A delayed Tenzel flap

A 71-year-old man presented with a lentigo maligna melanoma (Breslow 0.25 mm) of the left lower eyelid. Complete excision was achieved after three slow Mohs stages, resulting in a quadrangular 1.8x1.2 cm full-thickness defect. After the first stage, upper and lateral margins were found to be histologically infiltrated. Therefore, an additional lateral strip was taken after 3 days, resulting in a tumor-free outcome. Radicalization was completed after another 8 days on the posterior lamella and rim with immediate reconstruction.