A Case of Ectropion Caused by Skin Damage During Lower Blepharoplasty that Was Corrected with a Contralateral Lower Eyelid Skin Graft

Abstract

Lower eyelid transconjunctival blepharoplasty is a surgical procedure that is often performed in cosmetic surgery clinics to improve the appearance of orbital fat protrusion 1) . Blepharoplasty in general can be associated with several complications, including sunken eyes resulting from excessive fat removal, increased wrinkling, and lower eyelid depression due to heightened skin laxity. However, lower eyelid transconjunctival blepharoplasty is associated with a lower overall risk of complications than other blepharoplasty methods because it does not result in visible scarring 2) . Despite these advantages, improper surgical manipulation can induce skin damage that results in postoperative contraction and ectropion. We herein present such a case and show that it was successfully treated with a full thickness skin graft from the contralateral lower eyelid. CaseThe patient provided written informed consent and permission to publish the case details and associated images for scientific use. One year earlier, a 38-year-old woman underwent bilateral lower eyelid transconjunctival blepharoplasty at a local cosmetic surgery clinic. However, skin damage and debridement of the left lower eyelid occurred during the surgery, resulting in a skin defect. The skin defect was sutured, but the patient developed severe postoperative ectropion of the left eye after surgery (Fig. 1). She underwent taping treatment for approximately 1 year, but the ectropion did not improve, and the patient was referred to our clinic (Fig. 2).In our clinic, the patient՚s left lower eyelid skin was incised to release the subcutaneous contracture. This left a 35 × 3 mm skin defect that was addressed by taking an equal-sized fullthickness skin graft from the contralateral lower eyelid. The graft was sutured using 7-0 nylon and secured with gauze and