Ectropion is a functional issue with the lower eyelid. The causes of ectropion are many, but the common theme is that a scar or contracture has occurred in the eyelid skin or muscle (orbicularis oculi). This abnormal tissue tethers the lower eyelid, resulting in malposition of the lid. In mild cases, the defect is largely cosmetic – giving an unaesthetic appearance of the lower eyelid contour (sometimes called scleral show). In more severe cases, the eye may not close completely, leaving the cornea exposed. Corneal exposure can result in significant dryness, irritation, accidental trauma, and eventually vision loss if the problem is not addressed.

Treatment of ectropion involves repositioning the lower eyelid, either be breaking up the scar tissue or elevated a large soft tissue flap and resuspending the tissue (midface lift). In some cases, all that is needed is a procedure to tighten the lower eyelid against the eyeball, called a lateral tarsal strip. This is not a universal cure, however, and a detailed examination during your consultation is necessary to identify specific issues related to your eyelid anatomy, eye position, tear film (dryness of the eyes), and degree of skin and muscle excess or laxity.

Blepharoptosis (upper eyelid ptosis) has many causes, but the most common is ptosis of old age (senile ptosis). This problem is caused by a gradual loosening or detachment of the muscle fibers that open (pull on) the upper eyelid skin and results in a relatively high upper eyelid crease and a relatively low position of the eyelid margin. In some cases, the eyelid may be so low that it covers part of the pupil, and significantly impairs a patient’s vision! (This must be documented by an ophthalmologist before surgery, using a technique called formal visual field testing.) The treatment in such cases may include a ptosis repair with or without an upper eyelid lift and/or a browlift, depending on the overall function and appearance of the periorbital tissues.

Dr. Ransom would be happy to answer your questions about eyelid forms and function during your consultation. Please call today to schedule a consultation.

Please note that all patients are different and individual healing times and results may vary. The statements regarding procedures and recovery made here are general rules.

Double Board Certified Plastic Surgeon at

Dr. Evan Ransom is an Ivy League-educated and Ivy League trained Facial Plastic and Reconstructive Surgeon. He is a Double Board Certified Head and Neck Surgeon and Facial Plastic and Reconstructive Surgery and fellowship-trained in facial plastic, reconstructive, and laser surgery. His practice is in the San Francisco Bay Area, serving patients from San Francisco, Oakland, Marin County, Palo Alto, Silicon Valley, Walnut Creek, the East Bay, and all over Northern California.