Severe Ptosis, Advanced Ptosis, and Conjoint Fascial Sheath (CFS) Surgery

Severe Ptosis, Advanced Ptosis, and Conjoint Fascial Sheath (CFS) Surgery

Let’s take a closer look at this procedure.

Some people are born with eyes that look extremely sleepy and have difficulty opening properly. In these cases, the eyes often fail to open wider even after undergoing standard ptosis correction (eye shape correction).

Standard ptosis surgery is usually insufficient for such conditions. To achieve effective results, the surgeon must locate and operate on a deep tissue structure within the eye called the ‘conjoint fascial sheath’ (CFS).

This surgery requires advanced technical skills and is primarily performed by highly experienced plastic surgeons.

The area marked above is the CFS tissue, which is located almost directly above the eyeball. It is difficult to locate and even harder to dissect; it is a procedure that surgeons may find daunting unless they are highly skilled.

This surgery was first introduced by a surgeon named Holmström. The technique was significantly advanced in Korea, and currently, many surgeons in China are also adopting these methods.

This patient came to us in this condition from another hospital. They were born with one eye that barely opened. Even after surgery at another clinic, the eye still wouldn’t open properly, and they visited us because the eye could neither open nor close fully.

This is the appearance immediately after surgery. The eye opens well, but it does not close completely yet. This aspect will improve as time passes.

The patient returned for a follow-up two years after the surgery. The pupil exposure is now almost identical in size, and the eye closes much better. While it is difficult to achieve perfect symmetry when severe ptosis is present on only one side, it is possible to make them look nearly identical.

Comparison of before and after surgery.

The surgery appears to have been very successful.