The authors present a prospective study of a one-stage technique for managing both telecanthus and ptosis seen in blepharophimosis syndrome. The technique involves carrying out a Y to V medial canthoplasty followed by a frontalis suspension which the authors carry out using Tutopatch which is irradiated bovine pericardium. They carried out the technique on 12 eyes of six patients. It was a young group of patients (median age 14 months) and all were deemed to be at risk of amblyopia with superior margin reflex distances varying between -1mm and +1mm. The results showed a statistically significant change in margin reflex distance (MRD), inner intercanthal distance (IICD) and horizontal fissure length (HFL). The clinical change in MRD was approximately 2mm, IICD 6.5mm and HFL 3mm. No unexpected complications were encountered with 33% of patients having temporary lagophthalmos. The paper is supportive of correcting the ptosis and telecanthus seen in blepharophimosis patients in one rather than two stages.