The eyelids are not just aesthetic features — they are critical functional structures that protect the eye, distribute tear film, and preserve vision. When an eyelid becomes structurally unstable, it can turn outward away from the eye (ectropion) or turn inward toward the eye (entropion). Both conditions are uncomfortable, both impair the eyelid’s protective function, and both can put the eye itself at risk if left untreated. Ectropion typically produces a chronic watery, irritated, dry-eyed appearance with a visibly droopy lower lid. Entropion can be genuinely dangerous — when the eyelashes turn inward and rub against the cornea, the resulting friction can cause corneal abrasion, infection, scarring, and even vision loss. At Los Angeles Plastic Surgery, Dr. John Anastasatos performs ectropion and entropion surgery to restore proper eyelid function and protect long-term eye health, alongside the full range of eyelid surgery procedures available at the practice.

Dr. Anastasatos performs ectropion and entropion surgery with the academic credentials and anatomic foundation these functional eyelid procedures specifically reward. He has been an invited lecturer at the Royal Society of Medicine in London on advanced facial surgical techniques, with an invited 2026 return as featured speaker. He completed his plastic surgery training under Dr. Luis Vasconez at the University of Alabama at Birmingham — one of history’s foremost plastic surgeons — providing the foundational training in deep facial and eyelid anatomy that ectropion and entropion repair specifically demand. With over two decades of facial surgical expertise in Beverly Hills since 2007, he is board certified by the American Board of Plastic Surgery, a Fellow of the American College of Surgeons (FACS), a member of the American Society of Plastic Surgeons (ASPS) and American Society for Aesthetic Plastic Surgery (ASAPS), and named by The Luxe Insider as one of the Top 10 Plastic Surgeons in the World.

Understanding Ectropion and Entropion

Both ectropion and entropion describe pathologic positions of the eyelid that disrupt normal eyelid function. Both most commonly affect the lower eyelid, though either can affect the upper lid in rare cases. Both have multiple potential causes including age-related tissue laxity, scarring from previous surgery or trauma, certain medical conditions, and (less commonly) congenital anatomy.

Untreated ectropion and entropion typically worsen over time. The eyelid laxity or scar contracture that produces the misalignment continues to progress, and the resulting eye irritation, exposure, or corneal damage progresses with it. Surgical correction is generally the only durable solution — temporary measures such as lubricating drops, taping, or bandage contact lenses can provide short-term relief but do not address the underlying structural problem.

Ectropion Eye Surgery

Ectropion is the outward turning of the eyelid — typically the lower lid — away from the eye surface. The eyelid no longer maintains contact with the eyeball, exposing the inner conjunctival surface and disrupting the tear film that normally keeps the eye lubricated.

What Causes Ectropion

Several factors can produce ectropion:

• Age-related tissue laxity — the most common cause. As we age, the supportive tendons and muscles of the lower eyelid weaken and stretch, allowing the lid to descend and turn outward.
• Scarring — from previous eyelid surgery, facial trauma, burns, or skin conditions that create skin contracture pulling the lid downward and outward
• Previous over-aggressive blepharoplasty — when too much skin was removed from the lower lid during prior surgery, the resulting tension can pull the lid into ectropion
• Facial nerve weakness — Bell’s palsy or other facial nerve disorders can produce ectropion through loss of muscle tone
• Mass-related descent — tumors or growths near the lid that physically pull the eyelid downward

Symptoms of Ectropion

Patients with ectropion typically experience:

• Chronic excessive tearing (the disrupted tear film no longer drains normally)
• Eye irritation and dryness simultaneously
• Visibly drooping lower lid with red conjunctival surface visible
• Sensitivity to light
• Recurrent eye infections
• Crusting at the lower lid margin

How Ectropion Eye Surgery Is Performed

Ectropion repair surgery tightens the supporting tendons and muscles of the eyelid to restore proper position. The specific technique depends on the underlying cause. For age-related ectropion, the lateral canthal tendon is tightened (similar to canthoplasty) to restore lower-lid support. For scar-related ectropion, the contracted scar tissue is released and replaced with a graft when needed. For severe ectropion with significant skin shortage, a skin graft may be needed to provide adequate skin to allow proper lid closure.

Some patients also have blepharoplasty performed at the same time to address sagging skin or other aesthetic concerns under the eye, achieving both functional repair and aesthetic refinement in a single procedure.

Entropion Eye Surgery

Entropion is the inward turning of the eyelid — usually the lower lid — so that the eyelashes rub against the cornea and conjunctiva of the eye. Unlike ectropion, which is primarily an exposure and irritation problem, entropion can cause direct mechanical damage to the eye surface.

