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Figure 1.

Replacement of sutures corrects nasal under-rotation.

A) An immediate post-operative photograph of a participant with under-rotation of the nasal aspect of the upper eyelid margin fragment; B) the same eyelid after replacement of the rotating sutures; C) the same eyelid at the 6-week visit without recurrence (the lashes seen nasally are from the lower eyelid).

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Figure 2.

Replacement of sutures corrects eyelid margin over-rotation.

A) An immediate post-operative photograph of a participant with over-rotation of the eyelid margin fragment; B) The same eyelid after replacement of the rotating sutures; C) the same eyelid at the 6-week visit with a mild ECA.

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Table 1.

Eyelid contour abnormality definitions.

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Figure 3.

Immediate post-operative photographs used to correctly predict recurrence.

Immediate post-operative photographs in 6 participants used to correctly predict A–B) nasal, C–D) central, and E–F) temporal recurrence at 6-weeks post-operatively. Arrows show area of under-rotation and subsequent recurrence.

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Table 2.

Comparison of predicted versus true recurrence at 6 weeks post-operatively.

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Table 3.

Comparison of predicted versus true location of recurrence at 6 weeks post-operatively.

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Figure 4.

Immediate post-operative photographs used to correctly predict eyelid contour abnormalities (ECAs).

A, C) Immediate post-operative photographs in 2 participants that were used to correctly predict ECAs in the corresponding 6-week photographs, (B) moderate ECA and (D) severe ECA.

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Table 4.

Comparison of predicted versus true eyelid contour abnormality (ECA) at 6 weeks post-operatively.

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Table 5.

Comparison of predicted versus true eyelid contour abnormality (ECA) at 6 weeks post-operatively.

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Figure 5.

Surgical Photocard, side A, to assist surgical technicians with immediate post-operative assessment.

Surgical Photocard, side A showing the immediate post-operative photographs of 4 participants without recurrence and normal contours at 6 weeks. This degree of “slight over-correction” likely represents the ideal immediate post-operative appearance to minimize both recurrence and ECAs.

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Figure 6.

Surgical Photocard, side B, to assist surgical technicians in assessing and modifying the immediate post-operative eyelid position.

Surgical Photocard, side B showing (upper left) a participant with immediate post-operative over-rotation and (upper right) the resulting severe ECA at 6 weeks and instructions as to how to improve the over-rotation; and (lower left) a participant with immediate post-operative under-rotation and (lower right) the resulting nasal recurrence at 6 weeks and instructions as to how to improve the under-rotation.

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