Concierge oculoplastics · UK
Entropion and ectropion repair, by a consultant oculoplastic surgeon.
A proper day-case lid operation — matched to the cause, done under LA with light sedation in a licensed theatre, and followed through until the lid sits exactly where it should.
Why patients choose us
- 01
A consultant oculoplastic surgeon, in theatre
Not a general ophthalmology list. A named oculoplastic specialist, a proper day-case theatre, and the anaesthetic that suits you.
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The right operation for the right lid
Involutional, cicatricial, paralytic or congenital — we match the technique to the cause, not the other way around.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private entropion or ectropion repair costs in the UK.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A lateral tarsal strip in our network: £2,200–£3,800 per lid, home the same day.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Entropion repair — lateral tarsal strip + retractor reattachment | £2,400–£3,800 | 45–60 min | Same visit |
| Ectropion repair — lateral tarsal strip | £2,200–£3,600 | 45 min | Same visit |
| Medial spindle for punctal ectropion | £1,800–£2,800 | 30 min | Same visit |
| Cicatricial ectropion — full-thickness skin graft | £3,200–£5,000 | 60–90 min | Same visit |
| Paralytic ectropion — tarsal strip + midface lift or tarsorrhaphy | £3,000–£5,500 | 60–90 min | Same visit |
| Quickert sutures (temporary entropion) | £900–£1,600 | 20 min LA | Same visit |
| Bilateral procedure surcharge | +£800–£1,400 | +30 min | Same visit |
| Consultation only | £200–£400 | 30 min | Same visit |
Prices vary by clinic, by the oculoplastic surgeon, by the technique needed (a straightforward tarsal strip vs a cicatricial case with a graft), and by whether one or both lids are done at the same visit. We come back with a firm quote within one working day.
The problem
Symptoms, examination, and the medical bridge before surgery.
Entropion feels gritty and looks red; ectropion waters and looks droopy. The examination and the medical bridge look the same either way — and both matter.
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Entropion — the lid turns inward
Foreign-body sensation, watering, redness, corneal abrasion. The lower lashes are visibly rubbing the eye when you look up.
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Ectropion — the lid turns outward
Constant watering, exposure and dryness, a red beefy inner lid, and a visible droop of the lower lid away from the eye.
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The examination
Snap-back test, lid distraction (>6 mm is lax), orbicularis tone, canthal tendon laxity, and — for cicatricial cases — vertical shortening of the anterior or posterior lamella.
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Lubricants and taping
Preservative-free drops through the day, Lacrilube overnight, and lid taping at night hold the position while surgery is arranged.
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Botox for spastic entropion
A tiny amount of botulinum toxin into the orbicularis relaxes the squeeze — a useful bridge, and sometimes definitive in short-lived cases.
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Tarsorrhaphy for the high-risk cornea
When the cornea is at real risk — paralytic ectropion with exposure — a partial temporary tarsorrhaphy protects vision until definitive repair.
The journey
From enquiry to recovery — what happens, in order.
One clinician from first message to review — including the six-to-twelve-week window while the lid position matures.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Which lid, how long, whether the eye is watering, sore or the lashes are rubbing.
- 02
Before
We come back with a recommendation
Within one working day: the right technique, the right anaesthetic, and an indicative price. If lubricants and taping are enough for now, we say so.
- 03
Before
We arrange the appointment
Usually within one to two weeks. Any blood-thinning medication is reviewed with the team and you are told exactly how to prepare.
- 04
On the day
Arrival at the clinic
Arrival, consent and a chat with the surgeon. Local anaesthetic with a small amount of IV sedation is the usual choice.
- 05
On the day
The procedure itself
30 to 60 minutes per lid in a proper day-case theatre. Fine sutures, careful haemostasis, a light dressing and often an ice pack.
- 06
On the day
Home the same day
A short recovery, written aftercare, chloramphenicol drops for a week and Lacrilube overnight. Home within a few hours.
- 07
After
Recovery and review
Bruising settles over one to two weeks. The lid position matures over six to twelve weeks. A review is arranged at four to six weeks.
