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Page 20 of 23 Farber et al. Plast Aesthet Res 2020;7:20 I http://dx.doi.org/10.20517/2347-9264.2020.05

Figure 28. An elderly male with poor but adequate levator function before failed silicone slings were removed and an aggressive
tarsolevator advancement was performed

Figure 29. An elderly male with bilateral upper lid ptosis and lower lid ectropion from tarsoligamentous laxity shown before and after
bilateral tarsolevator advancement and bilateral lateral canthoplasties

is unsuccessful, lid stretching can also be performed under local anesthesia in the early postoperative
[2]
period . Patient dissatisfaction is higher in the aesthetic patient and can be upwards of 25%. Reassurance
and time, as well as massage lid stretching exercises, are often used. Unless overcorrection is felt to be a
technical problem that can be fixed with immediate surgery at one week, the senior author recommends