ENG
KOR
CHN
THAI
JAP
APGUJEONGYK
PLASTIC SURGERY
Congenital ptosis
※Recovery time, hospital admission
and visiting for treatment schedule
may vary among individuals.
What is ptosis?
We inform you that the ptosis surgeries
for aesthetic purpose and for treatment
purpose are different in standard
Classification of Ptosis
Ptosis is divided into congenital and acquired depending on the period of occurrence. Apgujeong YK Plastic Surgery Clinic performed ptosis surgery to adults for the last 10 years in Korea, and also provided surgery to children with congenital ptosis in Vietnam. Through these experiences, we have verified that there is a difference in the levator aponeurosis of the upper eyelid between the patients with congenital ptosis and acquired ptosis.
Anatomical Structure of the Eye
Cause of Congenital Ptosis
Congenital ptosis is being born with a disorder in the structure of opening the eyes, so there are many cases where it is difficult to be treated simply through surgery. It is not treated just by advancing or reducing the levator aponeurosis of the upper eyelid, and even if the eyes are opened, there may be other issues such as not acknowledging that the eyes are opened. Congenital ptosis can be divided into 3 types
01
Underdevelopment
Insufficient development of the levator aponeurosis of the upper eyelid
02
Mis-insertion
Tarsal plates must be attached to the levator aponeurosis, but when it is not attached or attached in other site.
03
Dis-insertion
Like the acquired ptosis, the structures are all developed, but the final attachment is not complete.
Treatment Method
of Congenital Ptosis
Type 1 is classified as severe, and it is difficult to restore to normal even with ptosis surgery. The surgical method is to connect the eyelid to the muscle that moves the eyebrow to be controlled through the movement of the eyebrow.
Figure A is an anatomical structure shown through the autopsy on a normal adult shown in the study by Dr. Kakizaki
Type 2 has different anatomical structure, and unlike Type 1, the development is at another site. Proper results cannot be acquired through normal ptosis correction, but may be expected through repeated surgeries.
Figure B shows the modified structure observed while I performed surgeries on Type 2 congenital ptosis.
In this case, the anterior layer (AL) passes through the WL to be changed in direction, and is inserted into the orbital septum (OS) (Orange Color).
For the correction, the AL inserted into the OS is found to be released from the peripheral tissue, and stitched to the posterior layer (PL) to create the normal anatomical structure.
The cause is the same as in acquired ptosis,
so proper results can be obtained either with non-incisional ptosis correction, or incisional ptosis correction.
Cause of Acquired Ptosis
In the case of acquired ptosis, all structures were normal when born. But due to atopy or allergy, inflammation is occurred on the eyelid (sty) from repeated rubbing; also, using contact lens from young age or using an eyelid tape may stimulate the site where the levator aponeurosis of the upper eyelid and the tarsal plates are connected, so this connection is weakened.
Treatment Method of Acquired Ptosis
Treatment is relatively simple for acquired ptosis, as we only need to reattach the detached site. In other words, all of the structures are normal but only detached, so we only need to find the anatomical structure for being connected again. Either non-incisional or incisional ptosis correction is all possible, and eventually, the levator aponeurosis of the upper eyelid must be attached properly to the tarsal plates.
