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Somenek. Plast Aesthet Res 2022;9:16 https://dx.doi.org/10.20517/2347-9264.2021.84 Page 3 of 10

Figure 1. Anatomy of the lower eyelid.

morbidity.

General consideration for lid reconstruction
Several factors determine the choice of reconstruction, including the nature of the defect, the availability of
surrounding tissues, and the overall health and age of the patient.

The primary objective is to reestablish the function of the eyelids so that they are able to protect the eye with
an equally important secondary objective of restoring the aesthetics of the eyelid. General treatment
algorithms are detailed in Tables 1 and 2 below.

Some general principles are useful when approaching eyelid and periorbital reconstruction:

(1) If both the anterior and posterior lamellae need to be reconstructed, one must be composed of a flap that
is well vascularized. Unfortunately, using a graft on graft reconstruction carries a high failure rate, likely due
to a lack of vascular supply.

(2) If the inside of the eyelid is affected, it needs to be lined with nonkeratinizing mucosal epithelium to
protect and lubricate the cornea.

(3) Allow for sufficient horizontal and vertical eyelid dimensions for maximal function in order to avoid
[1]
vertical tension to the lower eyelid .

(4) Tissue match characteristics are critical for grafts and flaps.

(5) Ensuring adequate levator muscle function for the upper eyelid.