Reconstruction of the total lower eyelid defect — useful modifications

Various techniques have been used for reconstruction of extensive lower eyelid defects, but it is difficult to achieve results which are satisfactory, both from a functional and cosmetic viewpoint. In the past three years, ten patients have been reconstructed using a cheek flap over a chondromucosal graft, after extensive resection of lower eyelid tumors. As a modification of the classic method, the dermal layer of the cheek flap was sutured to the inferior orbital rim to prevent late sagging and ectropion. In addition, a tie-over pressure dressing on the inner aspect of the lid was used to give good contact between the chondromucosal graft and the flap. At a one year follow-up, the results were judged to be good, both aesthetically and functionally.