Abstract
Introduction
Lower eyelid ectropion is a challenging postoperative complication that can affect
both function and aesthetics. Preventative strategies are critical, particularly in
high-risk periocular and midface surgeries.
Objectives and Hypotheses
This review aims to evaluate the efficacy and variety of prophylactic suspension techniques
used to prevent lower eyelid ectropion. Primary outcome: Incidence of ectropion; secondary
outcomes: Technique tolerability and reported complications.
Study Design
Systematic review conducted in accordance with PRISMA guidelines.
Methods
A systematic search was performed through June 2025 using keywords: “Frost suture,”
“suspension,” “ectropion,” “tape,” and “prevention.” Sixteen studies were included
(9 clinical, 8 technical). Data on patient indications, techniques, outcomes, and
follow-up were extracted.
Results
Techniques included Frost sutures, periosteal anchoring, barbed sutures, external
splinting, and forehead hitch. Ectropion prevention was generally successful, though
one clinical study reported no significant benefit with Frost suture use.
Conclusions
Multiple prophylactic strategies appear effective, but evidence quality is low. Higher-level
comparative studies are needed.
Keywords
lower eyelid ectropion - prophylactic suspension techniques - frost suture - barbed
suture - periosteal anchoring
