Fig. 12. A. Secondary, bilateral medial canthopexy was performed on the patient in Figure 11 with transnasal wiring. In this case an “open-sky technique” was used and combined with scar revision. Bilateral dacryocystorhinostomy was also performed in the same setting to treat coexistent nasolacrimal duct obstruction. B. Postoperative appearance showing improved medial canthal position. Epiphora was also successfully relieved.