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The middle and distal part of the nose has multiple well-defined cosmetic units with a distinct outline, color, consistency, sebaceous content, texture and function. Crossing these units with surgical incisions can lead to a more visible scar. Here we will deal with the case of an 84-year-old patient with basal cell carcinoma of the junction between the dorsum and the alar of the nose and the management of the resulting loss of surgical substance with the Marchac flap. This frontal flap described by Marchac is an axial flap based on a vascular pedicle emerging near the inner palpebral ligament, allowing coverage of the loss of substance while respecting the nasal subunits and less thickness difference is present.

In the case reported here coloboma followed the removal of a portion of the upper eyelid for basal cell carcinoma. The growth involved both the conjunctiva and the skin and was removed by excising a full thickness section of the lid extending from the free margin to a little above the upper border of the tarsus. Following operation, a small portion of the eyelid near the inner canthus remained, with the median palpebral ligament. Five months later there was no sign of recurrence, but the conjunctiva was becoming increasingly irritated from exposure. For repair of this defect, it is essential to have a lining to replace the conjunctiva and a cutaneous surface for the outside of the lid. In this case the remaining fibers of the orbicularis oculi muscle above and at the sides of the defect provided good closures, and sufficient of the levator attachment remained to

Summary The correct anatomy of the external palpebral ligament is demonstrated, based on microscopic studies. An analogy to the structures of the internal palpebral ligament is found.