Principles of eyelid reconstruction: Full thickness lower eyelid defect
For lower lid defect of between 25 to 66 % of
the horizontal dimension (Fig. 2a). The approximation will require either:
lateral cantholysis of the inferior crus of the lateral canthal
tendon (Fig. 2b)
if lateral cantholysis insufficient, combined with a local
periorbital skin and muscle flap (Tenzel's flap; Fig. 2c). The flap should
be within the orbital rim otherwise incision through the thicker skin can
leave prominent scarring.
Figure 2c Dotted line denote orbital rim
The above pictures show a woman who underwent
a Tenzel's flap following excision of a basal cell carcinoma on her lid
margin ( 2 day post-operative ).