A PROCEDURE for large lower lid reconstructions which I have found useful is reported.
A 73-year-old white housewife had an untreated basal cell epithelioma of the right lower lid for seven years. The lesion was 24 mm long and 18 mm wide with the lid margin also involved (Fig 1).
The lesion was incised 3 mm beyond its borders and resected in toto, leaving a small nubbin of lid at each canthus. A lateral canthotomy and cantholysis of the lower arm of the canthal ligament were made (Fig 2). This permitted approximation of the lid remnants to within 22 mm of each other. By means of two vertical incisions, a 22 mm wide skin advancement flap was fashioned in the lower lid and mobilized (Fig 3).A full-thickness lid advancement flap was fashioned in the right upper lid by means of a 24 mm central horizontal incision 4 mm
Fox SA. A Procedure for Lower Lid Reconstruction. Arch Ophthalmol. 1971;85(1):79-81. doi:10.1001/archopht.1971.00990050081012