Eyelid reconstruction series, post 13: non-traditional - using the cosmetic principles of a midface lift to reconstruct the eyelid after skin cancer removal with Mohs micrographic surgery.
The usual, customary, and most common way to reconstruct this defect can place scars in very conspicuous and bothersome locations. That way is often chosen to help protect from vertical tension vectors on the eyelid, which can be a huge problem with the function of the eyelids, leading to an outturning of the lower lid called
ectropion that tends to happen with age anyway.
This is where the cosmetic principles come in - midface lifting is a difficult procedure to maintain overtime. When done well, it can be incredibly rejuvenating, and the techniques that I have developed and use for cosmetic midface lifting are usually performed through an invisible incision inside of the eye, no external scars. The evolution and perfection of those techniques has led to durable midface lifting, and thankfully the same techniques can be utilized in a reconstructive setting like this to inconspicuously hide any incision points, while taking advantage of the durable lift to avoid any vertical tension vectors on the lid. It’s a match made in heaven! To boot, doing it through open access in a reconstruction is much simpler than completely hiding it as I do cosmetically!
I’ve been accruing cases and data related to this technique for years, and a publication is in progress, stay tuned!
