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Reconstruction of Full-thickness Lower Eyelid Defects After Basal Cell Carcinoma Excision Using a Modified Hughes
Francesco Perri1, Gianluca Di Monta2, Santolo D'Antonio3
1From the Head and Neck Medical Oncology Unit, National Tumor Institute of Naples, Naples, Italy.
Plastic and Reconstructive Surgery. Global Open
|May 12, 2025
Summary
Reconstructing lower eyelid defects after basal cell carcinoma (BCC) removal can be challenging. A tarsoconjunctival flap from the upper eyelid offers an effective solution for full-thickness lower eyelid reconstruction, achieving excellent results.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Oncology
Background:
- Basal cell carcinoma (BCC) is the most common eyelid malignancy.
- Eyelid reconstruction after BCC resection presents significant surgical challenges.
- Full-thickness lower eyelid defects require specialized reconstructive techniques.
Purpose of the Study:
- To evaluate the efficacy of a tarsoconjunctival flap for lower eyelid reconstruction.
- To assess functional and aesthetic outcomes following BCC resection and reconstruction.
- To present a modified Hughes procedure for extensive lower eyelid defects.
Main Methods:
- Four patients with full-thickness lower eyelid BCC underwent radical resection with 3-mm margins.
- Reconstruction was performed using a tarsoconjunctival flap sourced from the upper eyelid.
- Clinical outcomes were documented via digital photography and histological examination.
Main Results:
- Complete tumor excision was confirmed histologically in all cases.
- The modified Hughes procedure demonstrated high functional and aesthetic success.
- No tumor recurrences were observed during an average 12-month follow-up period.
Conclusions:
- Upper eyelid tarsoconjunctival flaps are effective for extensive lower eyelid defect reconstruction.
- This technique provides excellent functional and aesthetic outcomes.
- The procedure offers a reliable solution for challenging BCC-related lower eyelid defects.
