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2026, Number 2

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Dermatología Cosmética, Médica y Quirúrgica 2026; 24 (2)

Eyelid reconstruction after resection of cutaneous carcinomas

Ortuz LC, Rangel ME, Rodríguez SMC, Amador ES, Díaz MVL, Vázquez GD

Language: Spanish
References: 46
Page: 321-333
PDF size: 448.18 Kb.


ABSTRACT

BACKGROUND: The excision of periocular cutaneous carcinomas—primarily basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)—frequently results in complex defects that demand specialized reconstructive expertise. Beyond oncological clearance, achieving functional and aesthetic restoration is critical to ensure ocular protection and maintain facial symmetry.
MATERIAL AND METHODS: A narrative literature review was performed to evaluate surgical techniques for eyelid reconstruction following malignant tumor resection. Reconstructive strategies were analyzed according to defect location, size (horizontal tension), and depth (partial vs. fullthickness), with specific focus on upper versus lower eyelid dynamics.
RESULTS: Reconstructive selection is primarily dictated by defect size: primary closure is generally sufficient for defects involving less than 25% of the eyelid margin. Defects spanning 25% to 67% often require advanced local flaps, such as the Tenzel semicircular flap, Mustardé, or Tripier. Complex defects exceeding 67% necessitate multi-stage procedures—notably the Hughes (lower lid) or Cutler-Beard (upper lid) tarsoconjunctival flaps—or regional options like the Fricke flap. Success hinges on meticulous lamellar restoration to prevent complications such as ectropion, eyelid retraction, or lagophthalmos.
CONCLUSIONS: Eyelid reconstruction following tumor excision requires a highly individualized surgical plan. A profound understanding of eyelid anatomy, combined with the strategic selection of techniques, is essential to restore ocular surface integrity and periocular aesthetics while minimizing long-term morbidity.


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