Lower Eyelid Reconstruction Using a Myotarsocutaneous Flap while Considering the Superior and Inferior Palpebral Sulci

Various reconstructive procedures have been reported for full-thickness defects of the lower eyelid after tumor excision or trauma. In eyelid reconstruction, not only functionality but also cosmetic results are important; furthermore, making scars inconspicuous is challenging. The purpose of this study is to make the scars less noticeable in lower eyelid reconstruction. We reconstructed the anterior lamella using a myotarsocutaneous flap and the posterior lamella of the donor site using a palatal mucosal graft in a 61-year-old man with basal cell carcinoma of the lower eyelid. In designing the myotarsocutaneous flap, we matched the upper edge of the flap with the superior palpebral sulcus, and the lower edge with the inferior palpebral sulcus. The flap length was the same as the width of the defect. The lateral side of the postoperative scar was hidden by the excess skin of the upper eyelid, while the caudal side of the scar and the trapdoor deformity was covered with a tear trough. After movement, the flap was not located outside the lateral canthus, and good cosmetic results were obtained. This report describes our surgical procedure.