Effect of eyelid crease formation on aesthetic outcomes post frontalis suspension for unilateral ptosis

Background: The eyelid crease plays a very important role in determining eyelid

symmetry. This study was performed to compare the cosmetic results post silicone

rod frontalis suspension surgery, performed with and without eyelid crease forma-
tion, for correction of unilateral, congenital ptosis.

Methods: Prospective, interventional study. One hundred patients with unilateral,
congenital ptosis, with poor levator muscle action, operated on by a single facial
plastic surgeon, over 5-year duration (2011–2016). Group I had 50 patients, who
underwent silicone sling (Bvi Visitec) frontalis suspension surgery. Group II had 50
patients, who underwent frontalis suspension silicone sling (Bvi Visitec) surgery, in

combination with eyelid crease formation and levator muscle excision (when re-
quired). The cosmetic outcomes were evaluated by the patients themselves and by

3 blinded physician observers and recorded objectively via a 5-point questionnaire,
after a 1-year follow-up.
Results: Patients in group II were much more satisfied than the patients in group
I, as confirmed by the subjective and objective evaluations.
Conclusion: The silicone sling frontalis suspension surgery, when combined with
eyelid crease creation and levator excision procedure (when required), provides
better symmetry, superior cosmesis, and excellent patient satisfaction.

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