Midface lifting as an adjunct procedure in ectropion repair

Area of Science:

• Oculoplastic surgery
• Facial plastic surgery
• Reconstructive surgery

Background:

• Lower eyelid ectropion, characterized by eyelid turning outward, can result from cicatricial, involutional, or paralytic causes.
• Midface descent, often associated with aging or other conditions, can exacerbate lower eyelid malposition.
• Surgical correction of ectropion may require addressing concurrent midface structural changes for optimal results.

Observation:

• A retrospective review analyzed 32 procedures in 22 patients with ectropion and midface descent undergoing ectropion repair with supraperiosteal midface lifting.
• Success rates varied by ectropion type: 80% for cicatricial, 71.4% for involutional, and 100% for paralytic ectropion.
• Recurrences (5 patients) were linked to perioperative complications, anterior lamella shortage, or significant midface ptosis.

Findings:

• The combined procedure demonstrated a high success rate in correcting lower eyelid ectropion across different etiologies.
• Adjunctive midface lifting appears to improve or stabilize lower eyelid position by addressing underlying structural support.
• The anatomical proximity of the midface to the lower eyelid supports the efficacy of combined surgical interventions.

Implications:

• Midface lifting should be strongly considered in patients presenting with both ectropion and significant midface descent.
• This combined surgical strategy may enhance functional and aesthetic outcomes in complex lower eyelid reconstruction.
• Further research could explore patient selection criteria and long-term outcomes for this combined approach.