Midface lifting as an adjunct procedure in ectropion repair

Purpose: To evaluate the efficacy of ectropion repair with adjunctive midface lift. Methods: Retrospective chart review of patients with cicatricial, involutional, or paralytic ectropion with midface descent. Ectropion repair with adjunctive supraperiosteal midface lifting was performed on each patient. Surgical, indications included lower eyelid ectropion, lagophthalmos, and/or cosmetic deformity. Outcomes analyzed were recurrence or adequacy of ectropion correction, complications, and need for further surgery. Surgical success was determined by the need for further surgery. Results: A total of 32 procedures performed,on 22 patients under-going ectropion repair with adjunctive supraperiosteal midface lift were reviewed. Of the 15 procedures for patients with cicatricial ectropion, 80% (12 of 15 procedures) had improvement of lower eyelid position, without the need for further surgery; 71.4% of procedures for involutional ectropion (10 of 14 procedures) resulted in improvement in lower eyelid position, without the need for further surgery. There was improvement in ectropion in all patients with paralytic ectropion and no recurrences. A total of 5 patients had recurrences after ectropion repair with midface lift secondary to perioperative complications, a shortage of anterior lamella, or due to a heavy midface. Conclusions: We demonstrated that most patients undergoing midface lift in addition to ectropion repair have a favorable result. This is to be expected, given the close anatomic relationship between the lower eyelid and the midface. A midface lift should be considered in all patients who have both ectropion and significant midface descent.