Upper and Lower Eyelid Full Thickness Reconstruction Using a Retrograde Postauricular Island Flap

Upper and lower eyelid full-thickness reconstruction in a patient without available adjacent tissue because of burns or trauma is a surgical challenge. Our patient had severe thermal burns with complete unilateral defects in both the upper and lower eyelids. Although the skin grafts survived, contraction occurred quickly, subsequent ectropion of both the upper and lower eyelids, which could have lead to exposure keratitis and blurred vision. A retrograde postauricular island flap was harvested to provide skin eyelid coverage, and the donor site was directly closed. After another 2 surgeries, normal skin thickness and a color-matched appearance were achieved, and the donor-site scar was almost invisible from the anterior view. To our knowledge, it is rare to use a retrograde postauricular island flap in a full-thickness reconstruction of both the upper and lower eyelids, but the authors have ascertained that this method may be a reliable option in such selected and challenging situations.