Often after eyelid cancer removal there is a defect in the eyelid which needs repair. Oculoplastic surgeons such as Chris Thiagarajah are unique trained to reconstruct the eyelid to create normal form and appearance after the healing period.
Here we have a case of a patient who had basal cell carcinoma of the eyelid in Denver. He was diagnosed astutely by an Ear, Nose, Throat doctor and then referred to Dr Thiagarajah an eyelid, tear duct and orbital surgery specialist at his office in uptown Denver.
After the skin cancer was removed by a Mohs surgeon, Dr Thiagarajah reconstructed the eyelid defect using a sliding flap technique to rotation skin into the hole that was created from the eyelid skin cancer removal.
Using dissolvable sutures, Dr Thiagarajah was able to slide in tissue so once things healed, the eyelid looked essentially back to normal. When one has eyelid cancer, what are the most important criteria when reconstructing the eyelid?
First, the underlying eyeball and vision are the most important thing to protect. The eye and the vision are the most important things to be careful of. Protecting how the eye closes and making sure the eyeball is protected at all times overrides anything in eyelid reconstruction after eyelid cancer removal.
Second, there must only be tension horizontally around the eyelid to prevent the eyelid being pulled down. If the eyelid is reconstructed with a lot of tension vertically (up and down) the eyelid can become retracted or pulled down.
Third, if the eyelid is reconstructed the appropriate parts of the eyelid (front and back) should be reconstructed. The eyelid is not skin and has a front and back side. The back side is smooth and slides against the eye for lubrication. The front side is the skin and gives the eyelid a normal appearance.
The healing after reconstructing an eyelid takes 12 weeks at a minimum. Usually full healing requires a year to do. This is when grafts and rotational flaps fully are absorbed and blend in with the surrounding tissue.
Eyelid cancer reconstruction is challenging and difficult procedure to perform. As an oculoplastic surgeon who regularily repairs eyelid cancer, in depth knowledge of the anatomy and tissue is critical for a successful cosmetic outcome 3 months after the procedure. I use this knowledge even when performing cosmetic surgery on the eyelids such as blepharoplasty or eyelid lifts.