Six patients with malpositioned or surgically excised medial canthal tendons underwent repair with titanium microplate, and two patients underwent repair with titanium miniplate fixation. The T-shaped rigid fixation plates were chosen for medial canthal reconstruction to allow for stabilization of the plate along the anterior lacrimal crest and extension of the plate over the posterior lacrimal crest. The medial canthal tissue was reattached to the titanium plate with 3.0 polypropylene (Prolene) suture. This technique appears to be safer, faster, and, in many cases, more effective than traditional techniques for reconstruction of the medial canthus after tendon avulsion or loss from excision of cutaneous carcinoma.