What Causes Entropion

Entropion has several potential causes:

• Age-related muscle and tendon laxity — similar mechanism to ectropion but producing inward rather than outward turning
• Scarring of the inner eyelid surface — chemical injury, infection, or chronic inflammation can scar and contract the inner lid surface
• Spasm of the eyelid muscles — particularly the orbicularis muscle
• Congenital anatomy — rare but more common in certain ethnic populations

Why Entropion Is Urgent

Entropion can produce serious eye complications:

• The inverted eyelashes constantly rub against the cornea
• This friction causes corneal abrasion and irritation
• Repeated abrasion can produce corneal scarring
• Scarring can cause vision loss
• Secondary infection of the corneal surface is common

For these reasons, entropion typically requires more urgent surgical correction than ectropion. Temporary treatments — lubricating drops, bandage contact lenses, lid taping — can provide short-term protection but are not durable solutions.

How Entropion Eye Surgery Is Performed

Entropion surgery turns the eyelid outward and away from the eye. The specific technique depends on the cause. For age-related entropion, tightening the lower-lid retractors and lateral canthal tendon repositions the lid in its proper outward orientation. For scar-related entropion, the contracted inner-lid surface is released and reconstructed. The surgical goal is permanent restoration of proper lid position and eyelash orientation.

Combining Functional and Aesthetic Repair

When ectropion or entropion coexists with other eyelid concerns — sagging skin, puffy bags, dark circles, hooded upper lids — Dr. Anastasatos can address both the functional pathology and the aesthetic concerns in a single coordinated procedure. Combining functional ectropion or entropion repair with blepharoplasty or canthopexy consolidates surgery and recovery into a single period.

Frequently Asked Questions About Ectropion and Entropion Surgery

Will my insurance cover the procedure?

Ectropion and entropion repair are functional procedures, not cosmetic procedures. When properly documented as causing functional impairment or risk to the eye, they are typically covered by medical insurance. Cosmetic blepharoplasty performed simultaneously with functional repair may or may not be covered depending on individual policies.

How long is the recovery?

Most patients return to private daily activities within 7-10 days. Visible bruising and swelling resolve over 2-3 weeks. Final settling continues over 3-6 months. Strenuous activity is restricted for approximately 3 weeks.

Will the condition recur after surgery?

Properly performed surgery for ectropion and entropion produces durable results. Some recurrence over years is possible as natural aging continues, but typical surgical correction lasts a decade or longer. Recurrence is more common in patients with progressive skin conditions or facial nerve disorders.

Can entropion cause permanent vision loss?

Untreated entropion that produces severe corneal scarring can cause permanent vision loss. This is why entropion is generally treated as urgent — the longer the eyelashes rub against the cornea, the greater the risk of permanent damage. Most patients pursue surgery once entropion is diagnosed.

Can I have functional and aesthetic surgery together?

Yes. Many patients combine ectropion or entropion repair with blepharoplasty, canthopexy, or other eyelid procedures to address both functional pathology and aesthetic concerns in one operation.

What’s the difference between the conditions?

Ectropion turns the eyelid outward — exposing the inner surface and producing chronic irritation and tearing. Entropion turns the eyelid inward — causing eyelashes to rub against the cornea, which can damage vision. Both conditions disrupt normal eyelid function but in opposite directions.

Why Choose Dr. Anastasatos for Ectropion and Entropion Surgery

• Royal Society of Medicine London Lecturer: International peer-recognition with invited 2026 return as featured speaker.
• Trained Directly by Dr. Luis Vasconez at UAB: Foundational training under one of history’s foremost plastic surgeons in the deep facial and eyelid anatomy these procedures require.
• Two Decades of Beverly Hills Practice: Sustained experience in functional and aesthetic eyelid surgery since 2007.
• Combined Functional and Aesthetic Capability: Ectropion or entropion repair performed alongside blepharoplasty, canthopexy, or other eyelid procedures when indicated.
• Board-Certified, FACS, ASPS, and ASAPS: Certification by the American Board of Plastic Surgery and full membership in the specialty’s most respected peer societies.
• Revision Surgery Capability: Specific experience repairing ectropion or entropion produced by previous over-aggressive blepharoplasty performed elsewhere.
• Coordination With Ophthalmology: When concurrent eye-disease care is needed, Dr. Anastasatos coordinates with the patient’s ophthalmologist for comprehensive care.
• Top 10 International Recognition: Named by The Luxe Insider as one of the Top 10 Plastic Surgeons in the World.

Schedule Your Ectropion or Entropion Consultation in Beverly Hills

If you have an eyelid that turns outward (ectropion) or inward (entropion) — particularly if your eyes are constantly irritated, your vision is being affected, or your eyelashes are physically rubbing the eye surface — surgical correction is the durable solution. Dr. Anastasatos welcomes patients to the Beverly Hills office at 436 North Bedford Drive, Suite 202, Beverly Hills, CA 90210, for a private consultation evaluating your specific anatomy and outlining the appropriate surgical approach. Contact us at Los Angeles Plastic Surgery to schedule your consultation with Dr. Anastasatos to discuss ectropion or entropion surgery to protect your eye function.