Microphthalmia syndrome is a congenital genetic disorder. As the name implies, the patient’s eyelids are small and short. It is characterized by a series of eyelid facial developmental abnormalities such as marked bilateral ptosis, narrow lid fissures, reversed medial canthus, widened medial canthus distance, low nasal bridge, and possibly lid dysplasia. This makes the eyes look like small shrimp skin. Many children with small lids often hold their heads in a tilted position so that they can see through the tiny slits in their eyes. This is a true case of “small squinting eyes”. If a child is unfortunate enough to have microphthalmia, it can seriously affect their appearance and vision development, as well as their mental health, making it easy for them to develop low self-esteem. Surgery for microphthalmia is not simply cosmetic, it is also important to help children open their eyes and develop better vision. Parents must recognize this and not say that they will have a cosmetic surgery when their child grows up and needs to go into society. If they miss the critical period of vision development and form amblyopia, they will not be able to make up for it with treatment as an adult. Nowadays, people are gradually paying attention to the importance of children’s mental health, and surgical correction before the child enters nursery school is also beneficial to improve the child’s self-confidence. Generally speaking, surgery can be performed around the age of 3. As technology has improved, the age of surgery for children is advancing, and the youngest child to undergo surgery in our department is currently 1 1/2 years old. Another important issue regarding microtia surgery is that the correction cannot be done all at once. It is easy to understand that since it is called “microtia syndrome”, this deformity is not caused by a single problem. The first surgery is usually an inner canthopexy to address the reverse canthus and the wide inner canthus, which is a lengthening of the eye in the direction of the inner corner of the eye. The child’s appearance has not changed significantly after this surgery. A second surgery to correct the ptosis of both eyes is usually performed several months later, after the inner canthus scar has softened. Because the surgery is more extensive, it needs to be performed on both eyes sequentially. After this surgery, most children will be able to open their round eyes and see like a normal child. A small number of children may also need an external canthopexy to further open the lid fissure. Some parents cannot understand why the surgery is done in steps and expect several problems to be solved together in one surgery. This is unrealistic. A single surgery can only open the lid in one direction, while taking advantage of the elasticity of the skin to leave room for the next surgery to open the lid in another direction. If a single surgery is performed to open the lid in different directions at the same time, the results are not guaranteed.