Complex Eyelid Reconstruction After Cancer Removal

This 88-year-old patient was referred for reconstructive surgery of the right lower eyelid following removal of an aggressive basal cell carcinoma. At this age, eyelid reconstruction presents unique challenges: the support structures of the lower eyelid weaken significantly with age, and overly aggressive or simplistic closures can lead to distortion, poor eyelid function, or visible scarring.

Rather than using a generic or overly “tight” reconstruction approach that may compromise lid movement or ocular health, Dr. Pacella — a nationally recognized oculoplastic and reconstructive expert — performed a precision-based layered reconstruction designed for both function and longevity. The repair included a canthopexy to support the lid and prevent ectropion, a skin graft precisely harvested and inset for optimal texture and color match, and a temporary tarsorrhaphy to protect the eye and prevent scarring contraction during healing.

The result: a natural eyelid contour, stable support, full eye protection, and virtually invisible scarring — all achieved without compromising the patient’s comfort or long-term eyelid function.