Repairs of Large Defects of the Lower Lid and the Infraorbital Region With Suspended Cheek Flaps With a Dermofat Flap.

Abstract

After the repair of large defects of the lower lid and the infraorbital region using larger flaps without adequate support, retractions of the lower lid may be observed due to the weight of the flap. In this study, the authors' aim is to present the outcome of the repairs they performed on large defect areas in the lower lid and the infraorbital region using cheek flaps suspended by a dermofat flap.The method was performed on 7 patients between 2011 and 2015. Among the patients, 4 were female, while 3 were male. The mean age of the patients was 61.3 (54-69) years. In all the patients, the defects were secondary to tumor excisions. The mean size of the defects was 4.4 × 5 cm (4 × 4 cm to 6 × 5 cm). In all the patients, the repair of the defect was performed using the Mustarde flaps prepared in the subcutaneous plane. After the flap was advanced to the defect area, a dermofat flap was prepared from the part at the lateral canthal area and was sutured to the periosteum superiorly to the lateral canthus.Patient satisfaction and functionality was high during the long-term follow-up. While minimal scleral show occurred in 1 patient, the lid position was normal in the other patients.The authors are of the opinion that the method they used may reduce the risk of lid deformities that may develop with the cheek flaps used to repair large lid defects.