Technical StrategiesAdvancement Flap Using Excess Skin for Upper Eyelid Full-Thickness DefectsIto, Riri MD*; Maeda, Taku MD, PhD*; Yamamoto, Yuhei MD, PhD*; Funayama, Emi MD, PhD*; Murao, Naoki MD, PhD*; Osawa, Masayuki MD, PhD*; Ishikawa, Kosuke MD, PhD*; Ikeda, Masaki MD, PhD†; Hayashi, Toshihiko MD, DDS*Author Information *Faculty of Medicine and Graduate School of Medicine, Department of Plastic and Reconstructive Surgery, Hokkaido University, Sapporo †Department of Plastic and Reconstructive Surgery, Kushiro Rosai Hospital, Kushiro, Japan. Address correspondence and reprint requests to Toshihiko Hayashi, MD, DDS, Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan; E-mail: firstname.lastname@example.org Received 1 June, 2019 Accepted 13 August, 2019 The authors report no conflicts of interest. Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jcraniofacialsurgery.com). Journal of Craniofacial Surgery: November-December 2019 - Volume 30 - Issue 8 - p 2614-2616 doi: 10.1097/SCS.0000000000005944 Buy SDC Metrics Abstract Reconstruction of upper eyelid defects should aim for a moveable lid with perfect corneal protection and good aesthetic quality. Numerous procedures to reconstruct large upper eyelid defects have been reported, but these methods require 2-stage procedures. A new method for reconstructing full-thickness upper eyelid defects after tumor excision in a single stage was presented in this study. The preferred technique uses excess skin as an advancement flap together with an ear cartilage graft for the lining. Reconstruction was performed with an advancement flap using excess skin and ear cartilage for full-thickness defects after upper eyelid tumor excision. The rectangular flap was outlined on the excess skin of the upper eyelid. After tumor resection of the full-thickness defect, the ear cartilage was sutured to the remaining tarsus. The residual levator aponeurosis and posterior lamellar were connected to the transplanted ear cartilage. The outer layer was reconstructed with an advancement rectangular flap. The authors performed this technique for 4 patients, aged 62 to 88 years, for upper eyelid reconstruction. Good functional and aesthetic results were achieved for all patients. Our method involves a single-stage reconstruction, which is simpler and less invasive than other techniques. © 2019 by Mutaz B. Habal, MD.