The free 'V': a bipennate free flap for double eyelid resurfacing based on the second dorsal metacarpal artery

We present a patient who had a basal cell carcinoma of the left upper eyelid and ectropion of the left lower eyelid. The patient underwent resection of the tumour and release of the ectropion resulting in a full thickness defect of the skin of his left upper and lower eyelids. The eyelids were reconstructed with a second dorsal metacarpal artery free flap from the left hand. For safety, a dorsal vein of the flap was arterialised and one of the valves of the vein had a valvotomy. The flap survived completely.