Two years after facial palsy, the lower lid was ectropioned in the sitting position, especially when the eyes were looking up, and the closure was incomplete. Because of the discomfort, surgery was performed to correct the problem. The procedure was as follows: local anesthesia (to allow for intraoperative observation in the sitting position, as the degree of lower lid ectropion varies greatly between the sitting and lying positions). A 2 mm horizontal incision is made below the lower lid margin, the orbicularis muscle is separated, and the lower lid retractor muscle is disconnected and the lower lid margin is immediately lifted and repositioned (the orbicularis muscle is weak after facial palsy, so its antagonist should be weakened). The lower lid margin is horizontally amputated by 5 mm at the outer end of the lower lid to strengthen the horizontal tension of the lower lid (the extent of amputation depends on the degree of laxity of the eyelid). The orbital septum is opened and the naturally emerging fat is removed (without excessive removal of fat, as the orbital fat tissue has a supportive effect on the lower lid) and compression is applied to stop the bleeding (without electrocoagulation as much as possible, to reduce the force of later tissue contracture pulling downward); the orbital septum is closed with 3 interrupted stitches of 6-0 absorbable suture, and the fat does not come back out and the inferior orbital area is flattened. The orbicularis oculi muscle was separated and sutured laterally to the outer orbital rim (to further strengthen the horizontal tension of the lower lid). The patient was seated and observed that the lower eyelid was well positioned against the eye with complete closure, so the patient could be made to lie down and continue the procedure. The lateral skin lengthening incision is made along the original incision at the lateral canthus, extending the lateral skin of the lower lid outward, tightening and flattening it horizontally, making a triangular excision of the excess skin, and closing the skin incision with interrupted sutures. Antibiotic eye ointment was applied to the operated eye and pressure bandages were applied.