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Updated: Aug 20, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Reconstruction of Full-Thickness Lower Lid Defects Using Texier's Procedure: Retrospective Assessment of the
Sarra Cristofari1, Kessara Rem2, Marc Revol2
1Plastic Surgeon Practitioner, Department of Plastic, Reconstructive, and Esthetic Surgery, Saint Louis Hospital, Paris; Paris Diderot University, Sorbonne, Paris; Plastic and Esthetic Surgery Department, Hôpital Tenon, Paris, France.
Purpose:
Lower lid defects involving more than 75% of the lid's length or affecting the cheek are usually reconstructed with a Mustardé rotational cheek flap. This solution often induces postoperative ectropion. The Texier procedure (an upper lid myocutaneous flap and a chondromucosal alar graft) is usually indicated for 1-step reconstruction of full-thickness defects involving less than 50% of the lower lid. This retrospective study evaluated larger indications for the Texier procedure for full-thickness defects of the lower lid, results of lid defects longer than 50 or even 75%, and the use of a chondromucosal nasal septal graft for lid defects longer than 75%.
Materials And Methods:
All lower lid reconstructions using the Texier procedure over a period of 29 months were retrospectively included. Data on postoperative complications and patient satisfaction were collected.
Results:
Fifteen patients were included; one third had a defect involving no more than 50% of the lower lid, one third presented with a defect of 50 to 75%, and one third had a defect of at least 75%. In this last group, reconstruction included a septal graft. Mean follow-up was 35 months. Transitory palpebral edema was present in 100% of patients and lasted 8 months on average. No postoperative ectropion or nasal alar retraction of the graft donor site was observed. Mean satisfaction score was 2.86 of 3.
Conclusions:
The Texier procedure can be used as first-line treatment to reconstruct most full-thickness defects of the lower lid, including subtotal defects.
