Prevention of Lower Lid Retraction and Ectropion in Lower Lid Blepharoplasty

Abstract

At the recent fall meeting of the American Academy of Facial Plastic and Reconstructive Surgery in Washington, DC, Bruce B. Becker, Encino, Calif, noted ectropions to be one of the most common complications after lower lid blepharoplasty. He feels that the incidence of this complication can be reduced by a thorough preoperative evaluation and careful surgical technique. He felt that the major causes of postblepharoplasty ectropions were uncorrected horizontal lid laxity, excessive skin excision, and vertical retraction of the lid from scarring or orbicularis muscle shortening. Careful preoperative evaluation was felt to be very important, with special attention directed at evaluation of lower lid laxity. Two tests were recommended for evaluation of lower lid laxity: the snap test, in which the lower lid is pulled away from the globe and allowed to snap back, and the pinch test, where the distance the lower lid can be pulled from the globe