[Rari Plastic Surgery] Eyelid Ectropion Correction Surgery Methods According to Eye Condition

Ectropion is not a common condition, but

it can occur for various reasons and appear in different forms.

So the surgical approach also differs depending on the condition of the eye.

�00 Today, let’s take a look at before-and-after photos of various ectropion cases

and talk about them.

NO.1

This patient had lived with ectropion for nearly 20 years due to lower eyelid surgery

that he or she underwent as a child.

� In daily life, not only redness and dry eyes, but also a pronounced triangular white area under the iris made the face look unfriendly, so the patient had been thinking a lot about corrective surgery. At our clinic, the patient underwent ectropion correction surgery and improved the concerns mentioned above.

� Overall, the skin had sagged and the ectropion needed correction, but since the ectropion was more severe on the back side of the eye than on the front side, the skin to be grafted was designed with emphasis on the back side, and after harvesting skin from the upper eyelid, it was grafted to the lower eyelid. Because the skin and muscle of the lower eyelid had both sagged for a long time, during surgery the sagging lower eyelid muscle was also pulled up together with the skin graft and fixed to the outer corner of the eye to maximize correction of the triangular white area.

� At 3 months after surgery, the grafted skin still looks a little unfamiliar because of the scar and skin color, but the triangular white area that had been focused more toward the back was improved well, and by removing skin from the upper eyelid and grafting it, the patient also underwent non-incisional double-eyelid eye-opening surgery, which made the eye shape look much clearer.

NO.2

This photo feels different from the one above, right?! That’s right. This photo is not a front view.

� For this person, it was hard to tell from the front, but when they pulled their chin in and looked upward, it was possible to see the lower eyelid separating from the eyeball. At first glance, it may seem like that is normal, but once you try it, you’ll know. The lower eyelid does not separate from the eyeball like that ㅠㅠ

� For this patient, the front and back parts of the eye were fine, but the central part was ectropion in a concentrated area, so instead of grafting skin across the entire lower eyelid, the graft had to focus on the center, which required detailed design of the harvested skin! We harvested skin in a shape suited to the needed form from the double-eyelid crease line and grafted it to the lower eyelid, and stitches were removed on day 9 after surgery. Looking at the photo at 6 months, even when the patient looked upward, the lower eyelid no longer separated from the eyeball, showing that the lower eyelid ectropion was corrected naturally and well.

NO.3

This patient had undergone corrective surgery for congenital entropion (inward-turning eyelid) at a very young age. Because the patient was very young, the surgery was performed under general anesthesia. Since it is difficult to confirm the amount of skin to be removed during surgery under general anesthesia, excessive skin resection led to ectropion. As shown, the symptoms included eversion of the lower eyelid conjunctiva and a shortened lower eyelid, resulting in a triangular white area under the iris.

� To correct this, skin was harvested from the upper eyelid and grafted to the lower eyelid. Because the ectropion had persisted for a long time, if only skin grafting were performed, ectropion could recur, so the lower eyelid ectropion was corrected with a "composite tissue graft" that included not only skin but also orbital muscle.

� Unlike before surgery, the photo taken 1 year after surgery shows that the eversion of the conjunctiva and the triangular white area under the iris have been well corrected. And with this composite tissue graft, when smiling after surgery, the muscle layer forms aegyo-sal, making the eyes look much livelier.

NO.4

Looking at the preoperative photo above, you may not feel that the ectropion is very severe. However, when looking at the lower eyelid line, you can see that the conjunctiva is slightly turned outward, and on the left eye (right side in the photo), the front part of the lower eyelid line is not smoothly descending.

� When looking at the condition of the lower eyelid in this ectropion state, the design of the grafted skin must be made differently on each side. For the right eye, the skin graft was placed evenly overall, while for the left eye, the skin area toward the inner corner of the eye was designed more broadly within the overall graft and then transplanted.

� At 6 months after surgery, we achieved good results with ectropion correction surgery by grafting skin with different widths and shapes as needed.

� What was unique about this case is that there was not enough upper eyelid skin, so the grafted skin was taken from behind the ear. The skin behind the ear is similar tissue to the lower eyelid, like the upper eyelid skin, so it does not feel particularly unnatural at the graft site.

� Before surgery, when the eyes were looked up, the lower eyelid of the left eye seemed to separate from the eyeball, but in the post-surgery result, the lower eyelid is evenly attached to the eyeball without being偏 toward either side.

� The surgical method for ectropion correction requires an accurate determination of the cause through a doctor’s diagnosis, and in addition, it also varies depending on the degree of ectropion.

� So far, we have looked at before-and-after photos of several ectropion correction surgeries.

� If you want successful ectropion correction, it is important to receive surgery only after sufficient consultation with a specialist who has extensive surgical experience, and since the degree and process of recovery can vary from patient to patient, it is better to wait calmly without becoming impatient.

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