[Rari Plastic Surgery] Ectropion After Double Eyelid Surgery (Upper Eyelid Ectropion)

So far, I have written a series of posts about ectropion.

Ectropion is a condition of the eyelid in which the eyelid does not adhere to the eyeball and turns outward, causing cosmetic and functional problems ranging from dry eyes and redness to, in severe cases, decreased vision.

However, ectropion does not occur only in the lower eyelid.

Ectropion can be divided into two types depending on where it occurs:

• > If it occurs in the upper eyelid, it is called "upper" ectropion.

• > If it occurs in the lower eyelid, it is called "lower" ectropion.

In the previous posts on ectropion, most cases were lower eyelid ectropion. So today, I would like to take a look at upper eyelid ectropion.

Upper eyelid ectropion is not as severe as lower eyelid ectropion. Because the eyelid has to turn in the opposite direction of gravity, it is difficult for it to occur naturally unless it is caused by surgery or congenital ectropion. One of the representative causes of upper eyelid ectropion is double eyelid surgery. During the double eyelid surgery process, the eyelashes and conjunctival lining of the upper eyelid can be turned outward, resulting in upper eyelid ectropion.

As shown in the photo from <2024.03.29>. The degree is not severe, but this is still ectropion in a broad sense. (The severity may be greater or lesser depending on the patient.)

However, upper eyelid ectropion that occurs after surgery like this is usually temporary, caused by swelling and anesthetic medications, so as time passes it generally returns to the normal range as before surgery.

The problem is that there are occasionally people for whom this does not happen. In such cases, they may need to undergo revision double eyelid surgery again to correct the upper eyelid ectropion.

This kind of upper eyelid ectropion usually occurs when the double eyelid fold is fixed too high, beyond the upper margin of the tarsal plate.

If you look at the preoperative photo, you can see the eyelashes turned outward and pointing upward, right?

Some people like this upper eyelid ectropion in which the eyelashes are turned upward, but in many cases it makes the eyes look glaring, and the exposure of the conjunctival lining can also make the eyes functionally uncomfortable.

So, by releasing this fixation and anchoring it as shallowly as possible on the tarsal plate or the tissue above the tarsal plate, the upper eyelid ectropion is corrected.

Before surgery, the eyelashes were turned upward and the conjunctival lining was visible, but after the upper eyelid ectropion was corrected, the eyelashes also came down and the conjunctival lining was no longer visible, as clearly shown in the before-and-after photos.

In the photo above as well, before surgery the upper eyelash root area was lifted outward, so the conjunctival lining was visible from the front, but if you look at the recovery process after revision double eyelid surgery that also corrected the lifted conjunctival lining, as time passed the conjunctival lining gradually came down and became no longer visible, correcting the conjunctival lifting phenomenon.

Even mild ectropion can, over time, cause dry eyes or a stinging sensation, so if it feels uncomfortable, correction is recommended.

To a third party, the difference in this kind of upper eyelid ectropion correction may seem very subtle, and there may not be a major visible change, but patient satisfaction with the corrective surgery is definitely higher.