PMC6875030_01
Unilateral levator excision and frontalis suspension for MGJWS. (a-d) Procedures of levator excision and frontalis suspension with autogenous fascia lata. (a) Exposure of Muller muscle and levator aponeurosis. (b, c) The levator aponeurosis is transected from tarsal plate and Muller muscle, and dissected upward to Whitnall's ligament. (d) Frontalis suspension with two pieces of autogenous fascia lata. (e, f) Procedures of silicone rod suspension of a 2-year-old child with right-side MGJWS. (e) Levator muscle was dissected to Whitnall's ligament and held with a hemostat before transection. (f) The silicone rod was fixed on the upper 1/3 of the tarsal plate and the other two ends going through the orbital septum tunnel were fixed on the frontalis.
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Eyelid height was set at the estimated position according to both MRD1 and the height of contralateral normal eyelid (Figures 1(a)-1(d)). The two ends of silicone rod were passed through the lateral and medial orbital septum tunnels, respectively, and then formed a triangular frontalis suspension and drawn out of the forehead incision (Figures 1(e) and 1(f)).