Some one once said that blepharoplastic operations look very pretty—on paper—but in reality the results are anything but pleasing and satisfactory. The operations for cicatricial ectropium are not excepted from this criticism. The restored lids often look hideous, and still oftener are again everted after a few weeks or months. But we can overcome these drawbacks if we pay strict attention to the following points:
1. The proper division and fixation of the skin flaps.
2. The selection of the most suitable material for covering the lids.
3. The shortening of the overstretched lid border.
THE PROPER DIVISION AND FIXATION OF THE SKIN FLAPS.
The greatest difficulty we have to contend with in the operations for cicatricial ectropium is the tendency of the shrinking skin flaps to evert the lids again. As all transplanted flaps will undergo more or less shrinkage and as
HOTZ FC. THREE ESSENTIAL POINTS IN THE OPERATION FOR CICATRICIAL ECTROPIUM.. JAMA. 1903;XL(18):1186–1189. doi:10.1001/jama.1903.92490180004001a