Correction of the “Too High” Supratarsal Fixation

Abstract

In the supratarsal fixation blepharoplasty, the low levator insertion is moved cephalad to give a more dramatic result and to ensure permanence. It has been modified since its inception. Unfortunately, one of the complications of the original supratarsal fixation is the "too high" supratarsal fixation in which the amplitude of the levator is decreased and the eye is too wide. Sheen presented this complication and modified his operation but did not suggest a solution. Here the simple corrective technique is presented of reopening the incision and reconnecting the inferior orbicularis flap lower on the levator (the difference equaling the amount of ptosis desired).