Cosmetic Surgery Research Today is a free monthly online journal that collates and summarizes the latest research about Cosmetic Surgery, including details on microsurgery, reconstruction, techniques, risks.

Management of lower lid ectropion.

Liebau J, Schulz A, Arens A, Tilkorn H, Schwipper V

Department of Plastic Surgery, Fachklinik Hornheide at the Westfalian/Wilhelms University of Münster, Münster, Germany. jutta.liebau@fachklinik-hornheide.de

BACKGROUND: Ectropion repair is a challenge in plastic surgery. Depending on the etiology of the underlying problem, a variety of surgical techniques are available. The etiology, operative management, and recurrence rate are presented. OBJECTIVE: An improvement of the deformity or, in the ideal case, a functional and aesthetic restoration should be accomplished. MATERIALS AND METHODS: In this study, 58 patients with ectropion treated from June 2002 until March 2004 were analyzed, 33 with scar contractures, 13 with a tumor of the lid margin, 8 with facial paralysis, and 4 with senile ectropion. Surgical procedures included lateral or medial canthopexy, lateral tarsorrhaphy, wedge excision, skin graft, local flaps, cartilage graft, fascial slings, and combined procedures in one-third of the patients. RESULTS: Postoperative complications included incomplete correction and others in 18.9% of the patients. Eight patients (13.8%) had to be reoperated. CONCLUSION: Correction of the lower lid area including restoration of the lid margin in terms of shape and position is the surgical end point. The preoperative analysis is mandatory for a surgical solution to this severe problem, which is associated with a high incidence of recurrence, especially in difficult reconstructive cases. An individual sophisticated strategy combined with experience in the variety of surgical techniques is mandatory. Frequently, multiple procedures are necessary.

Published 21 August 2006 in Dermatol Surg, 32(8): 1050-6; discussion 1056-7.
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