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Open Access
CC BY 4.0 · Arch Plast Surg 2025; 52(05): 264-272
DOI: 10.1055/a-2640-3975
Cosmetic
Original Article

C-Shaped Frontalis Muscle Flap Suspension for Congenital Blepharoptosis: A Retrospective Analysis of Outcomes in Moderate to Severe Cases

Minh Ngoc Pham 
1   Craniofacial and Plastic Surgery Department, 108 Military Central Hospital, Hanoi, Vietnam
,
Rong-Min Baek 
2   Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Republic of Korea
,
Anh Mong Vu Luong 
3   College of Health Sciences, VinUniversity, Hanoi, Vietnam
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Abstract

Background

While various surgical techniques have been developed for blepharoptosis correction, the frontalis suspension technique is commonly applied in cases of poor levator function or prior surgical history. This study evaluates the efficacy of a modified frontalis muscle flap suspension technique in achieving satisfactory outcomes for severe or recurrent blepharoptosis with poor levator function.

Methods

A retrospective study conducted from January 2014 to January 2017 reviewed the medical records of 47 patients with a mean age of 17.3 ± 9.17 years at 108 Military Central Hospital, Ha Noi, Vietnam. These patients were diagnosed with moderate to severe blepharoptosis (marginal reflex distance 1, MRD1 0–2 mm) with poor levator function (<4 mm) and underwent modified C-shaped frontalis muscle flap suspension. The outcomes were measured by the sum of functional and cosmetic grading scales at 6- and 12-month follow-ups. Postoperative complications were also noted.

Results

There are 40 patients (85.1%) who have unilateral ptosis and 7 (14.9%) who have bilateral ptosis. Forty-seven patients (87%) had severe ptosis, while seven (13%) had moderate ptosis. A history of frontalis sling surgery was present in 38.9% of patients. At the 12-month follow-up, 37 patients (78.7%) had good outcomes, 9 patients (19.1%) had fair outcomes, and 1 patient (2.1%) had poor outcomes that underwent surgical revision.

Conclusion

Our analysis of the modified C-shaped frontalis muscle flap suspension technique demonstrates its efficacy in treating moderate and severe blepharoptosis, particularly in cases with poor levator function and prior surgical history.

Keywords

moderate and severe blepharoptosis - frontalis muscle flap suspension - poor levator function

Authors' Contributions

Conceptualization: M.N.P.

Data curation: M.N.P., A.M.V.L.

Formal analysis: M.N.P., A.M.V.L.

Funding acquisition: M.N.P.

Methodology: M.N.P., R-M.B., A.M.V.L.

Project administration: M.N.P., A.M.V.L.

Supervision: M.N.P.

Visualization: M.N.P., A.M.V.L.

Writing—original draft: M.N.P.

Writing—review and editing: R-M.B., A.M.V.L.


Ethical Approval

The study was approved by the Institutional Review Board of 108 Military Central Hospital and strictly followed the Declaration of Helsinki. IRB approval number is 5129/2002/QD-YT.


Patient Consent

Patients and their guardians were provided with information and gave consent for the surgery.




Publikationsverlauf

Eingereicht: 24. Juni 2024

Angenommen: 09. Juni 2025

Accepted Manuscript online:
23. Juni 2025

Artikel online veröffentlicht:
01. September 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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