Typical end-to-end: 2–3 weeks from enquiry to procedure. Full lid maturation: 6–12 weeks.
When it helps
When lid repair is the right step.
The five clinical categories we see, plus the one red flag that means an emergency rather than an appointment.
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Involutional entropion
Age-related lid laxity turns the lower lid inward — lashes rub the cornea, causing gritty pain, watering and redness.
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Involutional ectropion
The commonest ectropion — the lid falls outward, the eye waters constantly and the exposed conjunctiva reddens.
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Cicatricial entropion or ectropion
Scarring from burns, trauma, chronic blepharitis or previous surgery shortens the lamella and pulls the lid the wrong way.
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Paralytic ectropion (facial palsy)
A weak orbicularis after Bell’s palsy or stroke lets the lower lid sag, exposing the cornea and drying it out.
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Mechanical ectropion
A tumour, cyst or oedema weighs the lid down and pulls it away from the eye.
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Spastic entropion
Squeezing the eye shut after surgery or with ocular irritation forces the lid inward — often responds to botox as a bridge.
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Congenital entropion or epiblepharon
A folded lower lid margin in a child — the lashes rub the cornea and surgical correction is needed if symptoms persist.
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Red flag: corneal ulcer or sudden vision loss
A painful red eye with blurred vision, a white spot on the cornea or sudden visual loss is an emergency — same-day eye casualty, not a clinic booking.
Procedure options
The technique is matched to the cause.
For entropion — Quickert sutures, Wies tarsotomy or (the workhorse) a lateral tarsal strip with retractor reattachment. For ectropion — tarsal strip, medial spindle, skin graft, or a midface lift or tarsorrhaphy in facial palsy.
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Lateral tarsal strip
The workhorse for both entropion and ectropion — the lid is tightened at the outer canthus (Jones technique) to correct laxity.
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Retractor reattachment (Jones)
Added to a tarsal strip for involutional entropion — the lower lid retractors are re-anchored so the lid sits flat.
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Quickert everting sutures
Three transverse sutures that turn the lid outward — quick, done under LA, but temporary. Useful as a bridge.
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Wies transverse tarsotomy
A full-thickness cut across the tarsus with everting sutures — a reliable option for cicatricial entropion.
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Medial spindle
A small diamond of conjunctiva excised near the punctum — corrects punctal ectropion so tears drain properly.
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Full-thickness skin graft
For cicatricial ectropion — a graft (usually from behind the ear) lengthens the anterior lamella and lets the lid sit back.
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Hard palate mucosa graft
For posterior lamellar shortening — a small graft from the roof of the mouth rebuilds the inner lining of the lid.
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Midface lift or tarsorrhaphy
Added to a tarsal strip in paralytic ectropion — support from below, or a partial lid closure, protects the exposed cornea.
Our vetted UK network
A small panel of oculoplastic surgeons, we picked them.
Consultant oculoplastic surgeons across central, north, west and south London and key regional cities. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every oculoplastic surgeon in our network.
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Consultant oculoplastic surgeons on the RCOphth specialist register
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BOPSS-affiliated practice with a dedicated oculoplastic day-case list
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LA with anaesthetist-led sedation available, GA if preferred
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Cicatricial and paralytic cases handled in-house, not referred on
Safety and recovery
What to expect afterwards — honestly.
Lid repair is common and safe. The things worth planning are the drops, the no-rubbing window, and knowing what is normal after.
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Local anaesthetic with light sedation is usual
Most lid surgery is done awake with the area fully numb and a small amount of IV sedation. GA is available but rarely needed.
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Bruising and swelling for one to two weeks
A black eye is normal and settles quickly with ice. Vision may be blurry from the ointment for a day or two.
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Drops and ointment for a week
Chloramphenicol drops four times a day for a week, and Lacrilube ointment overnight until the lid is comfortable.
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No rubbing for two weeks
Rubbing is the commonest cause of the sutures giving way. Sunglasses outdoors help stop you touching the eye.
