Lower eyelid malpositions and ocular damage occur with inadequate reconstru
ctions of facial defects that encroach on the periocular region. Reconstruc
tive principles and techniques are presented that are essential in the prev
ention of ectropion in these situations. Eyelid and periocular anatomy is r
eviewed. The use of canthalplasties, canalicular reconstruction, and ancill
ary techniques for facial flaps are presented.