What is Ectropion?

Ectropion is a condition when the lower eyelid turns outwards. As the result the inner ‘pink part’ of the eyelid is exposed to the air and gets irritated.


Who can get an Ectropion of the eyelid?

Ectropion is more common in older people and can affect both men and women. Ageing structurally weakens all tissues that add to the risk of developing ectropion.


What are the symptoms of ectropion?

The symptoms of ectropion are due to abnormal, prolonged and constant exposure of the eyelid and the eye. Irritation of the eye, gritty feeling, feeling of dry eye and excessive tearing are the common symptoms.


How do I know if I have ectropion?

If you have ectropion you will experience symptoms due to irritation such as excessive tearing, and gritty feeling due to dryness. Your eyes will appear red and inflamed and the lower eyelid will be pulled down or turned outwards exposing the inner pink part of the lower eyelid.


Risk factors for eyelid ectropion

  • Old age
  • Significant skin ageing resulting in thinning of skin and loss of muscle tone
  • Negative Vector orbit where the under-eye cheek bone shrinks and no longer offers support
  • Scarring of the lower eyelid and tightening of the skin due to scarring.

What are the causes of ectropion?

There are numerous causes of ectropion.
  1. Weakness of the lower eyelid muscle leading to loss of eyelid support
  2. Facial nerve paralysis resulting in significant weakness of the lower eyelid
  3. Scarring of the lower eyelid due to previous surgery or trauma that pull the eyelid down
  4. Cancers of the lower eyelid that pull the lower eyelid downwards and cause ectropion.

Treatment of ectropion is always surgical

  • Early treatment with lubricating eyedrops can help improve symptoms.
  • Surgical treatment involves addressing the cause.
  • Removing excess skin and muscle and tightening them
  • Tightening the tendon of the eye by a process called canthoplasty
  • If it is excessive scarring, you will need either a skin graft or a midface suspension


Is ectropion surgery done in hospital?

Yes, ectropion correction surgery is performed under Anaesthesia in hospital as a day surgery procedure.


What should I do after the surgery?

* Lubricating eyedrops to the eye every 2- 4 hours
* Ice pack cold compress to reduce the swelling
* Antibiotic ointment to the suture * line three times a day for a week
* Keep the area clean and dry
* Light activities only for the first week

What happens at the first post operative visit?

Your first post-operative visit is scheduled for a week after surgery. The wound will be inspected to ensure it is healing well and there are no signs of infection. The sutures are removed, and you will be advised to continue antibiotic ointment for another week. The inside of the eyelid is inspected to make sure there is no evidence of chemosis, and if present appropriate steroid eyedrops are commenced.


What is chemosis?

Chemosis is swelling of the conjunctiva (lining of the eyelid) in response to prolonged inflammation of surgery and canthoplasty. There is a definitive predisposition for post lower eyelid surgery chemosis in elderly patients who have pre-existing lower eyelid and conjunctival laxity, poor eyelid closure mechanics and pre-existing ocular surface disease. 


Treatment of Chemosis 

The use of eyelid lubricating drops, steroid drops together with systemic steroids and anti-inflammatory medications can help treat mild chemosis.



You will generally see Dr Somia 2 times before your surgery.   If you prefer one of these consultations can be held via telehealth.    Two consultations are required by law before a date for surgery is scheduled.   This is to allow you plenty of time to ask questions and feel comfortable about the procedure.   Your third consultation will assist us to prepare you for your surgery (ie paperwork, pre-operative testing). 



The surgery takes approximately  1.5 hours to 2.5 hours depending on the procedure recommended and sometimes requires an overnight stay in hospital.   Our fees include specialist plastic surgeon, specialist anaesthetist, fully accredited hospital theatre, accommodation and 6 months aftercare.    A formal estimate will be provided after you have discussed your goals and what is possible to achieve them with Dr Somia.  



Each patient recovers at a different rate and anothers recovery should not be compared with yours. 

Generally, initial recovery from swelling and bruising is approximately 2 weeks.   A return to normal activities can usually be after 2 weeks.   Full results can be expected 3-6 months after.  

You can return to work when you feel well.   Most patients take a few days off work if they work in an office context.    

You can drive when the anaesthetic has worn off, your vision is clear, and you are pain free getting in and out of the care and whilst performing an emergency stop.   You should check your vehicle insurance policy for their requirements in this situation.  



All surgery carries risks. When travelling overseas on a plane whilst the expectation is a safe journey and arrival, it is understood things could go wrong. The choice of the airline based on safety record and flight path are important elements in determining risk. Similarly, for your surgery, the experience and expertise of your Surgeon, the skill of your anaesthetist and the standard of the hospital will determine the risk. Risks, both general and specific, will be discussed during your consultations and written information will be provided for you to take home.    

General risks include pneumonia, deep venous thrombosis and pulmonary embolism, stroke, heart attack, allergies, awareness, death, bleeding, infection, sensation change, haematoma and seroma, skin contour irregularities, damage to deeper structures, firmness, delayed healing and tissue death, exposed sutures, dog ears or additional skin golds, dressing issues, asymmetry, scars, lymphoedema and unsatisfactory results. 

Risks specific to Blepharoplasty (Eyelid) surgery are:  injury to the eye globe, need for extra tissue,  loss of vision, changes to tear secretion,  conjunctival oedema and chemosis, exposed sutures,  upper eyelid malposition, difficulty closing the upper eyelid and corneal exposure, lower eyelid malposition and eyelash loss.                                



Our practice privacy policy prevents sharing patient before and afters online. Indicative before and after photos can be viewed during your consultation.  

DISCLAIMERS:   All surgical procedures are performed by Specialist Plastic Surgeon, Dr Naveen Somia (MBBS PhD, FRACS - APHRA Reg:  MED 0001189889).  For full information on Dr Somia's qualifications and risk/recovery information on procedures please visit the procedure page on this website.  From July 1, 2023 all surgical procedures require a GP referral.
All surgery carries risks.  information provided is general only.  Outcomes experienced by one person do not necessarily reflect the outcomes of others given factors such as genetics, diet and exercise.  Please seek a 2nd opinion from a qualified Specialist Plastic Surgeon. 

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