Involutional ptosis

Aponeurotic defects and disinsertion of the levator aponeurosis are responsible for acquired involutional ptosis. The typical clinical findings in aponeurotic defects are high or moderate ptosis, good to excellent levator function, thinning of the eyelid above the tarsus, high to absent lid crease, and normal Müller's muscle function. The purpose of the treatment is to repair the defect or to advance the aponeurosis on the tarsus. This surgery can be done via the anterior approach with aponeurotic surgery or via the posterior approach with Müller's muscle conjunctival resection. In all cases, upper lid blepharoplasty is down.