eMedicine Specialties > Plastic Surgery > Eyelids

Eyelid Reconstruction, Lower Eyelid: Multimedia

Author: Mounir Bashour, MD, CM, FRCS(C), PhD, FACS, Assistant Professor of Ophthalmology, McGill University; Clinical Assistant Professor of Ophthalmology, Sherbrooke University; Medical Director, Cornea Laser and Lasik MD
Contributor Information and Disclosures

Updated: Jan 31, 2008

Multimedia

Direct layered closure of a lid margin defect, sh...
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Media file 1: Direct layered closure of a lid margin defect, showing placement of tarsal sutures. A - Posterior lid margin; B - Gray line; C - Anterior lid margin.
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Direct layered closure of a lid margin defect, sh...

Direct layered closure of a lid margin defect, showing placement of tarsal sutures. A - Posterior lid margin; B - Gray line; C - Anterior lid margin.

Tenzel rotation flap with steps outlined.
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Media file 2: Tenzel rotation flap with steps outlined.
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Tenzel rotation flap with steps outlined.

Tenzel rotation flap with steps outlined.

A - A shallow defect involving almost the whole l...
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Media file 3: A - A shallow defect involving almost the whole lower lid appropriate for closure using a modified Hughes flap. B - Preparing the Hughes tarsoconjunctival flap undermining the levator to the superior fornix and leaving at least 4 mm of tarsus for lid stability.
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A - A shallow defect involving almost the whole l...

A - A shallow defect involving almost the whole lower lid appropriate for closure using a modified Hughes flap. B - Preparing the Hughes tarsoconjunctival flap undermining the levator to the superior fornix and leaving at least 4 mm of tarsus for lid stability.

The flap is advanced and the upper tarsus sutured...
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Media file 4: The flap is advanced and the upper tarsus sutured to the lower lid conjunctiva and lower tarsus as shown in detail in A.
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The flap is advanced and the upper tarsus sutured...

The flap is advanced and the upper tarsus sutured to the lower lid conjunctiva and lower tarsus as shown in detail in A.

Mustarde rotational cheek flap.
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Media file 5: Mustarde rotational cheek flap.
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Mustarde rotational cheek flap.

Mustarde rotational cheek flap.

More on Eyelid Reconstruction, Lower Eyelid

Overview: Eyelid Reconstruction, Lower Eyelid
Workup: Eyelid Reconstruction, Lower Eyelid
Treatment: Eyelid Reconstruction, Lower Eyelid
Follow-up: Eyelid Reconstruction, Lower Eyelid
Multimedia: Eyelid Reconstruction, Lower Eyelid
References
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References

  1. Codner MA, Weinfeld AB. Pr47 comprehensive eyelid reconstruction. ANZ J Surg. May 2007;77 Suppl 1:A71. [Medline].

  2. Erdogmus S, Govsa F. The arterial anatomy of the eyelid: importance for reconstructive and aesthetic surgery. J Plast Reconstr Aesthet Surg. 2007;60(3):241-5. [Medline].

  3. Ambrozová J, Mesták J, Smutková J. Reconstruction of the lower eyelid after excision of major tumours. Acta Chir Plast. 1993;35(3-4):131-45. [Medline].

  4. Bartley GB, Putterman AM. A minor modification of the Hughes' operation for lower eyelid reconstruction. Am J Ophthalmol. Jan 1995;119(1):96-7. [Medline].

  5. Beyer CK, Bathrick ME. One-stage lower eyelid reconstruction. Ophthalmic Surg. Jul 1982;13(7):551-4. [Medline].

  6. Boynton JR. Semicircle flap reconstruction "plus". Ophthalmic Surg. Dec 1993;24(12):826-30. [Medline].

  7. Chandler DB, Gausas RE. Lower eyelid reconstruction. Otolaryngol Clin North Am. Oct 2005;38(5):1033-42. [Medline].

  8. Cohen MS, Shorr N. Eyelid reconstruction with hard palate mucosa grafts. Ophthal Plast Reconstr Surg. 1992;8(3):183-95. [Medline].

  9. Crestinu JM. Reconstruction of the lower eyelid. Plast Reconstr Surg. Oct 1988;82(4):720. [Medline].

  10. Custer PL. Tarsal kinking after Hughes flap. Ophthal Plast Reconstr Surg. Sep 1998;14(5):349-51. [Medline].

  11. Glatt HJ. Tarsoconjunctival flap supplementation: an approach to the reconstruction of large lower eyelid defects. Ophthal Plast Reconstr Surg. Jun 1997;13(2):90-7. [Medline].

