Background: Although several techniques for repair of medial canthal defects have been described, most have shortcomings which prevent satisfactory repair. We describe the use of a bilobed flap which allows for optimal reconstruction in this area.
Surgical technique: A bilobed flap was used to repair 36 medial canthal defects in 35 patients. The primary lobe is usually slightly smaller than the defect. The secondary lobe is smaller than the primary though of equal length, fashioned so that its axis lies within the relaxed skin tension lines of the face to allow direct closure with minimal tension. All patients achieved a satisfactory cosmetic and functional repair.
Conclusion: We recommend this technique as an excellent means of repairing all types of medial canthal defect. The technique allows reconstruction to be performed in a single stage with rapid rehabilitation and minimal morbidity.