Tian Yi, Zhao Hongli, Wang Xiancheng, Zeng Weiliang, Xiang Liping, Liu Ning, Liu Wen, Ma Zheng
Department of Wound Repair, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha City, Hunan Province, P.R. China.
Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha City, Hunan Province, P. R. China.
Aesthetic Plast Surg. 2025 Apr;49(8):2218-2226. doi: 10.1007/s00266-025-04665-7. Epub 2025 Jan 23.
Upper eyelid ptosis is a common aesthetic concern among Asian patients, resulting in a tired and drowsy appearance that affects their attractiveness. The levator advancement technique is widely used for ptosis correction; however, achieving precise results remains challenging.
This study introduces a modified approach to improve the accuracy of levator aponeurosis advancement by focusing on precise measurements and anterior displacement within a defined corneal range.
The study included patients with mild to moderate ptosis. We measured the mean margin reflex distance 1 (MRD-1) preoperatively and 12 months postoperatively. Histological evidence was obtained through staining of levator aponeurosis complexes using Hematoxylin and Eosin and Masson's trichrome.
In this prospective study, 29 patients showed a significant increase in mean MRD-1 from 2.56 ± 0.84 mm (range 1.02-3.98 mm) preoperatively to 4.38 ± 0.55 mm (range 3.09-5.35 mm) at the 12-month follow-up (paired t-test; P < 0.001). Masson's staining revealed that the levator aponeurosis tissue primarily consists of collagen fibers, which minimize potential errors due to their toughness and lack of elasticity during the surgical procedure.
The modified technique enhances the accuracy of levator aponeurosis advancement in ptosis correction, resulting in minimal surgical trauma and high patient satisfaction. Our technique appears to have a low incidence of severe adverse effects, based on the available data from the current case series.
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上睑下垂是亚洲患者常见的美学问题，会导致疲惫、困倦的外观，影响其吸引力。提上睑肌缩短术广泛用于上睑下垂矫正；然而，实现精确效果仍具有挑战性。
本研究引入一种改良方法，通过专注于精确测量和在定义的角膜范围内向前移位，提高提上睑肌腱膜缩短术的准确性。
该研究纳入轻至中度上睑下垂患者。我们在术前和术后12个月测量平均边缘反射距离1（MRD-1）。通过苏木精-伊红染色和马松三色染色获得提上睑肌腱膜复合体的组织学证据。
在这项前瞻性研究中，29例患者的平均MRD-1从术前的2.56±0.84mm（范围1.02 - 3.98mm）显著增加至12个月随访时的4.38±0.55mm（范围3.09 - 5.35mm）（配对t检验；P < 0.001）。马松染色显示提上睑肌腱膜组织主要由胶原纤维组成，这在手术过程中因其韧性和缺乏弹性而使潜在误差最小化。
改良技术提高了上睑下垂矫正中提上睑肌腱膜缩短术的准确性，导致手术创伤最小化且患者满意度高。根据当前病例系列的现有数据，我们的技术似乎严重不良反应发生率较低。
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