Upper eyelid reconstruction by making a skin defect similar to skin removal in blepharoplasty

A 49-year-old man had a sebaceous gland carcinoma in the right upper eyelid. The tumor was excised with an additional 5-mm safety margin. The posterior lamellar reconstruction was performed with a reverse modified Hughes flap and residual conjunctiva. The anterior lamellar reconstruction was performed by making a skin defect similar to a skin removal in blepharoplasty. The skin excision part was designed next to the upper portion of the defect, and the excised skin was grafted to the lower portion of the defect. The skin was closed after making 3 buried double eyelid anchors. The conjunctival pedicle was severed 2 weeks postoperatively. Three months later, the appearance was acceptable without a harmful functional outcome. The basic concepts of our procedure were to make an accustomed scenery, such as a defect similar to a skin removal in blepharoplasty, from an unfamiliar one, such as a defect after a tumor excision, and to make good use of the excised tissue.