Frontalis Sling for the Treatment of Congenital Ptosis

Krishna S. Vyas, MD, MHS; Urian Kim, BA; William D. North, MD; Daniel Stewart, MD


ePlasty. 2016;16(ic12) 

In This Article


A 28-year-old man with drooping right eyelid since birth was concerned about visual field defects and his appearance. He had no medical or surgical history.

Figure 1.

Preoperative photograph demonstrating severe ptosis on the right lid with levator function less than 5 mm (measured by blocking the action of the frontalis muscle). The patient is contracting his right frontalis muscle to keep his right eyelid open. Normal levator function is 11 mm.

Figure 2.

Photograph demonstrating suspension of the upper lid to the frontalis muscle with a strip of fascia lata. A blepharoplasty incision through the supratarsal crease is used to access the levator aponeurosis and tarsal plate.

Figure 3.

After suturing the fascia lata to the tarsal plate, it was tunneled and sutured to the frontalis muscle.

Figure 4.

Postoperative photograph at 5 months demonstrating improved margin reflex distance 1 (MDR1).