Park Nam Seok, Lee Won, Kim Seong Hwan
From the Point Plastic Surgery Clinic.
Yonsei E1 Plastic Surgery Clinic.
Plast Reconstr Surg. 2025 Aug 1;156(2):189e-193e. doi: 10.1097/PRS.0000000000011980. Epub 2025 Jan 22.
Upper eyelid retraction often results from overcorrection of the levator palpebrae muscle during upper eyelid surgery. In such patients, the time between wound healing and reoperation may be prolonged and could result in symptoms, including dry eye. Therefore, the correction surgery-in which the levator aponeurosis that was shortened by cosmetic blepharoplasty is lengthened-should be performed as early as possible for better patient satisfaction and surgical outcomes. Between August of 2020 and September of 2022, the authors performed spacer grafting using AlloDerm dermal matrix after detaching the levator palpebrae muscle from the tarsus in 64 patients who experienced upper eyelid retraction after bilateral eyelid surgery and cosmetic blepharoplasty. Among 64 patients, 50 (78%) had satisfactory results, 8 (12%) had blepharoptosis, and 6 (10%) had insufficient correction. The authors' method produced a normalized levator aponeurosis position, symmetric eyes, and reduced adverse effects, including surprised and dry eyes. In addition, the method is easy to follow and safe.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
上睑退缩通常是由于上睑手术中提上睑肌过度矫正所致。对于此类患者，伤口愈合与再次手术之间的时间可能会延长，并可能导致包括干眼在内的症状。因此，为了提高患者满意度和手术效果，应尽早进行矫正手术，即延长因美容性睑成形术而缩短的提上睑肌腱膜。在2020年8月至2022年9月期间，作者对64例双侧眼睑手术和美容性睑成形术后出现上睑退缩的患者，在将提上睑肌从睑板分离后，使用同种异体脱细胞真皮基质进行间隔移植。64例患者中，50例（78%）效果满意，8例（12%）出现上睑下垂，6例（10%）矫正不足。作者的方法使提上睑肌腱膜位置恢复正常，双眼对称，并减少了包括瞪眼和干眼在内的不良反应。此外，该方法操作简便且安全。
临床问题/证据级别：治疗性，IV级。
