A myriad of soft tissue problems accompany patients with TCS such as colobomata of the lower eyelid with canthal malposition, lateral facial clefts or grooves, malar soft tissue deficiency.
These can be managed with a combination of dermal fat grafts, fat grafts by injections, canthopexy and a variety of lid reconstructions such as z-plasty, upper to lower eyelid transposition flaps etc.