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Double Lateral Flap: A New Technique for Lower Eyelid Reconstruction Alternative to the Tenzel Procedure
- Source :
- Aesthetic Plastic Surgery. 39:935-941
- Publication Year :
- 2015
- Publisher :
- Springer Science and Business Media LLC, 2015.
-
Abstract
- The final esthetic result is a common concern of patients with eyelid tumors, especially young patients and those with tumors affecting the medial edge of the lower eyelid. The procedure herein described combines two lateral flaps: one tarsoconjunctival and the other from the periosteum. The first step is removal of the tumor lesion. Preseptal dissection is then performed through a subciliary incision on both the lateral and medial halves of the eyelid up to the orbital rim. Next, the lateral canthal tendon, lateral attachment of the orbital septum, capsulopalpebral fascia, and conjunctiva are cut. This allows the medial displacement of the tarsoconjunctival flap, which is sutured to the defect area. The second flap, a periosteal strip, is used to reconstruct the tarsus and lateral canthal tendon, providing firm support for the posterior lamella. The orbicularis muscle is anchored to the orbital rim, and the skin of the lower eyelid is directly sutured to the subciliary incision and periosteal strip. The author successfully carried out this procedure on nine patients. None of the patients developed ocular irritation or postoperative epiphora. The defects that can be repaired by this technique are equivalent in size to those repaired by the Tenzel procedure. Unlike the semicircular flap procedure, this technique allows eyelid reconstruction with no vertical scarring and a smaller lateral incision, and it ensures soft contact between the palpebral rim and surface of the eyeball. This procedure confers an attractive eyelid appearance that may be crucial for some patients. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
- Subjects :
- Blepharoplasty
Male
medicine.medical_specialty
Tarsus (eyelids)
medicine.medical_treatment
Eyelid Neoplasms
Surgical Flaps
medicine
Humans
Orbital septum
Aged
Aged, 80 and over
business.industry
Fascia
Middle Aged
Eyelid Neoplasm
eye diseases
Surgery
medicine.anatomical_structure
Palpebral fissure
Female
sense organs
Eyelid
business
Subjects
Details
- ISSN :
- 14325241 and 0364216X
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- Aesthetic Plastic Surgery
- Accession number :
- edsair.doi.dedup.....df52c16b8e38cbe097145bc799ea9313