Modified eyelid crease approach frontalis suspension without brow incision.

A 10-year-old boy with Noonan syndrome presented with bilateral ptosis. He had a history of keloid scarring. A modified technique of frontalis suspension with autogenous fascia lata is described to avoid forehead wounds. This uses an eyelid crease incision, dissection under the orbicularis to the orbital rim, and passage of the fascia lata into a shallow arc through the frontalis muscle. It is then passed inferiorly through the septum and secured to the tarsus.