Traditional methods of paralytic ectropion repair fail to elevate the medial lower lid and inferior punctum into the proper position. That deficiency does not exist with relatively simple, time-proven technique we have described. A lazy trapezoidal-shaped cartilage graft attached to a fascial sling restored the lost tone and medial lid posture, thrusting the punctum back into its normal and properly functioning position. The operation takes its name from Diamond Head crater in Waikiki, Hawaii, whose silhouette resembles the required cartilage graft responsible for the correction.