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Driving next day, gym at two weeks
Most people drive the following day and are back at desk work within 48 hours. Heavy exercise waits a fortnight.
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Cosmesis matures over six to twelve weeks
The lid looks tight and slightly high at first, then settles into its final position over one to three months.
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Recurrence in five to fifteen per cent
Involutional cases have the lowest recurrence; cicatricial and paralytic cases have higher rates and may need a second procedure.
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Uncommon complications
Over- or under-correction, infection, bleeding, corneal exposure, granuloma, ptosis and — in cicatricial cases — symblepharon are all possible but uncommon.
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Red flags
Severe pain, sudden vision loss, a white spot on the cornea, spreading redness or heavy bleeding after surgery are not normal — call the clinic or eye casualty the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Oculoplastic language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Diagnosis and cause
Which lid, entropion or ectropion, and the underlying cause — involutional, cicatricial, paralytic, mechanical or congenital.
- 02 Technique
Anaesthetic and surgical technique
LA with sedation or GA, and the exact combination performed — tarsal strip, retractor reattachment, medial spindle, skin graft and so on.
- 03 Findings
Lid laxity, canthal tendon and cornea
Notes on the snap-back and distraction tests, canthal tendon integrity, and the state of the cornea before surgery.
- 04 Impression
Aftercare, drops and review timing
Read this first: drop regimen, when to stop the ointment, when to return, and what to watch for.
Recognised by major UK insurers
Cover for entropion and ectropion repair varies by insurer — usually funded when the eye is symptomatic or the cornea is at risk, self-pay for purely cosmetic cases. We confirm cover before booking.
Frequently asked
Everything we get asked about entropion and ectropion repair.
Quick answers on the difference between the two, the causes, cost, recovery and recurrence.
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What is the difference between entropion and ectropion?
Entropion is the lid turning inward, so the lashes rub the cornea — the eye feels gritty, waters and reddens. Ectropion is the lid turning outward, exposing the inner surface — the eye waters constantly, feels dry and looks droopy. Both are commonest in older adults and both are fixed with day-case surgery.
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What causes entropion or ectropion?
Most cases (involutional) are age-related lid laxity. Scarring from burns, trauma, blepharitis or previous surgery causes cicatricial disease. Facial nerve palsy causes paralytic ectropion. Tumours or cysts cause mechanical ectropion. A few children are born with congenital entropion or epiblepharon.
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Do I need surgery, or will drops be enough?
Lubricants, taping and Lacrilube overnight are a good bridge and sometimes enough on their own. Botox helps spastic entropion. But once the lashes are rubbing the cornea, or the eye is watering constantly, surgery is usually the definitive fix.
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How much does private entropion or ectropion repair cost in the UK?
Roughly £2,200–£3,800 per lid for the standard lateral tarsal strip operation, £1,800–£2,800 for a medial spindle, and £3,200–£5,500 for cicatricial or paralytic cases needing a graft or midface lift. Bilateral surgery adds £800–£1,400. We confirm firm figures within one working day.
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How is the operation done, and does it hurt?
Under local anaesthetic with a small amount of IV sedation, in a day-case theatre. You feel nothing during the operation — the lid is fully numb. Afterwards there is some soreness and bruising for a few days, easily controlled with paracetamol.
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How long is the recovery, and when can I drive?
Most people drive the next day and are back at desk work within 48 hours. Bruising settles over one to two weeks. Heavy exercise waits two weeks. The final lid position matures over six to twelve weeks.
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Will the entropion or ectropion come back?
Involutional cases have the lowest recurrence — around five to ten per cent over the years. Cicatricial and paralytic cases carry higher rates, closer to ten to fifteen per cent, and may need a second procedure. Your surgeon will tell you where you sit before you consent.
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When should I see A&E or eye casualty urgently?
A painful red eye with blurred vision, a white spot on the cornea, sudden vision loss, spreading redness after surgery, or heavy bleeding are all reasons to seek same-day emergency eye care.
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