Whenever possible lid lesions are best resected in spindle-shaped fashion parallel with the orbicularis fibers and the lid margin. Thus the healing scar follows the course of the normal lid wrinkles and does not run across cut muscle fibers.
The trouble is that lid lesions are nonconformists. Perversely, they present round, square, rectangular, or irregular shapes which, if resected as a spindle, would entail the sacrifice of a lot of healthy skin. This is especially undesirable in cases where the lesion is obviously benign. In all such cases I have found the following little plasty very useful.
Technique of Repair
After resection of the lesion an incision is made continuing the lower lip of the wound in an upward curve to form the flap A. Flap B is formed in similar fashion by continuing the upper lip of the wound downward. The pointed tips of the flaps are resected for
FOX SA. The Flat—X Plasty. Arch Ophthalmol. 1965;73(2):204. doi:10.1001/archopht.1965.00970030206012