Upper eyelid reconstruction is a surgical procedure used to correct lid defects of the upper eyelid that occur from surgical resection of tumors, trauma, or congenital anomalies like a coloboma. Reconstruction of upper eyelids due to surgical resections of neoplasms, such as skin cancers excised by Mohs micrographic surgery, requires additional consideration. Restoration of the upper eyelid is much more complicated than the lower eyelid. Careful deliberation is necessary for the approach to reconstruction since the repair is highly dependent on the location and the extent of the defect.
The eyelids serve essential functions to the face. In addition to providing cosmetic appearance, the eyelid mechanically protects the cornea and the globe. Furthermore, meibomian glands in the tarsus produce lipids that, upon contraction of the tarsal orbicularis oculi, stabilize the tear film to prevent dry eye. To serve this function, the upper eyelid must descend to cover the cornea during blinking but must be mobile enough to clear the visual axis upon elevation. Ptosis can significantly impact the visual fields and the cosmetic appearance of the face. An ideal upper eyelid reconstruction should, therefore, address any of these potential functional or aesthetic deficits that can occur from eyelid defects.
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