Fig. 12. A. A skin and muscle incision is made approximately 3 mm below the eyelid margin to the level of the tarsus. B. The eyelid is everted and a corresponding tarsal incision is made, thus creating a full-thickness eyelid incision. Extreme care should be taken not to interfere with the blood supply of the eyelid margin. C. Double-armed sutures are passed from the tarsal edge to the skin edge, thus connecting the skin margin to the tarsal edge. D. This effectively rotates the eyelid margin outward.