Revisiting Upper Eyelid Anatomy: Introduction of the Septal Extension

Abstract

A septal extension to the ciliary margin of the upper eyelid is established. Suture plication of the septal extension can induce lid elevation, with potential postoperative lid retraction. Intraoperative failure to recognize and distinguish this extension from the aponeurosis proper may lead to the high reported rates of unsuccessful ptosis correction. This refinement of septal anatomy should increase precision and help surgeons avoid complications in advanced blepharoplasty and ptosis surgery.