Belt Buckle Ectropion: A Unique Cause of Lower Eyelid Misalignment Post-Mohs Reconstruction - Takeaways - MDSpire

Belt Buckle Ectropion: A Unique Cause of Lower Eyelid Misalignment Post-Mohs Reconstruction

  • By

  • Gokce Cinel Pasa

  • Addison M. Demer

  • Lilly H. Wagner

  • March 25, 2026

  • 0 min

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  • 1

    Belt buckle ectropion is a newly identified cause of lower eyelid malposition after Mohs reconstruction, distinct from cicatricial ectropion.

  • 2

    This condition arises from horizontal flap tension on a lax tarsus, leading to anterior tarsal tilt without vertical skin deficiency.

  • 3

    In a study of three patients, one case resolved spontaneously, while two required lateral tarsal strip procedures for correction.

  • 4

    Successful outcomes were achieved with horizontal tarsal tightening, avoiding the need for skin grafts in ectropion correction.

  • 5

    Preoperative assessment of eyelid laxity is crucial to prevent belt buckle ectropion following Mohs surgery.

Original Source(s)

Belt Buckle Ectropion: A Unique Cause of Lower Eyelid Misalignment Post-Mohs Reconstruction

  • by Gokce Cinel Pasa, Addison M. Demer, Lilly H. Wagner

  • March 25, 2026

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