Aesthetic total lower eyelid reconstruction

This article describes the reconstruction of the lower eyelid in two layers. Mucosa is provided by mobilizing the bulbar conjunctiva; the cutaneous layer is furnished by a laterally based myocutaneous flap from the ipsilateral upper lid. The tarsal plate is no longer taken into consideration. In 24-48 hours, the eyepad is removed and the patient can use the eye. The unaltered neurovascular supply to the flap provides good eyelid function and tone, and the aesthetic result is satisfactory.