Right lower lid basal cell carcinoma
This 62 year-old man presented with a slowly enlarging right lower lid lesion. A punch biopsy confirmed the diagnosis of a basal cell carcinoma. A frozen section with 3 mm clear margin was performed. The histology showed complete excision of the tumour. Although half of the lower lid was excised, the eyelid could be closed with little tension following lateral cantholysis. (Note: to close a lower lid defect, the following techniques can be used with increasing size of the defect: direct closure, lateral canthotomy, lateral cantholysis, Tenzel's flap, Mustarde's flap or Hughes' flap or Hewe's flap.)

Nodular basal cell carcinoma with central ulceration and rolling edges 
involving the right lower lid.

Half the lower eyelid was removed for frozen section. The picture shows 
the lower lid appearance prior to reconstruction.

Appearance of the right lower lid on completion of the reconstruction. 
Lateral canthotomy and cantholysis were performed to allow closure of the
wound with minimal tension. 


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