Anna Waldie1,2,3, Ian Francis1,4, Minas Coroneo1,4, Geoffrey Wilcsek1,4
This is a surgical technique ﬁlm demonstrating FESplasty ‘Floppy Eyelid Syndrome plasty’, a pro- cedure in the surgical management of Floppy Eye- lid Syndrome (FES). FESplasty combines three established surgical techniques around the orbit. FESplasty utilizes a periosteal ﬂap harvested from the inferolateral orbital rim, based at the vertical level of Whitnall’s tubercle, and then advanced medially, rotated on its long axis, and sutured to the anterior surface of the upper tarsal plate. The lateral raphe is stabilized by suturing it to the residual periosteum just posterior to the base of the periosteal ﬂap. A medial full-thickness upper eyelid pentagonal wedge excision is titrated to the lateral raphe stabilization, aiming to restore nor- mal anatomical and physiological function to the upper eyelid. FESplasty appears to stabilize the tarsal plate safely, effectively, and rapidly, and confers structural integrity minimizing upper eye- lid stretchability.