Reconstruction of the lower eyelid after excision of major tumours.

The authors report on a pretentious surgical procedure which is essential after excision of major tumours of the lower eyelid. They describe in detail the reconstruction of the lower lid in case of a 70% loss of the lid. They used Mustard's method during which the tarsoconjunctival defect was replaced by a mucochondral implant from the nasal septum. After suture of the implant the residual skin defect was covered by rotation of a cheek flap. A two-stage reconstruction of the lower lid was used in case of 95% excision of the width of the lid. In the first stage the authors transferred a tarsoconjunctival flap from the upper lid and covered the musculocutaneous part by a transplant of retroauricular skin. In the second stage they released the tarsoconjunctival flap with subsequent plastic surgery of the lower lid. In 100% loss of eyelid the authors used for replacement of the tarsus of the lower lid a mucochondral implant from the nasal septum and to cover the skin defect they used a bridge-shaped myocutaneous flap from the upper lid in the defect of the-lower lid.