Lower Eyelid Reconstruction with Mustardé Flap

Abstract

Restoring defects in the lower eyelids, particularly those that extend beyond two-thirds, can be challenging, especially after tumor resection. Basal cell carcinoma (BCC) is the most common form of skin cancer, affecting the lower eyelid and inner canthus. Grafts are often combined with flaps for replacing the posterior lamella or anterior lamella. The Mustardé rotational cheek flap is a popular choice for reconstructing the anterior lamella of the lower eyelid, as it meets the basic requirements of an ideal cutaneous flap. This wide-based pedicle flap can support free grafts needed to line the inside of the flap. Other autogenous grafts, such as labial mucosa, hard palate mucoperiosteum, auricular cartilage, and nasoseptal cartilage, have also been used in eyelid reconstruction. However, hard palate mucosa transplants provide uniformity and can be expensive. Hughes procedures are not suitable for individuals with amblyogenic age or one-seeking eyes. Combining a vascular flap with a superior graft like pericranium may provide a viable surgical option for enduring functional and aesthetic outcomes.