  12. Hatoko M, Kuwahara M, Shiba A, Tanaka A, Tada H, Okazaki T. Reconstruction of full-thickness lower eyelid defects using a blepharoplasty technique with a hard palate mucosal graft. Ann Plast Surg. Jun 1999;42(6):688-92. [Medline].

  13. Holds JB, Anderson RL. Medial canthotomy and cantholysis in eyelid reconstruction. Am J Ophthalmol. Aug 15 1993;116(2):218-23. [Medline].

  14. Iliff CE, Iliff NT. Partial and total reconstruction of the lower eyelid. Ophthalmology. Apr 1980;87(4):272-8. [Medline].

  15. Jordan DR, Anderson RL, Holds JB. Modifications to the semicircular flap technique in eyelid reconstruction. Can J Ophthalmol. Apr 1992;27(3):130-6. [Medline].

  16. Leone CR Jr. Periosteal flap for lower eyelid reconstruction. Am J Ophthalmol. Oct 15 1992;114(4):513-4. [Medline].

  17. Lowry JC, Bartley GB, Garrity JA. The role of second-intention healing in periocular reconstruction. Ophthal Plast Reconstr Surg. Sep 1997;13(3):174-88. [Medline].

  18. Matsuo K, Sakaguchi Y, Kiyono M, Hataya Y, Hirose T. Lid margin reconstruction with an orbicularis oculi musculocutaneous advancement flap and a conchal cartilage graft. Plast Reconstr Surg. Jan 1991;87(1):142-5. [Medline].

  19. McCord CD, Nunery WR, Tanenbaum. Reconstruction of the lower eyelid and outer canthus. Oculoplastic Surgery. 1995;119-44.

  20. Mehta HK. Simultaneous spontaneous and primary surgical repair of eyelids. Br J Ophthalmol. Jul 1989;73(7):488-93. [Medline].

  21. Miller EA, Boynton JR. Complications of eyelid reconstruction using a semicircular flap. Ophthalmic Surg. Nov 1987;18(11):807-10. [Medline].

  22. Papp C, Maurer H, Geroldinger E. Lower eyelid reconstruction with the upper eyelid rotation flap. Plast Reconstr Surg. Sep 1990;86(3):563-5; discussion 566-8. [Medline].

  23. Rohrich RJ, Zbar RI. The evolution of the Hughes tarsoconjunctival flap for the lower eyelid reconstruction. Plast Reconstr Surg. Aug 1999;104(2):518-22; quiz 523; discussion 524-6. [Medline].

  24. Steinkogler FJ. Reconstruction of the lower lid. Br J Ophthalmol. Jul 1984;68(7):507-10. [Medline].

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Further Reading

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Keywords

eyelid reconstruction, lower eyelid reconstruction, Tenzel flap, Tenzel semicircular rotation flap, tarsoconjunctival bridge flap, modified Hughes procedure, modified Hughes flap, free tarsoconjunctival graft, Mustarde cheek rotation flap, free tarsoconjunctival graft, eyelid tumor, eyelid malignancy, eyelid trauma, eyelid defects, eyelid surgery, basal cell carcinoma, BCC, squamous cell carcinoma, SCC, sebaceous cell carcinoma, SebCC, cutaneous melanoma

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Contributor Information and Disclosures

Author

Mounir Bashour, MD, CM, FRCS(C), PhD, FACS, Assistant Professor of Ophthalmology, McGill University; Clinical Assistant Professor of Ophthalmology, Sherbrooke University; Medical Director, Cornea Laser and Lasik MD
Mounir Bashour, MD, CM, FRCS(C), PhD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American College of International Physicians, American College of Surgeons, American Medical Association, American Society of Cataract and Refractive Surgery, American Society of Mechanical Engineers, American Society of Ophthalmic Plastic and Reconstructive Surgery, Biomedical Engineering Society, Canadian Medical Association, Canadian Ophthalmological Society, Contact Lens Association of Ophthalmologists, International College of Surgeons US Section, Ontario Medical Association, Quebec Medical Association, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Medical Editor

Neal R Reisman, MD, JD, Associate Chief, Department of Plastic Surgery, Clinical Associate Professor, St Luke's Episcopal Hospital, Baylor College of Medicine
Neal R Reisman, MD, JD is a member of the following medical societies: American Association of Plastic Surgeons, American College of Medical Quality, American College of Surgeons, American Society for Aesthetic Plastic Surgery, American Society for Surgery of the Hand, Lipoplasty Society of North America, Texas Medical Association, and Texas Society of Plastic Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Practice Director, Colorado Plastic Surgery Center at Swedish Medical Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Lars M Vistnes, MD, FRCSC, FACS, Professor of Surgery, Emeritus, Stanford University Medical Center
Lars M Vistnes, MD, FRCSC, FACS is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

 
 
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