Ectropion after blepharoplasty. Experimental and clinical observations.

Ectropion, or eversion of the lower lid, is the most common serious complication of blepharoplasty. Although many factors can be related to the production of this phenomenon, excess tension on the suture line has been implicated as a causal factor in the past. Because of the lack of instrumentation for measuring suture line tensions during the performance of blepharoplasty, and the relative difficulty in identifying suitable animal models, there has been little investigation of excess suture line tension as a cause of ectropion. This study was designed to establish a technique for measuring suture line tension during the performance of blepharoplasty and evaluating the effects of excessive suture line tension in the experimental production of ectropion in the stump-tailed monkey. In both monkey and human eyelid excisions, suture line tension is evaluated with the use of a fine-balance dynamometer. Suture line tension is shown to be a measurable parameter, and the technique of measurement is described. Excessive suture line tension has been demonstrated in monkeys and humans to be a causal factor in the production of ectropion following eyelid excisions.