A new technique for the management of medial ectropion with a mild to moderate cicatricial component is presented that avoids the necessity for skin grafting. A subciliary incision is made inferior to the punctum and extending laterally, followed by preseptal dissection to the orbital rim. A base-up triangle of the posterior lamella is then excised lateral to the punctum. This is closed with a marginal mattress suture. Tightening of the posterior lamella in this fashion produces laxity in the anterior lamella, which can then be closed without tension, eliminating the need for skin grafting.
Keywords: Cicatricial medial ectropion.