Horizontal skin wound closure in full thickness eyelid excision

Abstract

The direct closure of full thickness lid margin defects is well described. The most popular method of closing this defect is to convert it to a pentagon by excising a triangle of skin and muscle below. The resultant scar is perpendicular to relaxed skin tension lines and may be cosmetically obvious. An alternative technique is presented whereby a horizontal subciliary incision is extended either side of the defect. After undermining and minimal excision the skin is closed leaving a horizontal linear subciliary scar, parallel to relaxed skin tension lines.