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Total Upper and Lower Eyelid Reconstruction

A Rare Procedure—A Report of Two Cases

Bertrand, Baptiste M.D.; Colson, Thomas Roger Jr.; Baptista, Claire M.D.; Georgiou, Charalambos M.D.; Philandrianos, Cécile M.D., Ph.D.; Degardin, Nathalie M.D., Ph.D.; Bardot, Jacques M.D.; Casanova, Dominique M.D.

Plastic and Reconstructive Surgery: October 2015 - Volume 136 - Issue 4 - p 855–859
doi: 10.1097/PRS.0000000000001600
Reconstructive: Head and Neck: Ideas and Innovations
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Coding Perspective

Summary: Reconstruction after total amputation of the upper and lower eyelids with preserved globe is rare. The primary goal is immediate corneal protection. The second goal is to restore mobility, occlusion, and facial symmetry. Two women had full-thickness excision of both upper and lower eyelids to treat a melanoma. The reconstruction method required four steps over a period of 5 months. A buccal mucosal graft was used to recreate the conjunctival lining, and an oblique forehead flap was used to recreate the skin. Resection of the flap and replacement by a full-thickness skin graft made it possible to recreate a thin and mobile upper eyelid. Visual acuity remained unchanged, and the eyelids remained functional despite a degree of ptosis and lower eyelid retraction.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

Coding Perspective for this Article is on Page 858.

Marseille and Nice, France

From the Department of Plastic Surgery, La Conception Hospital, the Department of Plastic Surgery, North Hospital, and the Department of Pediatric Plastic Surgery, La Timone Hospital, Assitance Public-Hôpitaux de Marseille, Aix-Marseille Université; and the Department of Plastic Surgery, St. Roch Hospital.

Received for publication January 19, 2015; accepted April 8, 2015.

Presented at the 59th Meeting of the French Society of Plastic Reconstructive and Aesthetic Surgery, in Marseille and Nice, France, March 29, 2014.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

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Baptiste Bertrand, M.D., Department of Plastic Surgery, La Conception Hospital, 147 Boulevard Baille, 13005 Marseille, France, baptiste.bertrand@gmail.com

©2015American Society of Plastic Surgeons