Extensive lid reconstruction using an augmented pedicle flap

A method is described for reconstructing a total or subtotal defect of the lower lid. Essentially, it consists of a lateral sliding pedicle flap that has been augmented by including semicircles of additional skin on its upper and lower margins. Results of this procedure following excision of extensive basal cell carcinomas of the lower lid have been satisfactory in seven patients followed for one to four years. The major advantages of the method are: (1) occlusion of the eye is minimized; (2) it is a one-stage operation; (3) surgery is far simpler than many other methods for such conditions; (4) complications have been minor; (5) the upper lid is not disturbed. The technique was suggested by Tenzel's method for repairing smaller lid defects. Further trial of the method is indicated to assess its true value.