A cheek island flap for the lower eyelid.

An island transposition flap for use in lower eyelid reconstruction and the treatment of ectropion is described. The flap is based on a subcutaneous pedicle 1 to 2 cm lateral to the outer canthus. Its long axis extends inferolaterally from this point, and the donor site can be closed directly. The skin of the full width of the lid can be replaced, and where skin replacement is not required the flap may be de-epithelialised and used to provide bulk and support only. The flap has also been successfully lined with a nasal muco-chondral graft. Clinical examples are described, including the treatment of cicatricial, senile and paralytic ectropion, and the repair of defects ranging from skin alone to the full thickness of the lid.