109 cases of blepharoptosis treated by forked frontalis muscle aponeurosisprocedure with long term follow-up

109 cases of severe or recurrent blepharoptosis have been treated with the Forked frontalis muscle aponeurosis (FFMA) technique since 1989. In compari son with other frontalis muscle flap (FMF) protocols, this technique has th ree advantages: (i) no skin incision in the lower rim of the eyebrow; (ii) no incision in the frontalis muscle, and (iii) no dissection under the fron talis muscle. The FFMA is formed at the junction of the frontalis and orbic ularis muscles. The 9-year follow-up shows that this is a highly effective procedure. The postoperative function of the frontalis muscle is good and t he lack of damage has been confirmed by EMG. There are a few complications such as the sluggishness of the upper eyelid on downward gaze and the possi bility of asymmetrical brow height in unilateral blepharoptosis. However, t his technique may serve as the best choice in the treatment of severe or re current blepharoptosis. (C) 1999 The British Association of Plastic Surgeon s.