Ptosis of the upper eyelid is one of common deformities of the eye region. To obtain the best surgical result in ptosis, it is necessary to select the appropriate operation for each case according to levator function, degree of ptosis, its etiology and other factors.
For the correction of the congenital ptosis with very poor or absent levator function, frontalis suspension with various many materials and direct transplantation of the frontalis muscle have been used by many authors. Each of the above has its specific virtues and inherent shortcomings. On the basis of comparative study of the conventional techniques and anatomical study of the eyebrow region, we designed a superiorly based frontalis myofascial flap. The orbital portion of the orbicularis oculi muscle was included in the distal end of the frontalis myofascial flap to lengthen the flap. According to our results, this technique of frontalis myofascial flap has several advantages compared to Song´s direct frontalis transplantation : (1) the operation can be done under a local anesthesia at the out-patient department with simple procedure and less bleeding. (2) the forehead wrinkles are not disturbed, (3) this procedure needs only a single incision and does not disturb the important anatomic structures around the eyebrow region.
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