediate post-operation and at 6 months was 0.25 mm without statistical significance (p > 0.05). Complications (fold loosening, asymmetry, and ptosis recurrence) occurred in three cases (8.8%), all of which were re-corrected by applying the TMMT method.


The TMMT method was useful for correction of mild ptosis, showed little recurrence, and prevented loss of fold by giving a vertical force to the double-fold.

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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Video showing non-incisional double-eyelid blepharoplasty (MP4 69965 kb)
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