Essential blepharospasm is an idiopathic disorder that consists of spontaneous, 
spasmodic, and involuntary eyelid closure in the absence of ocular disease. Some 
patients develop an inability to open their eyelids in the absence of 
orbicularis spasms. These patients have essential blepharospasm combined with 
apraxia of eyelid opening. Botulinum toxin injections are the treatment of 
choice for blepharospasm but results may be insufficient, especially in cases 
associated with apraxia. Apraxia can be treated surgically by levator 
aponeurosis advancement, frontalis suspension, and upper myectomy. The authors 
report the first browlift using polypropylene suture to manage eyelid apraxia 
associated with blepharospasm as an alternative and minimally invasive 
procedure.