Introduction:

The Fasanella-Servat procedure, also known as the Fasanella-Tiedemann procedure, is a surgical technique used to correct ptosis, a condition characterized by drooping of the upper eyelid. This procedure involves removing a small segment of the upper eyelid's tarsal plate to elevate and improve eyelid function. In this article, we will explore the indications, surgical technique, recovery, and potential complications associated with the Fasanella-Servat procedure.

Indications:

The Fasanella-Servat procedure is indicated for patients with mild to moderate ptosis, especially those with a relatively good levator muscle function. Ptosis can be congenital or acquired due to age-related changes, trauma, or neurological conditions. Candidates for this surgery should have a healthy cornea and sufficient tear production.

Surgical Technique:

The Fasanella-Servat procedure is typically performed under local anesthesia on an outpatient basis. The surgical steps include:

• Marking the Incision: The surgeon marks the planned incision line on the upper eyelid, usually 4-6 mm above the eyelid margin.
• Incision and Dissection: A small incision is made along the marked line, and the underlying tarsal plate is exposed.
• Tarsal Plate Resection: A segment of the tarsal plate, typically 2-4 mm wide, is excised from the upper eyelid.
• Closure: The incision is meticulously closed with sutures, ensuring proper alignment of the eyelid margin.

Recovery:

After the Fasanella-Servat procedure, patients may experience mild swelling, bruising, and discomfort, which usually resolve within a few days. Eye drops and ointments are prescribed to promote healing and prevent infection. Strenuous activities should be avoided during the initial healing period. Most patients can resume regular daily activities within a week after surgery.

Complications:

While the Fasanella-Servat procedure is generally safe, potential complications may include:

• Undercorrection or Overcorrection: In some cases, the eyelid height may not be adequately adjusted, leading to residual ptosis or eyelid retraction.
• Asymmetry: There may be subtle differences in eyelid height or contour between both eyes.
• Infection: Although rare, there is a risk of postoperative infection.
• Scarring: Scarring at the incision site can affect the eyelid's appearance.

Conclusion:

The Fasanella-Servat procedure is a reliable and effective surgical technique for correcting ptosis in patients with good levator muscle function. It provides excellent aesthetic and functional outcomes, helping patients achieve a more balanced and youthful appearance. However, like any surgery, careful patient selection, meticulous technique, and postoperative monitoring are crucial for successful results.

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