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Principles of eyelid reconstruction: 
Full thickness lower eyelid defect
The most common cause of eyelid defect is excision of lid margin tumour. Trauma is the second most comon cause. Congenital defect is an uncommon cause.

Reconstruction of the eyelid defect requires three elements:

  • an outer layer of skin 
  • inner layer of mucosa 
  • semi rigid supporting structure (acting as the tarsal plete)  interposed between them 
  • Compared with the upper lid, the lower lid is not as critical in maintaining the intergrity of the cornea. Therefore, most of the techniques used  (except Hughes flap) seldom utilize the upper lid component to reconstruct the lower lid as this may affect the upper lid function.

    The following pictures summarize the most useful techniques for the reconstruction of the lower lid according to the extent of the defect:

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