Sub-cilial sliding skin-muscle flap repair of anterior lamella lower eyelid defects.

Defects of the anterior lamella of the lower eyelid are common following Mohs micrographic surgery. Often, such defects are repaired with free skin grafts. The author reviews the treatment of such defects utilizing a single subcilial incision to develop a sliding blepharoplasty-type flap, which is advanced medially or laterally, as needed, into the defect. Larger defects may require Putterman's modified Tenzel flap. Final lid function, position, and cosmesis were superior to the results expected from free skin grafts alone in four of the author's five cases. Indications, limitations, modifications, technical aspects, benefits and potential pitfalls of reconstructive subcilial flaps are discussed.