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A Crossover Reconstruction Between the Forehead Expansion and Upper Eyelid Skin

Li, Haidong MD; Tao, Song MD; Zhenmin, Zhao MD

doi: 10.1097/SCS.0000000000002008
Brief Clinical Studies

Background: In cosmetic surgery, the authors have successfully used forehead expansion for reconstruction of the upper eyelid, and have found it to be indispensable for reconstruction of the upper eyelid. In such an operation, preserving the eyebrow is often a problem, and they suggest an approach in 2 stages, which allows us to both save the eyebrow and use the expander flap at the same time. In the last 6 years, they have performed 5 forehead expansions for total upper eyelid skin reconstruction, achieving very good aesthetic outcomes.

Methods: Firstly, the authors measure the defect and choose an appropriate expander implant for the forehead. Secondly, they cut out the pathologically changed—turned red or scarred—skin to protect the eyebrow. Next they get out the tissue expander and use the tissue flap to repair the upper eyelid defect, while the eyebrow is under the expander flap, covered by skin, which they originally cut from the upper eyelid. Three weeks later they can cut down the pedicel and the flap becomes the new upper eyelid skin.

Results: The authors find that the new upper eyelid skin may be vascularized by dermatological vessels from the expander flap. The forehead expander flap is reliable and particularly well suited for an upper eyelid, with numerous advantages. In this way, they make maximal use of the expander flap and no additional incision is needed.

Level of Evidence: Level IV, therapeutic study.

Plastic Surgery Hospital of the Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China.

Address correspondence and reprint requests to Zhao Zhenmin, MD, Plastic Surgery Hospital of the Chinese Academy of Medical Science and Peking Union Medical College, Ba-Da-Chu Road, Shi-Jing-Shan District, Beijing, 100041, People's Republic of China; E-mail:

Received 20 August, 2014

Accepted 25 May, 2015

The authors contributed equally to this study.

The authors report no conflicts of interest.

© 2015 by Mutaz B. Habal, MD.