In view of demographic changes in the population pyramid age structure an increase in eyelid malpositions such as ectropion is likely to occur. The surgical correction of ectropion requires a detailed knowledge of anatomical and pathophysiological factors to be able to effectively evaluate changes of the anterior and posterior lamellae with shortening, weakness, dehiscence and paralytic components. The choice of surgical procedure considering the age of the patient, genesis and the exact localization of the pathological change is of utmost importance in order to achieve ideal cosmetic and functional results.