Outcomes of Reconstructing Lower Lid Defects Using Midface Lifting and Full-Thickness Skin Grafts

Lower lid defects often require flap or graft repair. It is a functionally and cosmetically important midfacial structure.

Herein, the authors investigate the cosmetic and functional results of the single or combined use of midface lift and skin grafting depending on the location and size of the defect.

From 2012 to 2020, 142 patients with lower eyelid skin defects were selected. Superficial cheek lifts or full subperiosteal midface lifts were performed in 128 patients. In 14 patients, midface lifts and skin grafts were performed simultaneously to reconstruct the lower eyelid.

For defects in the middle and outer part of the lower eyelid, a midface lift technique was used. Superficial cheek lifts were performed for defect sites <1.5 cm, and full subperiosteal midface lifts were conducted for defect sites >1.5 to 2 cm. For larger defects, subperiosteal midface lift and skin graft were performed simultaneously.

Lower eyelid reconstruction using a midface lift with skin grafts from the defect and alignment of the postoperative scar with the subciliary area could achieve satisfactory functional and cosmetic outcomes.