The correction of lower lid malposition following lower lid blepharoplasty

Lower eyelid malposition is the most common complication following lower eyelid blepharoplasty. This may take the form of a mild scleral show with the round eye syndrome or may progress to frank ectropion in some patients. When this problem occurs, it is imperative to soothe an already distressed patient by correcting the malposition by the most efficient method. A horizontal tightening of the lower lid at the lateral canthus can be helpful in many patients; however, in the more severe cases or in those in which the medial component is prominent, this procedure may not give the best correction. It is preferable to avoid using autogenous grafts in these patients because in most cases they will induce another incision line with potential deformity and, more important, are perceived by these sensitive patients as being more of an involved procedure. The preserved fasciae latae sling is an alternative procedure which is effective in the more severe cases of postblepharoplasty lower eyelid malposition, particularly in those cases in which the medial component of malposition is prominent.