Congenital ptosis: This is due to hypoplasia of the levator muscle or a central or peripheral defect in the innervated levator muscle and is often associated with genetics. The closer to normal the amount of transverse muscle fibers contained in the levator muscle, the less ptosis there is; conversely, the less there is, the more ptosis there is. Timing of surgery for congenital ptosis in children: We have observed intraoperatively that in children, the frontalis muscle is thin but well developed and not easily damaged during separation, and the frontalis flap it makes is sufficient to raise the upper lid to the desired height and the upper lid is not easily bloated compared to its own thinner lid plate and orbicularis oculi muscle. Also, the younger the child, the easier the separation of the frontalis muscle, the relatively less bleeding, the faster the postoperative recovery, and the more natural the blepharoplasty as the child grows older. We believe that children with severe ptosis can be operated on at around 1 year of age as long as they are in good general condition, especially if they have unilateral ptosis, which should be corrected as early as possible to avoid amblyopia and strabismus; children with mild ptosis should also be operated on before school age to prevent amblyopia from occurring as much as possible. If other eyelid deformities are combined, the eyelid deformity should be corrected first. The advantage of this procedure is that it is less destructive, has clear anatomic criteria via the skin, is well exposed, and the amount of shortening can be easily adjusted; it is easier to handle if lid margin incision, entropion, or poor lid margin curvature is found during surgery. The frontalis flap suspension is suitable for children with an upper eyelid lift of 4 mm or less, and has the advantage of being relatively simple and easy to master, avoiding postoperative frowning and frowning that can affect appearance due to the indirect method; the healing is firm and long-lasting, and postoperative lid closure is faster than other procedures. It is generally believed that ptosis is due to the inability of the levator muscle to lift the upper lid. In most patients with congenital ptosis, we have found several small, transverse, dysplastic fibrous bands within the levator aponeurosis near the superior margin of the lid plate, and releasing these bands increases the lid fissure and essentially corrects most mild ptosis. The mechanism is that when the levator muscle contracts to open the eyes, the levator muscle is not fully acting on the upper eyelid because the transverse fibrous bands within the levator tendon are connected to the inner and outer canthus, so the levator muscle is held in the inner and outer canthus during contraction and cannot fully act on the upper eyelid, resulting in inability to open the eyes. We were able to correct ptosis with only 2 to 3 mm of folding of the levator aponeurosis after releasing the transverse band, without significant incomplete eye closure and with less recurrence of postoperative ptosis, indicating that the transverse band restricts the lid lifting function of the levator aponeurosis and that releasing the transverse fiber band restores the lid-opening function of the levator aponeurosis. In the case of severe ptosis, the frontalis muscle lifting force is relatively small due to the release of the band, and the frontalis fascial flap separation is small and does not need to be overcorrected, resulting in a light degree of postoperative incomplete lid closure and avoiding serious complications such as keratitis, which can cause loss of vision.