Eyelid Cancer Reconstruction with FlapEyelid Reconstruction Mustarde Cheek Flap - for Basal Cell Carcinoma

Eyelid reconstruction after basal cell carcinoma was done with a Mustarde cheek rotational flap. The flap lining and support came from the nasal septal cartilage and mucosa.

Michael Bermant, MD
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Facelift / Neck lift (rhytidectomy)

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Eyelid Reconstruction

 

eyelid cancer close to lacrimal drainage system Bermant Plastic Surgery

Tumor Before Surgery

86 year old male biopsy proven cancer lower eyelid.

  • tearing started about 2 weeks ago
  • lower punctum (tear drain hole) pulled from eye surface

 

Basal cell cancer Bermant Plastic surgery blepharoplasty Close up of tumor shows that it is very close to the punctum (the hole that the tears drain from the eye). Basal cell carcinoma tends to grow much more rapidly when mucosa is involved.

Tumor Excised Modified Mohs' Technique

Defect after first specimen

Eyelid cancer - Bermant Plastic Surgery

The metal probe is in the punctum and into the caniculus- the drainage system for the eye's tears.

Eyelid cancer - Bermant Plastic Surgery

After second specimen, the orbital fat is seen in the center of the wound.

Three separate excisions were needed until all margins were clear of tumor. This was a sclerosing basal cell carcinoma. The wire is in the tear drainage system (punctum and caniculus). Pathology cleared the margins and this did not need to be excised.

Reconstruction - Graft from nose

Nasal cartilage graft eyelid cancer defect Bermant Plastic Surgery

This is a 17 mm piece of cartilage and mucosa from the nasal septum (wall between the nasal passages. It will be placed under the cheek flap to add support to the eyelid. Normal eyelid has cartilage support (tarsus) and mucosal lining to protect the eye.

The black protector behind the eyelids protects the eye during surgery.

 

Mustarde Cheek Reconstruction

Eyelid reconstruction Bermant Plastic SurgeryTape keeps suture away from eye after surgery

Eyelid reconstruction Cheek flap Bermant Plastic Surgery
  • Reconstruction by sliding remaining eyelid towards nose.
  • Cheek skin then slid to provide remaining eyelid outer skin
  • Cartilage and mucosa from nose add support for the cheek flap.

The forehead flap is a second area of reconstruction for another cancer (squamous cell carcinoma).

See how this reconstruction improves over time.

 

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This page last updated on: February 24, 2012

 

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