J.R.O. Various techniques have been described in the literature for eyelid reconstruction. Ectropion Lower Eyelid Reconstruction. Ectropion Ectropion is an eye condition in which the eyelid turns outward. Methods: A retrospective review of patients who underwent lower lid reconstruction performed by a single surgeon was performed. Before (left) 56-year-old male with large eyelid defect following eyelid basal cell carcinoma removal. In case of lower eyelid reconstruction after segmented tissue loss, the Mustardé principles of the quarters are applied [7], so that depending on skin laxity, a defect of less than a quarter of the eyelid (or even a third of the eyelid in old patients) can be directly sutured (Fig. An irritated eye will have blurry vision, pain, tearing and ultimately will have scarring of the cornea which can cause permanent vision loss. Frozen section. 2. Orbicularis muscle mobilisation in eyelid reconstruction. References. Facial Plast Surg Clin N Am. Arch Ophthalmol 1986; 104:910-4 Codner MA, McCord CD, Mejia JD, Lalonde D. Upper and lower eyelid reconstructions. 2016;24:183–91. 2019 Mar 12; [PubMed PMID: 30882581] Goddard L,Chesnut C, Simultaneous Lateral Tarsal Strip and Medial Spindle Procedures for Cicatricial Ectropion. This area is also aesthetically important; therefore, operations should be carried out with caution. Removal of an eyelid tumor without checking margins has a lower cure rate and is not generally performed. Czyz CN, Cahill KV, Foster JA, Michels KS, Clark CM, Rich NE. The Journal of craniofacial surgery. After (right) 3 months after total left lower eyelid reconstruction, retraction surgery, with skin graft. Anatomy Eyelid is traditionally described as a bilaminar structure. 14. Eyelid tumor excision and trauma are 2 common causes of eyelid defects requiring surgical reconstruction. 2: Lower eyelid reconstruction: (A, B): pre-operative and (C, D, E): 6 months post-operative. Code all procedures. Highly practical eyelid surgery resource informs important reconstruction decisions and strategies . The lower eyelid blepharoplasty is a very safe procedure. This emphasizes key points in reconstruction—the upper eyelid must remain mobile by replacing deficient tissue and having thin tissue that does not restrict that mobility. 5 Lower Eyelid Reconstruction 6 Upper Eyelid Reconstruction 7 Lateral Canthal Eyelid Reconstruction 8 Eyelid Reconstruction following Trauma. The authors propose a new classification system that includes the vertical defect component to predict functional and aesthetic outcomes. Case Report A 60 years old female presented with black colour lesion over right lower eye lid which was slowly increasing in size for the last six months. Collin, Manual of systematic eyelid surgery, 3rd … Reconstruction of the lower eyelid anterior lamella is done using a skin-muscle advancement flap, local skin, or free full-thickness skin graft. Plastic and reconstructive Surgery 2. Defects of the lower eyelid can be divided into those that involve the eyelid margin, and those that do not. Like the lower eyelid, both the anterior… Small defect. Upper Eyelid Reconstruction Michael K. Yoon Summary The upper eyelid provides the majority of total eyelid movement with eyelid closure and a blink. The reconstruction of defects in the lower eyelid region is prone to complications such as ectropion and epiphora. The technique of upper eyelid reconstruction with a free tarsal graft and a cutaneous lower eyelid advancement flap divided at 2 weeks is described. The team at Consultants in Ophthalmic & Facial Plastic Surgery utilizes a variety of surgical techniques to obtain the best results. Plast Reconstr Surg 2010; 126:231e-45e. Last Updated on Mon, 07 Dec 2020 | Opthalmology. Upper and lower eyelid reconstruction: the year in review Curr Opin Otolaryngol Head Neck Surg. 2011 Jan;25(1):67–74. Poon JS,Vahdani K,Thaller VT, Comparison of four Combined Procedures for Correction of Involutional Lower Eyelid Entropion. If it is needed, one can perform an inferior or superior cantholysis to mobilize the lateral eyelid margin 3 to 5 mm. Lower eyelid reconstruction. J Plast Reconstr Aesthetic Surg JPRAS 2007 ; 60 : 256-9. Her dermatologist knew she was in the public eye and wanted the optimal aesthetic and functional result. Lower eyelid reconstruction with pericranium graft and Mustarde flap Reconstrucción de párpado inferior mediante injerto de pericráneo y colgajo de Mustardé ☆ Author links open overlay panel N. Ibáñez-Flores C. Bruzual-Lezama J.J. Castellar-Cerpa L. Fernández-Montalvo Reconstructive options for the medial canthus and eyelids following tumor excision. Other types of cancers and trauma may also lead to lower eyelid defects. Four cases were involved in lower eyelid reconstruction, two in upper and two in both. reconstruction of the right lateral canthal tendon secondary to lateral canthal tendon laxity on the right side. The second goal of reconstruction of the eyelid is to make an eyelid that covers the eye. 1 The article reports a retrospective review of outcomes for lower eyelid reconstruction with consideration of vertical dimension.This study indicates significantly higher rates … Summary Normal eyelid structure and function is critical for ocular protection. If you are experiencing concerns such as Graves’ eye disease, pulling down of lower eyelids, severely drooping eyelid skin, excessive tearing, orbital fractures, or even eye socket asymmetries following the loss of an eye, we encourage you to read through the sections provided below and/or contact our office today to schedule a consultation. Multiple aesthetic subunits coalesce in the periocular region. Lower Eyelid Reconstruction Dr. Suiyibangbe M.Ch. Anterior lamella-skin and orbicularis muscle. Lower eyelid reconstruction. Ueda K, Oba S, Okada M et al. Saudi J Ophthalmol. It may be beneficial to work with a … Fig. Ann Chir Plast Esthét 2007 ; 52 : 62-7. To perform safely, I recommend mild sedation or general anesthesia. After (right) reconstruction surgery using multiple flaps for natural-looking results and preserved function. Here we report a case of lower eyelid BCC where total surgical excision was combined with primary reconstruction of lower eyelid with good functional and cosmetic outcome. lower eyelid reconstruction with opening of the tarsoconjunctival flap and . Personnel. Eyelid reconstruction, although not as involved as for cancer or trauma, can also come into play with conditions such as droopy eyelids or entropion/ectropion. Thick split grafts are often used for the upper eyelids, since this is a more mobile unit [1-4]. Eyelid reconstruction with a composite radial forearm palmaris longus tendon flap. 3. Fujiwara M. Upper eyelid reconstruction with a hard palate mucosa-lined bipedicled myocutaneous flap. It typically affects the lower eyelid, exposing the inner lid in either one section of eye or across the entire lid. Close. Lower eyelid defect repair algorithms vary based on the size and location of the defect. Background: Lower eyelid defects are traditionally classified based on depth and 25 percent increments in defect width. Eyelid Cancer/MOHS Reconstruction. Blepharoptosis (Droopy Eyelid) Tearing & Lacrimal Tear Duct Surgery; Eyelid Malposition Menu Toggle. 2019;144:443–455). An eyelid defect of 25% or less may be closed directly. All tumor excisions with their adequate security margins were completed by frozen section analysis. Lower eyelid reconstruction using upper eyelid muscular-cutaneous flap with external pedicle and chondro-mucous nasal graft and full thickness retro-auricular skin graft placed inferior to the lower lid - A. Preoperative aspect; B. Intraoperative aspect - complete excision; C. Postoperative aspect - moderate impairment of the eyelid function with temporary oedema. 2nd year. O’Donnell BA, Mannor GE. Reconstruction of the posterior lamella was always performed using a palatal mucosal graft which size exceeded about 10% the defect size, vertically and transversally. Product Description . Defects involving the eyelid margin a) Small defects. Since most eyelid cancer can be cured by excision alone, radiation and chemotherapy are usually reserved for very special circumstances. There are various techniques available for lower eyelid reconstruction, and these depend on the of the size of the defect as well as patient-specific factors. A small defect encompasses less than one-third of the lower eyelid and can usually be repaired by primary closure. 1). This will be for a basal cell, lower right eyelid, The reconstruction surgeon said most likely I will not be a candidate for just the sew together procedure. PubMed Google Scholar. [1] [3] Traditionally, the second stage of the procedure, severance of the flap, occurred 3 to 4 months after the initial stage. It usually occurs in older adults as a result of … Lower Eyelid Reconstruction Read More »