Reconstructing large eyelid defects after skin cancer removal

By Joseph Walrath, MD | Oct 11, 2015 | Reconstruction, Tumor

One year after cancer removal and reconstruction, a patient with basal cell carcinoma (now disease-free) returned for followup evaluation.  Happily, there was no visible recurrence of carcinoma.

Her story started with a non-healing ulcer of the right lower lid.  This lesion was removed by a Mohs-trained dermatologist, so that the entire tumor was gone.  She returned to me for the reconstruction.  As can be seen, the defect involves about 50% of the right lower lid.


Below, the actual defect is highlighted in blue.  The green triangle depicted demonstrates the additional region that will have to be removed to allow for the best reconstruction.


The reconstruction involved removing the highlighted tissue, freeing up the entire lower lid, the cheek, and the temple region adjacent to the lower lid. Immediately after the surgery, the patient is depicted below.


The reconstructions can be scary for patients to go through.  It takes some degree of faith on their part, because the defects never look good before the repair, and the repair itself can look dramatic in the early stages.  Some people require more than one operation to restore eyelid position / function.  Fortunately, this patient did not. This patient is now depicted one year after her reconstruction.



She has minimal symptoms: occasionally a little tearing at the outer corner of the right eye.   But other than that, she is disease free and quite pleased with her outcome.  The incisions are essentially invisible at this point.