A skin/muscle advancement flap was used to repair the defect. Fax (310) 594-5958, Copyright © 2020 Christopher I Zoumalan, MD FACS Inc. All Rights Reserved. Some patients tend to scar more than others and we attempt to optimize our patients as best as possible before, during and after surgery to help prevent as much scarring as possible. Oculoplastic Surgeon. 2) Once the biopsy was proven to be a malignancy, MOHS surgery was then performed by a fellowship-trained MOHS surgeon to completely remove the lesion and to provide free margins of healthy tissue. Oftentimes, multiple surgeries are done, spread out over a period of time. This picture was taken a little over three weeks after surgery. This patient was diagnosed with an atypical pigmented lesion (pre-melanoma) in her right lower lid. Procedure performed:  Excision of left lower lid skin cancer with eyelid reconstruction using a skin/muscle advancement flap. The skin cancer also involved her tear duct system. 1) This patient presented with a squamous cell carcinoma of his right upper lid (Top left photo). In such instances, tissue from the upper lid is often needed to repair the defect through a procedure called a Hughes flap (aka tarsoconjunctival flap) named after one of the pioneers in Oculoplastic Surgery, Dr. Wendell Hughes. Eyelid tumour removal and reconstruction surgery This leaflet explains more about tumour removal and reconstruction surgery, including the benefits, risks and any alternatives. Post surgery photo was taken 4 months after right lower lid reconstruction after the patient underwent a myocutaneous advancement flap (Tenzel flap). She did well and this photo (top right) was taken 6 weeks after surgery. Note the lid symmetry and lack of abnormal scar formation. The patient had siginficant loss of tissue in the medial aspect of his eyelids and had to undergo two local skin and muscle advancement flaps to mobilize local tissue to close the defect. Her tear duct system remains patent and functioning normally. How did you hear about us? All before and after pictures displayed are real patients who have consented to having their pictures published on our site. If it is a small defect, often local tissue can be rearranged or brought together to repair the eyelid. This patient was seen by her Dermatologist specialized in Mohs surgery and underwent a removal of a large basal cell carcinoma that involved her eyelid, medial canthus, and lower cheek. Warning: You do not have JavaScript enabled. A second surgery is then performed to “take down” the flap and allow for the eyelid to be reconstructed to a normal-appearing eyelid. Basal Cell Carcinoma Treatment Eyelids The most common type of cancer of the eyelid is basal cell carcinoma.Most of the basal cell carcinomas can be removed surgically. Many patients with eyelid cancer require reconstructive surgery. He also lost his tear ducts during the removal of the tumor but has since remained tumor free and very happy with the cosmetic results. Plastic Eye Surgery Associates 3730 Kirby Drive, Ste. Preoperative Diagnosis: Right lower lid basal cell carcinoma. The post operative photos were taken 3 months after surgery. This patient had a large left lower lid skin cancer (basal cell carcinoma). (Middle photo). Experience you can count on! Preoperative Diagnosis: Right lower lid basal cell carcinoma that was biopsied in the office. Reconstructive surgery differs from cosmetic surgery in that it is generally performed to improve eye function, although it may also be done to approximate a normal appearance. If not treated, these tumors may grow around the eye and orbit, sinuses, and brain. Treatment required complete excision with several millimeters of free margin tissue. Some patients may need to wear an eye patch for a few days. She is four months out in this photograph above and shows a great result with little scarring. Dr. Zoumalan performed eyelid reconstructive surgery to help repair the defect. Unfortunately, the eyelid is sewn shut for at least one month until the flap takes place. Notice the natural looking result and normal lid position and contour. The patient underwent a myocutaneous advancement flap (Tenzel flap). Mohs surgery by a dermatologist was performed to remove the skin cancer (which is located between the black border as shown above). She underwent excision of the lesion and eyelid reconstruction was then performed. Some risk factors can be controlled, such as smoking, and some cannot be controlled, such as age and family history. Procedure performed: Eyelid reconstruction using skin flaps and tear duct reconstruction. All rights reserved. 1) This photo above shows a squamous cell carcinoma of the right lower lid that after its complete excision, was left with a defect that spanned the markings drawn on the photo. Then, on the day of surgery, the oculoplastic surgeon performs the closure after I’ve removed the cancer.” Recovery After Eyelid Surgery. Eyelid Cancer Surgery – Eyelid Reconstruction After Cancer Removal – MOHS Eyelid Reconstruction See the Gallery About five to ten percent of all skin cancers occur on the eyelids. Marking pen was drawn around the lesion prior to it being excised. 3) Next, the defect was repaired by Dr. Zoumalan using local tissue advancement flaps once the MOHS surgeon had completed the resection. 900 Houston, TX 77098 Phone: (713) 795-0705 Fax: (713) 807-0630, Plastic Eye Surgery Associates 4012 Commons Drive West Suite 110 Destin, FL 32541 Phone: (850) 473-0990 Fax: (850) 473-0790, Plastic Eye Surgery Associates 17 E. Main St. Suite 100 Pensacola, FL 32502 Phone: (850) 473-0990 Fax: (850) 473-0790, 128 Vision Park Blvd. The vast majority of eyelid cancers are basal cell carcinomas (90%), followed far behind by squamous cell carcinoma (5%), and melanoma (1-2%). This patient had a large, nodular basal cell carcinoma of her right lower lid. Eyelid skin cancer usually occurs on the lower eyelid, but it can be found elsewhere. It was removed by a Mohs trained dermatologist. Procedure performed: Right lower lid excision of basal cell carcinoma and reconstruction using a myocutaneous advancement flap (Tenzel flap). Preoperative Diagnosis:  Left lower lid basal cell carcinoma (skin cancer). If it is a large defect like seen in the photo below, up to 80 percent of the lower lid is mssing along with the tear duct system. Her post operative photograph was taken six months after surgery and note the natural appearing result with very well healed incisions. The patient had over 33% loss of his lower lid from the Mohs surgery. It also provides information on what you can expect when you come to hospital. Tel (310) 278-4000. Plastic Eye Surgery Associates 3730 Kirby Drive, Ste. Preoperative Diagnosis: Right lower lid atypical pigmented lesion (pre-melanoma), Procedure performed: Excision of lesion with eyelid reconstruction (skin muscle rotational flap, also referred to as a Tenzelmyocutaneous flap).